First Night with SH Data Please Help.

[BlueMachine]

Sleeprider pid='263352' dateline='1529345509']Periodic breathing is just a repeated or "periodic" increase and decrease in the respiratory flow rate and volume.  In an acute case, it may have an apnea at the  minimum.  There are a lot of graph examples of it if you want I can post some.  Yours is relatively mild and not even flagged.  With ASV, the machine will apply more pressure support when your respiration volume drops, and less when it is normal in an effort to keep every breath about the same size. The Resmed ASVs including the Adapt actually measure your baseline respiration rate and volume and maintain that.

Sleeprider,

So I have another night of data and I will not be using Auto Cpap anymore.  My centrals are still high even at lower pressure and I woke up with a headache. On Thursday I have surgery for my nasal valves and on that same day I will have the S9 vpap adapt 36007.  Since a pressure of 8cm seemed to be my sweet spot for cpap; given my history, can you tell me what settings I should be starting out with for the ASV?
Thank you again.

[Sleeprider]

Your chart with no OA shows you are using a pressure of 7.4, so I'm going to suggest you can use EPAP at 7.0 and do very well.  The default for pressure support is 3.0 minimum and 15.0 maximum.  I think those recommendations are solid, but a good case could also be made for lower pressure support on both minimum and maximum.  I have seen some people do better with zero minimum pressure support, but most like 2-3 cm.  Also most people can limit the maximum pressure support to 12, and they find that more comfortable.  Unfortunately you will be using this for the first time in an unfamiliar setting and experimentation is probably not the best advise.  

Here is the VPAP Adapt titration protocol. Just ignore the Auto ASV recommendation.  Since you successfully use CPAP at 7.0 to control OA, that is your starting EPAP rather than 5.0. The protocols recommends 3-15 PS, and I think you should start with that, and we can adjust if you find that is too energetic. 

[BlueMachine]

[attachment=6936]Hi. I decided to postpone the surgery.   I also got the s9 adapt machine and a new F20 mask.  My AHI score is looking alot better than on CPAP, but I have alot of large mask leaks.. I have a large F20 I suppose I need a medium.. I tried the fitting guide and I can't really tell if I am a large or medium.  Do I need to put the F20 on tighter perhaps?  Also I do not like nasal pillows I feel suffocated when I use them.  The F20 was more relaxing to me.

Is my pressure settings ok? Anyway to handle the hypopena events?

[ShaunBlake]

Hi. I decided to postpone the surgery.   I also got the s9 adapt machine and a new F20 mask.  My AHI score is looking alot better than on CPAP, but I have alot of large mask leaks.. I have a large F20 I suppose I need a medium.. I tried the fitting guide and I can't really tell if I am a large or medium.  Do I need to put the F20 on tighter perhaps?  Also I do not like nasal pillows I feel suffocated when I use them.  The F20 was more relaxing to me.

Is my pressure settings ok?  Anyway to handle the hypopena events?

BlueMachine, I'm glad you've decided to postpone the surgery; there is time for you to evaluate your health and decide if it is necessary, and as you've discovered, you are able to get a lot of advice to help improve your sleep health and hopefully avoid surgery altogether.

I've always used either a nasal mask or nasal pillows so I can't help with your F20.  Perhaps the Mask Primer Wiki will help.  I don't want to beat a dead horse, but your symptoms using the nasal pillows sounds like a pressure fault, not a mask fault, so I encourage you to investigate that.  If you were able to use the nasal pillows, it would reduce your difficulties with leaks.  (However, in complete candor I must say that I am struggling with leaks and have had to add a cervical collar to help reduce (not eliminate) them.)

Best wishes for a quick solution!

[Sleeprider]

I think your results are progressing rapidly. I think you should keep settings as they are, and I think you will find results will improve even more as you adapt. A soft cervical collar may avoid some events and help with mask leaks by stabilizing your position. I think this will also resolve with some work. Leak rates are not so high that the machine is losing control.

[BlueMachine]

Sometimes the machine wakes me up. Will lowering the max PS help with this?

[BlueMachine]

[attachment=6978]Ok so I made few changes and now I have 0 AHI!  I used a small cervical collar and went back to nasal pillows.  Can anyone check if there is anything wrong with my graphs?   Also on my fit bit it says I basically get almost no rem sleep..  Do the ASV Machines affect REM sleep?

[jaswilliams]

You graphs look great to me, the VPAP Adapt is adjusting pressure to eliminate both OSA & Central Apnea.


I have no idea how good the Fitbit's are at detecting REM sleep and what measures they use.

A much better question at this point is how do you feel ? As long as your sleep is not being disturbed by the mask and the pressure changes then its all good

[BlueMachine]

Not feeling all too great. I still get daily morning headaches even with the latest ahi of 0. Or do I need to give it more time for my body to adjust?

When I sleep over my gfs with no machine, For some reason that makes me feel the best. I'm going to see how a neck collar goes with no asv.

When my Fitbit shows a normal amount of rem I feel great.