New to ASV, new to SleepyHead

[richb]

The other thing I wonder about is how they arrived at a recommended PSmin of 0, when there's no further mention of PS in the entire report.

One of these nights, I'm going to put my machine in CPAP mode at 11 and see what happens. That's the setting I had for nine years, before I had any idea what AHI was. I sometimes wonder if nine years of constant pressure trains the brain so strongly that it can't adjust to anything else.

Hi tmoody,
Your machine handles the higher pressure settings automatically when it provides the "timed breaths". It can go up to the max setting of your machine. The EPAP and PS are for issues that are handled at the lower pressure range of your settings. My machine is set at EPAP 6 with a PS of 2. I don't have the complex apnea issues that you suffer so I don't need to fine tune the lower settings. It seems worth a try to see if an exact setting eg. 7.5 might be helpful. The trouble is that, as others have pointed out, things change from night to night. So you might want to try a range using a minimum of PS to see if that helps your average night.

Regarding your 2nd idea: I did this very thing when I knew I had to return my S9 bipap machine. I did a night each at a different setting starting at straight 5. I got some great data that I was able to show to my new Doc. No question that I needed an ASV machine.

Rich

[tmoody]

Hi tmoody,
Your machine handles the higher pressure settings automatically when it provides the "timed breaths". It can go up to the max setting of your machine. The EPAP and PS are for issues that are handled at the lower pressure range of your settings. My machine is set at EPAP 6 with a PS of 2. I don't have the complex apnea issues that you suffer so I don't need to fine tune the lower settings. It seems worth a try to see if an exact setting eg. 7.5 might be helpful. The trouble is that, as others have pointed out, things change from night to night. So you might want to try a range using a minimum of PS to see if that helps your average night.

For the past couple of nights, I've been at PSmin=3 and EPAPmin=7.5. AHI 4.7 and 3.5, with a couple of centrals, the rest hypos. This is pretty typical at just about all settings I've tried. Possibly it's as good as it gets. I'll leave it there for the rest of the week before I contemplate any other changes.

[tmoody]

Just for the hell of it, I made a table of my ASV data, with EPAPmin along the columns and PSmin along the rows.

click

In each cell with multiple entries, I've calculated the average for that combination of EPAP and PS.

Obviously, due to the small sample size, especially in some of the cells, the data don't mean much, but I thought it might be useful to update it from time to time as I experiment with settings. And since I enter the AHIs in calendar order, I can also see whether there's a chronological pattern, such as higher AHI immediately after a change.

But based on the weak data I have, my best combination so far has been EPAPmin=8.5 and PSmin=2.

I'm sure there's a better way to do this sort of thing.

[richb]

Just for the hell of it, I made a table of my ASV data, with EPAPmin along the columns and PSmin along the rows.

click

In each cell with multiple entries, I've calculated the average for that combination of EPAP and PS.

Obviously, due to the small sample size, especially in some of the cells, the data don't mean much, but I thought it might be useful to update it from time to time as I experiment with settings. And since I enter the AHIs in calendar order, I can also see whether there's a chronological pattern, such as higher AHI immediately after a change.

But based on the weak data I have, my best combination so far has been EPAPmin=8.5 and PSmin=2.

I'm sure there's a better way to do this sort of thing.

All I see is a SH screenshot.

Rich

[tmoody]

All I see is a SH screenshot.

Rich

Fixed it: click

[richb]

All I see is a SH screenshot.

Rich

Fixed it: click

I like your spreadsheet. This is a good way to document your own titration. Can you add data and have it recalculate the averages?

Rich

[tmoody]

I like your spreadsheet. This is a good way to document your own titration. Can you add data and have it recalculate the averages?

Rich

Nah. That can be done with a spreadsheet, I guess, but I just did the table by hand. It is a useful way to eyeball the record though.

[tmoody]

As another update, I'm currently trying EPAP min 8.5 and PSmin=1. After four nights, this is the best setting so far, as can be seen from the table (link in previous post). It's still not a lot of data, but between this and the combination of EPAP min=8.5 with PSmin=2, I have 12 nights with that EPAP setting, with lower AHI than any other setting I've tried. So I'm getting some degree of confidence that 8.5 is a good EPAP setting. It'll take more experimentation to see what difference changes in PSmin make. But I'll leave it alone for a while before making any more changes.

[Sleeprider]

Sometimes the lower PS works. Everyone presents a puzzle that usually gets sussed out. You've worked hard to get here, so enjoy, and take some time before making more changes.

[Jeffo1]

Could be useful. I don't know if it's been posted here before.
[/quote]
Hi Tmoody!

Thanks!! I found the Carolina Sleep Society document presentation (above)regarding the basics of ASV incredibly helpful! The chart comparing Respironics and ResMed ASVs was truly enlightening.

I've found that the AHI data that I've gotten from "ResMed Air" using the ResMed Aircurve 10 has been inconsistent. With the highest AHI, yet, of 16 on Monday night to an AHI of 3 last night, I have had at least five AHIs above 10 in the last two and half weeks, Do you think it's reasonable to switch from the ResMed Aircurve 10 to the PR System One Bipap Auto SV Advanced? My pulmonologist seems to think so.

Since we have very similar treatment histories, I hope you're sleeping much better these days!

Best,

Jeffo1