Hey Guys, Help Tweaking machine

[Justbreath]

Hey Guys,
So I'm back trying to use my asv again after some time off. I was just in a very difficult place. I did get a jaw advancement mouthpiece and am using it with my cpap. I started using my cpap about a week ago(again) and have slowly graduated to these statistics. I still do have some issues swallowing air but I'm hoping my body adjust.
My guess is i need to raise my min epap. What do you think? Last night I slept with just mouth piece and was gonna try using my cervical collar tonight to see if it helps some. Any thoughts on adjusting the machine? Thank you very much
https://imgur.com/a/85XoSPo

[Sleeprider]

I don't know if you need more EPAP or more PS max. The problem looks obstructive, but it would help to look more closely at the flow line around some of the events and see if the 10 cm PS is making things move, or if obstruction is preventing air flow. At this point, I'd try a higher EPAP min and iif that does not improve things, move to the PS max.

[Justbreath]

Will do , thank you sir

[Justbreath]

Hi Guys, I have been working on trying to tolerate my asv. Still struggling with the aerophagia but I am determined. I know my machine is maxed out due to my settings. Can someone please confirm these snapshots. Are these all centrals. I think the obstructive element is gone. I can normally get about 4 or 5 hours of asv usage per night, although last night was tough. Can someone tell me at what pressure a breath is induced to overcome a central(ballpark)?
Thank You

[Sleeprider]

Your graphs seem to show what is going on.  The events highlighted here, show you take a flow-limited, larger than normal inhale, then hold your breath.  There is no exhale, and the machine hits you with higher pressure support, but there is nowhere for the air to go. You are clearly holding your breath.  The apnea ends with an exhale and normal breathing resumes.  There is no therapy for when you subconsciously go to "diver mode" and hold a breath for whatever reason.  Your respiration rate is very slow at 7.6 BPM, and is compensated by a high tidal volume of 840 which results in normal minute vent.   I think the apnea events are being scored as a result of your very slow respiration rate and these are not treatable central apnea nor obstructive, but breath-holding events.  In your case the UA events may be nothing more than your normal breathing pattern, and while the machine tries to intervene with more pressure support, there is no place for the air to go.  So from the example provided, I see neither OA or CA, but a respiratory disruption that is untreatable.

[Justbreath]

I wonder if the higher pressures cause me to do breath holds, in any case I would like to show a few more for review. I also have several home sleep studies, but not sure how to submit those. I have a resmed apnea link air that I have access too also. Is it possible that the machine can cause breath holds. Will a home study show breath holds vs centrals? Just wondering if this therapy is a complete failure for me and what I should do.

[Justbreath]

few more

[Dormeo]

One thing I notice on the additional charts, compared to the earlier one, is that your TV measures are lower and your respiration rates are higher. I don’t know whether this will change the expert assessment of your situation.

[Sleeprider]

Change IPAPmin to 5.0 and IPAP max to 8.0. Increase PSMax to 12. I’m on a phone but want to get these changes in ASAP. I still see a breath holding in the flow chart but if there is an open airway we need more PS to trigger a breath and if obstruction is present higher EPAP should help.

[Dormeo]

Sleeprider, any typos in the recommendation? Max IPAP is currently 16, and your last sentence suggests you mean to be recommending an increase in EPAP, not IPAP.