initial aircurve pacewave setup

[cexer]

there was again an hypopnea catapulting me out of sleep just after falling asleep
and afterwards i couldn't sleep again. not flagged, but enough to wake me up.



this time i was tweaking psmin, so i can breath in without to much effort
and not being rushed.. ..for this there was just one value really,its 3,6,
but my position is on the side looking on the screen of the asv
and maybe its different, when i'm lying on my back.

when i have my hypopneas, i would need psmin higher, i guess,
but the asvauto is not auto there. i could cope with a little rushing and put it to the test.

ps max is tweaked so there is lo leak (plus i don't get an headache from the pulsing)
under 29 i had condensation again with humidity 6 i could try 5 or 4 again and then go colder.
outside its cold AND humid in the night which seems t make my nose open up,
but this seems not to be achievable.. ..4 was a little dry.
i could try 5 and see how far down i could go with the temperature.

i decreased epap min and max by one.
i could have a better idea, here.

is the leak-rate ok now ?

[SarcasticDave94]

The leak rate is very good, shows improvement. Congratulations.

You recorded zero events last use, so that's hopefully going to benefit.

This early not flagged Hypopnea you refer to I think isn't a Hypopnea at all but a changing breath pattern, which the ASV interpreted as needing to blow hard, disrupting. Try this next time instead of quitting therapy, when it blows while you're in sleep transition, literally blow back through the mask to signify to the ASV to back off.

The PS range has 2 values where it automatically roams. It won't Auto adjust PS min specifically. Same can be said of EPAP. These Min and Max values are bookend values, both EPAP and PS move between to address events. And since IPAP is tied to EPAP and PS, all 3 are ranges.

You'll have to try humidity values as you see fit. It's all personal preference for this. It shouldn't affect therapy other than overall comfort.

[cexer]

last time i haven't slept much,
but one benefit is not having the retainer eating up my teeth (acid buildup underneath)
and ruining my jaw. yesterday i felt the dislocation very much,
and it was . it still was dislocated yesterday
and i had the tendons cracking when i chew something.

another beefit is the centrals being gone,
but the hypopneas may be worse,
at least i'm waking up from them now.

what does exactly qualify as an hypopnea and what doesn't,
lets say in a sleep study ?

to me its shallow breathing over a prolonged period of time,
which makes me dizzy. the machine doesn't support me
with much pressure, here. almost as if it were off.
i also sense my shallow breathing after waking up.
the hard blowing is on other occasions (where i will try your suggestion).



sidenote: oscar is again dropping old sessions on the same day while importing.

this time i had 3 hypopneas (flagged or not).
the one in the middle at 22:24 the last one rather mild.
this time, one can see something on my oximetry, too.

to make them milder,
i have been setting psmin to 6 (max) instead of 3.6 at the cost of comfort.
if it were possible with asv, i would like to have this elevated
only when i'm going through an hypopnea.
i've tweeked epapmin to not feeling claustrophobic/freshness to 6.4 .
after getting used to pressure and cause of the mask being the limiter,
i've maxed out the other values so the algos are spinning freely, there,
don't try at home.

why does especially epap vary at all ?
when would the device for instance increase epap ?
related to what would one tweek epapmax ?

in the first line of post 27 i confused psmax and psmin,
but it's right in the oscar chart, there.

[cexer]

now it flags something and look at the ox.



which limits would you suggest,
for not getting air into the stomach ?

[SarcasticDave94]

Your OSCAR charts have been added in a method that I cannot zoom in well, it makes it blurry rendering it hard to help. Are you taking screenshots via F12 on the computer? They need added to the post via new attachment.

Hypopnea are 10 second or longer typically Obstructive based events like full Apnea, but with a somewhat lower restriction to the airway. I'm pretty sure there's no direct way to affect your shallow breathing with what you have.

ASV may be called ventilator, but it's not a breathing support machine like true ventilators. It can add some pressure, but it'll be based on Apnea events not breath deficient issues.

You cannot set the ASV to respond only to what's on your wish list. It's main purpose is treating Central Apnea, however it treats all other Apnea as a result of the therapy it does provide. CA treatment being a necessity was why we recommended it.

EPAP is the portion of ASV therapy that acts much like CPAP, to treat Obstructive Apnea, keeping the airway open. It may assist in Hypopnea treatment. PS being the other half, may also help Hypopnea and definitely CA. Due to the pressure differential, it makes exhale easier when PS drops momentarily much like any AutoSet with EPR or BPAP with PS.

PS Min 6 is too high for most, 3-4 being more likely a better range. Also PS Max 18.x being probably too high.

[cexer]

sleepraider sent me back
and since i'm preparing to apply for a device (sumup there)
i guess we are reevaluating to make sure i don't just have the wrong settings or something.

@dave, could you do left click, open picture in new tab ?
there you click on the picture and you have it in original size.

maybe it could still be, but i don't feel the hypopneas being obstructive.
it's more like a loss of breathing drive.

if you give me a range of 3-4 i once tweaked out a psmin of 3.6
the epap also lower ?
maybe also limiting the maxes ? i have aerophagia anyway,
which makes me doing a short break in the night, in which i hopefully not pass away
without putting the mask back on. i had the feeling, that it already sets in on low pressures,
therefore i ignored it, cause i thought i need the pressure.

so folks please give me sets of settings to try out
after maybe reading again, what we tried so far.

also i would be glad for any advice about how to best communicate with the doctors.

[Sleeprider]

Cexer, the UA events are clearly obstructive, and the clustered nature of them clearly points to positional apnea. On your zoomed chart we can see the EPAP increases to the maximum of 15, and the remaining PS 10 (IPAP 25) is being used to attempt to create breaths. Between the UA events you are only getting 5-6 breaths per minute due to obstruction. You are already using the highest pressure available to keep your airway open while retaining some ASV functionality, and it's not enough. You must consider getting a soft cervical collar or fundamentally changing your sleeping position to avoid chin-tucking. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

When making these charts, especially zooms, using mask pressure rather than pressure will be more informative. These most recent charts use Oscar 1.5.2. Current version is 1.6.0.

[cexer]

thanks for the help. that's much info and i haven't slept over yet.

i updated my oscar (just a few small fixes as i see).
i picked up your hints and would probably nicen stuff up,
which i would be going to document in the thread.

hopefully i choose the zoom windows right. would you need an overview screenshot ?

a whole other idea would be getting along with the jaw retainer they gave me,
and adding some medicine to mitigate the centrals/hypopneas i experienced.
probably i wouldn't like the side effects, but still something to think about.
what does anybody think ?

if i could go with asv and a collar, the breathing could be indeed more natural and comfortable.
i sleep without a pillow. can you give me a hint about which collar to choose and where to get it ?
this would probably help me getting the collar before the next steps.

according to your hints, i would need to reduce epapmax then,
and i'd probably have to try out how much, if i got you right.

an asv basically needs my breath for triggering an inhale, although it can support me with extra breaths.
an ivaps has this ibr backup frequency which can be tightly set, (so that it still does not rush ones breats).
it is still somewhat flexible, but basically it just would plow through with its rhythm,
where there is no pressure increase during the ua's with a asv.
the amplitude of the induced breaths would be slightly lower,
so that the resulting amplitude would slightly fluctuate.
the events would be flagged as hypopneas, then.
the ox level would be nearly ok, tough.

so much for now.

[SarcasticDave94]

The ASV has timed breath rate as well. It's just not manually adjustable in any way. iVAPS machines will have a full compliment of timing settings that can be edited.