Joey's Mother: CPAP to ASV Therapy Thread

[JoeyWallaby]

Nice to see these excellent results!

Thank you! 

That last chart on bilevel looks ideal for all parameters. There may be some obstruction from lower ramp pressures but I don't see a compelling need to change anything other than adjust for comfort.

Yea, a few events but pretty peachy overall   I'm hoping the CAs will mostly diminish over the next few weeks

[arunjb]

@JoeyWallaby, Am newbie here, what is shallow breathing - flow rate amplitude in absolute terms or relative ? For eg in the first plot you showed throughout the nite the flow rate was between +20 and -20 and within this you have shown drastic drops to between -13 and +13. Whereas in the last plot flow rate jumped to between +30 and -30. Looking at the last plot one could say the entire nite of first plot is shallow breathing ?

I went through the posts, at first you were on APAP, then you switched to Bilevel (I@12 and E@9), then last plot on bilevel (I@15 and E@10). And you added chin strap. 

In the first plot (post #6, APAP setting) there is drastic reductions in flow rate amplitude.. shallow ones are between +13 and -13, whereas in the next two (post #13 & #23, bilevel setting) it is much better in relative terms but still the amplitudes are smaller and in the final plot (post #23) the amplitudes have jumped up to between +30 and -30. 

Am wondering if it just that the splinting effect at lower pressures were not enough. So the airway was narrow and so if a leak happened on top of this it caused a dramatic drop in flow rate.. Whereas in the last plot the splinting effect of higher pressure overcomes leaks easily ? In other words am wondering if the chin strap is even necessary ?

[JoeyWallaby]

Recent nights

Auto

Bilevel

ASV

[Sleeprider]

If I had to judge by image alone, I'd say the Auto CPAP seems just fine, but this is really about how your feel, and you didn't say. Leaks could stand to be improved regardless of machine.

[JoeyWallaby]

Last night data with ASV, very good results. She didn't used the chin strap last night and on any of the nights in my last post.

@JoeyWallaby, Am newbie here, what is shallow breathing - flow rate amplitude in absolute terms or relative ? For eg in the first plot you showed throughout the nite the flow rate was between +20 and -20 and within this you have shown drastic drops to between -13 and +13. Whereas in the last plot flow rate jumped to between +30 and -30. Looking at the last plot one could say the entire nite of first plot is shallow breathing ?

I went through the posts, at first you were on APAP, then you switched to Bilevel (I@12 and E@9), then last plot on bilevel (I@15 and E@10). And you added chin strap. 

In the first plot (post #6, APAP setting) there is drastic reductions in flow rate amplitude.. shallow ones are between +13 and -13, whereas in the next two (post #13 & #23, bilevel setting) it is much better in relative terms but still the amplitudes are smaller and in the final plot (post #23) the amplitudes have jumped up to between +30 and -30. 

Am wondering if it just that the splinting effect at lower pressures were not enough. So the airway was narrow and so if a leak happened on top of this it caused a dramatic drop in flow rate.. Whereas in the last plot the splinting effect of higher pressure overcomes leaks easily ? In other words am wondering if the chin strap is even necessary ?

Maybe shallow breathing isn't the right term, I don't know, those ones I posted just looked weird and they don't happen anymore with BiLevel or ASV. Waveforms are good on BiLevel and ASV. She did the mouth tape really well last night and a hose management system has been installed, both of those have significantly improved leaks.

This is a typical waveform from last night.

If I had to judge by image alone, I'd say the Auto CPAP seems just fine, but this is really about how your feel, and you didn't say.  Leaks could stand to be improved regardless of machine.

Not me, my mother. The Auto CPAP is fine going off numbers alone but zoomed in, there is obvious flow limitation. She felt better on BiLevel but comfort has been issue, due to the high EPAP required to prevent OAs. ASV has significantly improved comfort, numbers are even better, waveforms are similar. It's impressive that ASV has been effectively treating OAs with a lower Min EPAP.

[JoeyWallaby]

She's had nightmares for the past three nights but otherwise, okay sleep.

Anything interesting on these charts?

[JoeyWallaby]

Changed settings last night, she says she feels better and data looks better

[Sleeprider]

Looks like the move to PS min 4 is helpful. Glad to hear your mother is more comfortable and clearly well-treated on ASV.

Joeywallaby, would you be okay with a title change for this thread to add [mom's data]? I have been confused more than once which thread is yours and which is hers.

[JoeyWallaby]

Yea, change it to "Joey's mother's CPAP treatment" or something like that. Thank you.

[JoeyWallaby]

Data looking better with the different settings and leak rate has improved with better cleaning of face and tape application.