Obst & Central Apnea - on ASV. why do most say- resmed vs dreamstation auto sv?

[My3rd3y3]

Out of order as i posted my most current first  but this most of been my orig 1st ever sleep study as its from 2012

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[My3rd3y3]

Going to wear that collar tonight, shall I try reg avs setting vs asvauto?

[My3rd3y3]

That one report that is 6 or 7 pages from 3 years ago. It might of only been a sleep study to show i fail on reg cpap and bi-pap and was needed in order to get my asv ? i dunno if I did an asv tritration thingy

[Sleeprider]

If you add a collar, which I think is a great idea, then keep the same settings or we won't know what caused a change. We're looking for anything we can find, and don't want to introduce multiple variables at ones...we have plenty of time.

[My3rd3y3]

Will do - keeping it ASVAuto

Using the Collar Tonight

Min EPAP - 13.0
Max EPAP - 15.0 (max as it sits)
Min PS - 3.0
Max PS - 12.0 (max as it sits)

Thanks!!!!

[My3rd3y3]

Last night screenshots -  used collar.   Not sure if these screens have the info you need the most....     also,   did my sleep study show anything - was it an ASV Tritration or whatever it is called ?   This is the section of when I truly went to Sleep.   Sometimes prior to sleeping if I am watching a movie etc and might fall sleep ill wear my mask 
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[Sleeprider]

The lack of response for the triggered breaths before the UA event flag is pretty convincing for obstruction, and that is at the maximum available EPAP and PS. The breaths that do occur are not particularly flow-limited, but the lack of exhale makes me wonder if the lack of expiration is perhaps the real problem. It would take a longer look at the respiration building up to these events to see if there is a sustained imbalance that results in a kind of breath holding that gets flagged as apnea. This could be for any number of reasons, but makes me want to try much lower pressures to see if that offers any resolution. The honest truth is, you should be under the care of a knowledgeable pulmonologist, not a forum posting hack.

[My3rd3y3]

lol I was under such care of a pulmonologist - he had me on the reg cpap fo 3 years said things are fine lol.

my current sleep dr is let me see what her qualifications are below.... while not a pulmonologist per say this is on her website/ info. She is aware that my AHI is indeed getting higher when it should be def below 5. I do have a follow-up in a month with her. I can with my insurance also go see a diff. pulmonologist also. I have a family Dr, The doctor below that does my sleep stuff, A cardiologist who just said I no longer need to go to him as my heart score is strong he did look for a murmur my surgeon thought I had but I do not have, I see a Bariatric / general surgeon who did my weight loss sleeve surgery 10/9/18 (down 100 lbs since then and still losing) every 6 weeks.... oh and and endocrinologist every 3 months. I have no problems adding a pulmonologist. Your not a hack, hell you have helped me more then anyone else that is for sure. lets lower it, let me know..... below is my sleeps dr - shes the one that got my a last study and the asv

Sherin Ibrahim Howett, DO
As the founder of The Pearl Clinic, it's my mission to provide the community with excellent primary and sub-specialty health care in a personalized fashion. I strive to create an environment where you, as a patient, will feel valued, respected and appreciated. You can always expect honesty, integrity and dedication from me and my staff to ensure that your health and needs are addressed. I am committed to actively listening to your concerns and offering the most appropriate medical advice and encouraging you to make healthy lifestyle choices.

Dr. Sherin Ibrahim Howett's Professional Path
I started my journey into medicine after high school by attending a 7-year accelerated program and graduating from the New York College of Osteopathic Medicine (NYCOM) in 2003. As an Osteopath, I believe in the philosophy that focuses on the body as a whole, instead of individual unrelated parts. Taking the road less traveled, I decided to complete an Osteopathic Rotating Internship at St. Vincent’s Midtown Hospital in Manhattan. In a hospital without residents, I learned to be efficient with my time, delegate authority and deal with the stress of being solely responsible for another's life. From there, I went on to do an Internal Medicine Residency at Morristown Memorial Hospital in NJ. My time in residency gave me the opportunity to learn evidence based medical practice, look at long-term goals of my patients and expand my fund of knowledge. I was also fortunate enough to have worked with Dr. Marc Benton, who introduced me to the field of Sleep Medicine. With his encouragement, I applied and successfully completed my Sleep Medicine Fellowship training at Clinilabs, Inc. in Manhattan in 2008. I just completed a 2-year surgical Critical Care Fellowship at Mount Sinai Hospital in Manhattan this past June 2010. The ICU allowed me to be meticulous about details, manage chaos and address end of life issues with patients and families.

All the stops along my path have helped shape me into the physician I am today. If you want to read more about me, please visit my personal website, ibrahimdo.com.

[My3rd3y3]

Some other screens

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[Sleeprider]

Thanks for the kind words and confidence. I am seeing a lot of evidence of breath holding with a lack of expiration. The machine adds in triggered breaths and gets no response, because there is no where for the air to go. This could be extreme folly, but I'd like to start over again using default ASV settings and see what we can learn. I can't promise that this won't be worse!

EPAP min 5.0
PS min 3.0
PS max 15.0
Max pressure 25.