Inhale/exhale ratio

[supyasieve]

Everything I read says your inhale to exhale ratio should be 1:2. When i was in bipap that was my experience.

I have since switched to asv and now my inhale is longer than my exhale. 

What does that usually mean, is it bad, and how to I fix it

[Jay51]

Sometimes the I:E ratio can be distorted.  

If you could upload a 3 minute zoomed in OSCAR of a time when you were asleep (using the ASV), it might gives some clues.

[supyasieve]

Waking up with headaches 

Settings as prescribe from sleep study:

ASVAuto

EPAP: 5-7
PS: 1-6

[Sleeprider]

Your profile information is incorrect for the type of device. Edit  your profile in the User CP to avoid confusion. https://www.apneaboard.com/forums/usercp.php

Your graph shows inspiration is actually shorter than expiration, and the device is improperly reporting the moment you reach zero flow after expiration as the beginning of inspiration. If you mark the crossover when the expiration increases above zero (the actual start of inspiration), I'm sure you will see inspiration is generally shorter duration.

It appears you are using ASV to attempt to increase tidal volume. Your previous results with the Vauto showed no problems with central apnea or other anomalies, and the closeup you recently posted shows you had a similar respiratory pattern with the Vauto with an extended expiratory time at or near zero flow before spontaneous inspiration initiated.  The older Vauto threads also show you have given up significant tidal volume after changing to ASV.  This is due to a lower PS min and higher respiration rate than your normal spontaneous rate with Vauto.  You don't need ASV, and your results with the Vauto are demonstrably better than ASV at this point. With the ASV algorithm, your respiration is a mix of machine triggered and spontaneous, and the machine triggered and supported breaths are very flow limited. While this is acceptable for someone with central sleep apnea syndrome, it is not an improvement for you because you have no issues with spontaneous respiration, supported by a steady pressure support. If you post an image with ASV showing both the Flow Rate and Mask Flow graphs, we may see why the ASV is triggering breaths, even though you don't need that. This will be more evident in a period with higher pressure support. Based on the graph below, I suspect your normal respiratory pattern includes a long period of null flow in expiration, the the ASV is cutting that off.

[supyasieve]

Thanks for the reply.

I have attached a shot of the mask pressure for asv as well as the last night I used bipap (the pressure it says is wrong for some reason in settings but you can see what it operated at).

Note: I went through a rough period where I started having a number of centrals, so much so my doctor prescribed me something used for altitude sickness to help reduce them which helped. 

I have both machines. Based on these screen shots, what would your suggestion be?

[Sleeprider]

Tidal volume recovered a bit and there is no difference in events. I'm surprised to see "bilevel-S" mode with variable pressure. Is that right? Is the device delivering pressure changes with Easybreathe™? If you have your Vauto, I see no good reason not to use it. Next version of Oscar will have changes that correct the errors. You might want to join the Beta group to assist testing. Here is how to apply https://www.apneaboard.com/forums/Thread...er-Request

[DreadPirateRawburts]

No it isnt correct. It is in auto mode (9-13 PS 2). For some reason when I put my card in, it always defaults to show S 10/15.

[supyasieve]

I have attached a recent ASV night and last night with Bipap based on settings you mentioned using in a different conversation (10/6 PS 4).

Had some trouble getting good rest last night as I kept waking up. I did try a nasal mask earlier in the night and then switched to FF around 330ish.

Where do I go from here based on your thoughts. Commit to the bipap or the asv. One thing is certain, I need to just stick to one long term and adjust. 

Just FYI, I was moved to ASV based on meetings and review with my doctor who looks at my data over the last few months, wasnt something I just picked up.

[SarcasticDave94]

Normally the standard VAuto would be just fine. Neither VAuto or ASV are designed to change your breath stats, just the Apnea treatment. ASV specifically is used for Central Apnea treatment, the VAuto cannot do this but can avoid some CA.

Can you state specifically what mode and pressure settings are being used on the ASV, and what amount of CA is a lot? A non sarcastic question, from a former ResMed ASV 10 series user.

[G. Szabo]

... , and how to I fix it

Using AirCurve VAuto 10's Cycle setting, you can alter the I/E ratio. The higher the Cycle, the shorter the Inhalation period. This method allowed me to move my I/E ratio closer to the ideal one.