Just getting into this . . .

[TSVanwinkle]

 

After six weeks, my ASV results have gone from the first chart April 18th, to last nights chart, May 30th.  I would not have gotten there relying on the DME or pulminologist, who weren't very interested beyond telling me to  "come check in with us again in 2 months".   I am very grateful for the working partnership I have had through the Apneaboard forum and members.

And--special thanks to Ajack. Good on you, mate!

[ntntnt58]

 

After six weeks, my ASV results have gone from the first chart April 18th, to last nights chart, May 30th.  I would not have gotten there relying on the DME or pulminologist, who weren't very interested beyond telling me to  "come check in with us again in 2 months".   I am very grateful for the working partnership I have had through the Apneaboard forum and members.

And--special thanks to Ajack. Good on you, mate!

Was increasing max pressure support what helped you? It looks like the only setting difference between the first and 2nd one is the maximum pressure.

[TSVanwinkle]

re PS settings:
Ajack took me through a range of settings before we went back to the original prescription settings and then settled on highest PS-Max level.  The other factors were positional stuff; getting the mask adjustments right; buying a mattress topper for side sleeping (I usually am on my back..) getting a Cpap pillow so the mask stays in place; wearing a soft cervical collar to avoid chin tucks; using a knee wedge pillow; and a special pillow for relieving weight on the lower shoulder for comfort.  Those items, alone, require time to get comfortable with.  Finally, my body is getting used to and/or adapting to ASV.  When first starting, I felt that ASV was a pretty brutal experience,  as other members have also expressed.  What helped me with that was encouragement from those that finally "got there'' to be patient and keep at it.  Getting it right  can be a long hard process that might  take up to three months.  Just knowing that gave me the patience to take it one night a a time and keep notes on what helped and what didn't help.  In the early weeks, I was only getting "restful " sleep for 20 - 30 minutes at a time, then I would have a 8 to 10 minute period where my breathing TV Minute flow were all over the place.  With time, (and solving the positional issues) my sleep periods have lengthened nicely.  I have heard it explained that the ASV "trains" the user--and I think I would agree with that.  It feels like my brain has learned to respond quicker when the ASV ramps up at the beginning of a central event and once I breathe on my own-even lightly-- the ASV quickly scales itself back.  The only waking I am aware of now is when I have to re-position to sleep on my other side-or head for the bathroom.  I can also say, that I am now waking and getting into the day feeling pretty refreshed and have more energy.  

Having said all that, I hope I haven't just jinxed it all.  Friday's chart, however was another encouraging second "zero events" in a row. 

Hope this is helpful!

With regards,

[ajack]

Thanks TSV, but you're giving me far more credit that I deserve. I think the main driver now, is that the min epap has settled down, look at the median, 95% and max in the column. I think father time was the hero here. I'd give it a few more weeks. You could back off the min epap to 5. You might get some events tagged, that will raise the epap back to 6 and lose the 0.0 AHI. It may help the pressure CA more.

We went for a stroll through some pressure changes and decided the original were better. They shortened the CA low resp rate and low minute vent cycle and it recovered quicker. The pressure CA seems to be settling down and the chart looks a lot better. The good news is the o2 isn't affected too much and is maintaining a good level over 92%. I'd give it a few more weeks. Your epap6 is spot on now, but could back off the min epap to 5 later.

[TSVanwinkle]

Thanks, Ajack.  Will stay the ASV course as is for a while and continue to work on fine tuning the positional  / comfort stuff. 

VanWink

[TSVanwinkle]

Fine tuning  ASV for Altitude

G'day Ajack,

Haven't posted for a while, because there is little to post.  AHI scores of zero are becoming more of the norm rather than the exception.   I do have a new question regarding possible adjustments for altitude.  I've posted graphs from two nights.  Charts 1 and 2  (June 9) are in Phoenix where are altitude is appx 1,100 feet.  Charts 3 and 4 (June 10th)o are from last night where I am at an altitude of 7000 ft.  

Chart one is an expanded look at normal "cruising" where the ASV isn't having to do much.  THe 2nd is an expanded area where the ASV has kicked in due to a  pause.  In absence of flow limitation, I  am guessing its the start of a central and the machine is doing its job to get me to breathe until I finally do again on my own.   Chart 3 is at 7000 ft and is an example of normal breathing with little action from ASV.  The fourth chart is an example of the ASV stepping in.   One thing that does stand out is an overall lower oxygen rate, minute flow and tidal flow, which I think are to be expected.  During the night, I had times when I felt like Ii wasn't getting enough air and I purposely held my breath until the ASV kicked in and gave me a nice blast and lung fill-up.  Would you recommend changing  any settings to help compensate for the higher altitude? 

- VanWink . .