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[Pressure] Improving ASV Treatment
#1
Improving ASV Treatment
Hi all,

I posted on this forum roughly 6 months ago with issues related to starting APAP therapy. I had a large number of central apnea events, which (after nearly a year of fighting my pulmonologist) finally resulted in my starting ASV therapy. Short story, my number of total events has plummeted, and I definitely feel better than I did prior to starting ASV therapy. That being said, 6 months on, I'm still noticing quite a bit of daytime sleepiness that I am hoping to improve. Additionally, I've struggled with gas and stomach pain upon waking up. To this point, because my numbers are so low, I haven't really changed my settings. I tried to leave it alone instead of tampering and obsessing over it too much. 

Introduction aside, I'm interested if there is anything I can improve. I'd be happy to provide any other OSCAR screenshots as required. 

Thanks!


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#2
RE: Improving ASV Treatment
As of this chart, I’m not seeing much requiring edits.

On OSCAR there should be within somewhere a setting to auto configure advanced views of that detailed chart. See if you can post that, minus the calendar. Given the ASV doesn’t do much with the FL that can be pushed down if needing to do so manually.

OK, here is some info on advanced charts:

View -> Reset Graphs -> Advanced
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Improving ASV Treatment
Which charts should I post?
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#4
RE: Improving ASV Treatment
Do you think you might benefit from lower pressure? Current settings of EPAP 7, PS 3-10 has resulted in very low events, but if you want to try a lower EPAP, we can let the machine self-titrate and perhaps dial in lower overall pressure. I think you could lower EPAP min to 5.0 and let the results tell us what you need to eliminate obstructive events, and continue to have effective control of CA events. I think this would be a good start, and we can continue to look at increases of PS min to address comfort and other issues. Your results are very good, so we are looking for more comfort and better sleep. This is not easy to interpret from Oscar charts alone and we will need your feedback.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Improving ASV Treatment
Will do. I’ll check back in with updates. Thanks!
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#6
RE: Improving ASV Treatment
I too have started ASV .  I have been on it since September.  I notice you have a lot of leaking as well as aerophagia from high pressures.  Rather than lower your pressures try to get to 0.0 leaks.  For me leaks lead to hypopneas which cause the machine to crank up the pressure and then I get centrals and chipmunk cheeks.
Here's how I got my leaks to a minimum:    I started wearing a soft cervical collar to help hold my jaw closed.  I also got a Kingsbridge dual strap chin strap to hold my jaw up and forward.  I use an O ring to keep track of oxygen drops (essential} and I slowly moved towards sleeping on my side all night. As my sleep was fractured into many sessions I was started on a mild sleep aid.  So now I am much less sleepy in the day and less anxious.  The ASV is adapting to my changes and lowering the amount of pressure sent to me.  I have gone from 25 to around 15 to 18 as my 95% pressure which is great because my burping and chipmunk cheeks are gone.  Its a lot of changes but I was not doing as well as I am now.
I could not lower my pressures but getting my leaks down to 0 or at least less than 7 allowed my machine to operate at a lower pressure. I imagine my clinician will lower my pressures in May to the 95% pressure. I cannot lower my own pressure because payment for my ASV is still being contested by Medicare and both my PCP and sleep specialist do actually check my data and would give me grief for manipulating my own pressures. Last night my AHI was 0.0. My ASV pressures are 10-0-15 not ideal but by having the pressure support wide open like that, the machine really did a good job adjusting to my nightly changes as I fought to control leaks which is probably why pressure support was put at 0.
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