New CPAP User, Trying to Reduce CA's

[Ratchick]

Yep, that's the blower hours. Really good deal, in that case! Fingers crossed, tonight will be the first of many good ones to come.

[Sleeprider]

You made one heck of a deal on the low-hour ASV. The machine will report apnea as UA (unknown apnea), and since the machine is about 100% effective in creating a breath during a central apnea (cessation of breathing with open airway), we can assume any reported UA is obstructive. You appear to be using default settings with EPAP min 4.0, EPAP max 15.0 PS min 3.0 and PS max 15.0. The machine is never moving away from EPAP 4.0 and varies pressure support up to about 10 cm to maintain the minute vent. You had no events and a couple of minor periods of reduced respiratory flow rate that, based on your zoom, may have been the result of arousal or could have been the beginning of an apneic oscillation that was rapidly mitigated by the ASV algorithm and re-established normal respiratory rate and volume. As long as you can adapt to be comfortable, this is fine, and actually proves any obstructive component of your sleep disordered breathing is addressed at very low EPAP pressure.

[ubersteiny]

Thanks for the informative report!

The obstructive component is for sure less of an issue last night as I forced myself to stay on my side. Some nights I roll onto my back but I don't think I did last night.

[SarcasticDave94]

Very good chart on the first night. You can't get better than 0 AHI. Congrats. Keep at it.

[ubersteiny]

Past 2 nights have been 0.65 and 0.00 AHI. Noticing my flow limits are quite a bit higher on the ASV vs. the Autoset, is that anything to be concerned about?

[Sleeprider]

Flow limits are normal on ASV. As it uses pressure support to treat CA events, without spontaneous respiratory effort, the airflow tends to slow as the lungs fill. This is a flattening of the inspiratory curve and interpreted as FL. In every case of FL being flagged on this chart, there is elevated PS indicating a breath being delivered. There is no need for a change, and nothing available to offset this phenomena.

[turk0ZzZz]

What are UF2s? How are you feeling after several nights with the ASV compared to your old machine?

[Ratchick]

Most of the flow limits seem to be matching up to the (very few) apneas or "not quite apneas" as you're also using OSCAR to mark flow restrictions - which obviously makes sense, really. I should pay more attention for the future, so that I know the best way to handle this on ASV (in the hope I finally get mine). I'm sure the others with more knowledge will let you know.

[ubersteiny]

What are UF2s? How are you feeling after several nights with the ASV compared to your old machine?

UF2 is a user defined flag. I'm using the default settings for it, which are a 50% flow restriction for a minimum of 8 seconds.

Not much change in qualitative feeling yet. Dealing with some neck pain and other things so it's a work in progress.

[Geer1]

Flow limitations are always flagged more aggressively on these ASV units, it must be related to their programming. Single flow limited breaths, individiual spikes like your data indicates, are not an issue.

The odd UF2s being flagged are during times where the machine has been supplying high PS to try and maintain ventilation, without backup rate they would probably be central apnea but in this case they are no issue.

Your data looks very good and all you can do now is wait, let body adapt and see if you start to notice benefits weeks/months down the road.