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

[SarcasticDave94]

As far as COPD, yes there's 4 stages ranked 1-4 in level of severity. I'm at stage 2 BTW. So far this has yet to be a hindrance to sleeping.

OK anyway, here's to hoping that you get to use whatever device serves your needs best, be it an ASV or a ventilator.



PS regardless of what your doc thinks, self advocacy wins always. Your therapy, so you should be in control of the settings.

[My3rd3y3]

Well not much change as far as AHI goes with the Adjustment she made to the EPAP in making it 14.  

So the Settings are

ASV Mode -  non-Auto
EPAP - 14
Min PS - 3.0
MAx PS - 11.0  

with the above my AHI is 10.0

She wants me to not touch the settings and see her again in like 10 days.... Ugg --  She said if this did not work she would send me in for the ASV Tritration.    Not sure how that is going to help but maybe it will show us some helpful data,  who knows.   This is getting so frustrating.  

I do have an appt with a really good ENT on the 13th -   maybe she will be able to see whats up as far as the "flow limitation/ obstruction etc" While I have used the P-10 Pillow Mask for a few years now,  I do think I have air flow issues with my nose.  I think when I exhale it only feels like air is coming out of one nostril.  Maybe its the hole in my septum or i dunno -   the sleep doc seems to think that it does not matter I have that as the ASV should take care of that?./  Unsure if switching back to a full face mask I have in the bin would be helpful in all this or if masks dont matter.  

I did request a referral to a local pulmonologist,    my family dr sent it over along with my records.   I am thinking the pulmonologist might be able to see also whats up with my inhale/exhale issues,  and also since he I think also deals with sleep medical I will have a second person over seeing my ASV / reports etc.   (Might be why my current non-pulmonologist  sleep doc has not recommended me going to a pulmonologist).

[Sleeprider]

I still think you are on the right track. Your issues are simply too complex to resolve over the internet. Don't even consider not keeping us informed on what you learn

[SarcasticDave94]

My opinion, maybe trying another mask could help some. Just so changes and linked effects can be accurately tracked, I'd not do more than one at a time. Just note that while a different mask may help, there's still other issues that medical specialists will need to diagnose and treat.

[My3rd3y3]

My wife just reminded me that back in October when I was in the hospital for 2 nights after my Robotic Assisted Vertical Sleeve Gastrectomy,   They required me to use my ASV and they ran Oxygen thru it.  

I just looked at my sleep reports from those two night,   man they are my lowest AHI's Ever!    The 2nd night is really fragmented as they kept waking me every hour damn near for one reason or another - taking blood,   checking whatever etc

I hope Oxygen is not the missing link with my Therapy......

If different screens are helpful,  let me know!

Night 1


Night 2

[Gideon]

We generally assume that with good numbers comes good oxygen.  But we don't monitor that.  The only way to know if your oxygen is ok now would be to monitor it overnight. You would get some indication from your last sleep study.  Check the Oximetry Import for models compatible with Sleepyhead.

[My3rd3y3]

Yea I have one but lost the cord for it and have learned other cords do not work with it. Ugg

[My3rd3y3]

AHI has been hanging around 8-10.   One night it was right at 5.0    

I go to the ENT   this morning.    

I go back to my orig sleep doc later next week to follow up how the pressure change to 14 and non-auto ASV has changed anything.   Am sure a ASV Tritration / Sleep Test will be scheduled and unsure if I should continue going to her or just change to the below doc for sleep needs.

I got my pulmonary function test around March 6th  with a follow-up with the Pulmonoligist March 11th - was told to bring not only my data card,  but all equipment, masks etc with me for the first appt.

Since I listed my older ASV for sale / trade for a Philips Dreamstation BiPAP AutoSV on a diff forum,   Someone there mentioned I might want to look into an iVAPS (ST-A) from Resmed  -  (surprised no doc prior has mentioned it).  I was wanting to trade for a Philips only for the fact that it reports centrals and I wanted to see the Diff.  

Going to also see about supplemental oxygen to run thru the ASV to see if anyone recommends it etc -  As the nights I had it were my lowest ever AHI's

The Saga Continues ...

[Sleeprider]

iVAPS is a good solution if the problem has been obstructive, and it is capable of higher pressure than the ASV. Take a look at the information in the titration protocol, and understand its applications. Supplemental oxygen has been used effectively to reduce AHI and of course to ensure proper oxygen saturation in individuals with high AHI or CPAP intolerance. It will be interesting to hear if the ENT has any impressions of why you seem to have such persistent restriction.

[My3rd3y3]

Well saw the ENT,   she was great!   Believe it or not,    she said I do not need to do anything,   no surgery etc!!!   She numbed each side of my nose first then used this scope type thing to take pictures of all parts of the inside of my nose.   While I do have a Large hole in the middle (Cocaine use in the early 2000's,  lots of it),   all other parts are perfect and there nothing limiting flow.   She said I could repair the hole,   but she thinks the repair would cause more issues then its worth.  

So this must be different and pulmonary related -  will find out next month.

I did look back on Sleepyhead.   Prior to March 2018,   my AHI was always well under 5.  Mostly under 1-2 most of the time.   

Looking back in my Pharmacy records I wanted to see what the heck changed.   I did find one thing.   The first week of March 2018,  I was prescribed and started Testosterone for my Extremely Low T (was a level of 32 vs normal 900-1200).  Did not think there would be any connection to AHI and the Testosterone Gel but for me it has seemed to increase my AHI.