How to read my new ASV Charts

[richdreher]

I finally got a new ASV Machine (purchased it outright) but do not know how to read it vs 8 years of CPAP BiPAP focused on AHI. 

Also, I bought my own Oxygen Concentrator and use it every night with my ASV just for good measure (previous posts showed my SpO2 below 88% with my Central Apnea)

See my bad Central Apnea as recorded by my old BiPAP ResMed AirCurve 10 VAUTO BiPAP (see image).

   

For the ASV readings; I think I remember something about the Flow Rate being the focus; I don't know.

I am mostly down to single digit AHI now, but sometimes the ASV machine is not keeping up.
I own the ASV machine so I can set it however I want.

Here is a good ASV night and a not so good ASV night.
   
   

My ASV settings are not exactly as the "Recommendations" as shown here:
EPAP 10 cmH2O
MAX PS 15 cmH2O
MIN PS 3 cmH2O

1) What is the key factor to read/see in my chart?
2) Any advice on new settings to try?

ps. this Forum helped me get the ASV Machine and my SpO2 levels up.

[SarcasticDave94]

I'm certainly inclined to have you change a few things. I would somewhat start over with the ResMed recommended Titration, and would strongly have you consider using the ASV Auto mode instead. This mode change introduces EPAP as a min and max, where your current ASV mode has EPAP as a static pressure. I think comfort and controlling of the events will improve.

Proposed changes:
Mode ASV Auto
EPAP 4-15
PS 3-15

[Sleeprider]

I agree with Dave. We are going to learn a lot more using the default ASV settings.

[richdreher]

Thanks Dave, Sleeprider,

I cant believe I did not know about the AUTO ASV setting!  Of course that is why everyone says ResMed ASV is the best!
One push of a button and now it is on AUTO and the other settings were left at default.

I got your reply post just before I went to bed last night and changed it before I went to sleep.
AHI of 5 last night which is good for me.

The first thing I noticed was how much more comfortable it was because I was not starting off with an EPAP of 9

My trace shows the EPAP peaking at 15 a couple times but most of the time it was far below 10.
Pressure peaked at 25 a few times, but came right back down!

I will post a good trace here when in the next couple of nights

I'm so happy.  I regret some of the past trial and error, but happy to be here.

Rich
p.s. I donated yesterday

[Crimson Nape]

Rich, think of all your trial and error as a learning curve. Now, you know what doesn't work!

[richdreher]

Thanks,
I am proud to be a part of this group where I can learn from my mistakes without judgement!!
So much more freedom that dealing with the Doctor.!

That's one main reason I bought my own machine!

Rich

[Crimson Nape]

Another good reason for coming here; Unlike the Doctor, you don't have to pay us for showing our disdain.

[Sleeprider]

Rich, the fact your ASV went to EPAP at 15, and considering the pattern of your last charts, tells you have both complex apnea, which the ASV can fully resolve, but you also likely have "positional apnea" where your chin tucks in a manner that restricts or obstructs the airway. Read these two wiki articles we wrote for the many people on this forum that have this problem, and look for the pattern of clustered apnea or hypopnea that are its signature. Maybe try the chin-tucking exercise and see if you get the expected result of obstructed airway. Pay particular attention to the Oscar charts in the Soft Cervical Collar wiki, where we show ASV before and after the collar. Like you, the pressure without a collar rises to the maximum and leaves clusters of unresolved apnea and hypopnea, while with a collar, the same individual has consistently achieve AHI less than 1.0.

Positional Apnea: http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar: http://www.apneaboard.com/wiki/index.php...cal_Collar

[SarcasticDave94]

Having used that same model ASV for about 2 years, I can point out things after night 1 of the edit if you like. Do keep in mind unlike other PAP machine therapies, we ignore the flow limit chart as the method of attacking CA doesn't give us pretty FL charts, in most cases.

My go-to OSCAR chart order was Events pinned to the top, Flow Rate, Pressure, Leaks, maybe mask pressure. But mask pressure and pressure can be swapped if necessary.

You are certainly in the right mindset though. Building trends is what success is about.

So whenever you choose to, post a new setting chart and remind us how your felt, including what's changed for good or bad. End goal is AHI about 3 or so consistently and with good comfort.

[richdreher]

Happy to donate ! ; )