Questions regarding ASV use and effectiveness (new sleep study?)

[themetnut]

Hello,
     First time viewer and user of these boards, but I was referred here by reddit. I was diagnosed with severe sleep apnea last March, and was prescribed a Resmed AirCurve 10 ASV. My AHI at the time was registered at 121/hr. At the time I weighed 370 pounds. I have used my ASV every single night. My AHI has lowered to under 1 almost every night. Fast forward to today and I now weigh 275. While I still use the ASV every night, I always wake up every 2-4 hours. Sometimes I have to go to the bathroom, sometimes I just get up for no reason. I have a few questions:

1)What would cause me to keep waking up 2-4 hours every single night? I can only remember 2 or 3 times in the last year that I slept 6 hours or more. 

2)Should I get a new sleep study now that I have lost weight?

I believe I attached the OSCAR readout correctly, but if I haven't please let me know. Thank you!

[Gideon]

Welcome to the forum.
First congrats on your weight loss, that was significant.

Please be critical of how you feel, both when you wake up and thru the following day, bathroom call is fine. But we are looking for clues/,symptoms

Do you need another skeep test? No, it is obvious that both the ASV is doing the job and without it you would have significant apnea.

More info. Please download the new version of OSCAR. In your case we want to see 2 sets of charts, the standard chart you have already shown us, and the advanced charts which contains more 'advanced' breathing stats including both tidal Volume and minute vent which ASV controls.
View / Rested Graphs / Advanced sets these up, Standard restores them.

Your weight loss implies that you may be able to reduce your EPAP value which may help, or there is ASV Auto mode which alters the EPAP automatically. Have you tried either.

[SarcasticDave94]

Hi and welcome to Apnea Board.
A few things from an ASV user: Congrats on the weight loss. CA that was likely significant doesn't just go away, so the ASV is still needed. You can treat it but not cure apnea. New sleep test? Not needed.

I'll suggest getting into the clinical menu and switching to ASVAuto mode. This will give you an auto ranging EPAP that is more comfortable and effective. This mode gives you 2 EPAP settings instead of 1 static number as it is now. Pressure gurus will help with this setting range, but myself says you'll want a range of 8-12 or similar, and the possibility can be that a bit lower such as 7 as your EPAP Min can be tried if a bit more comfort is needed. I don't think you can get away with less than that however. Note that the goal is not to improve numbers, because frankly the numbers are excellent. Comfort improvement can be had though. Let's try this and see what happens. As I'd always suggest, if the adjustment you try feels bad in some way, change it back to the prior setting and we'll explore other options. Even so, I am confident that changing to ASVAuto mode will be a nice change.

[themetnut]

        Thank you for the response, I have not tried AutoASV mode, how do I go about getting there? Here are the other screenshots you requested. 

Thank you.

---

Hi and welcome to Apnea Board.
A few things from an ASV user: Congrats on the weight loss. CA that was likely significant doesn't just go away, so the ASV is still needed. You can treat it but not cure apnea. New sleep test? Not needed.

I'll suggest getting into the clinical menu and switching to ASVAuto mode. This will give you an auto ranging EPAP that is more comfortable and effective. This mode gives you 2 EPAP settings instead of 1 static number as it is now. Pressure gurus will help with this setting range, but myself says you'll want a range of 8-12 or similar, and the possibility can be that a bit lower such as 7 as your EPAP Min can be tried if a bit more comfort is needed. I don't think you can get away with less than that however. Note that the goal is not to improve numbers, because frankly the numbers are excellent. Comfort improvement can be had though. Let's try this and see what happens. As I'd always suggest, if the adjustment you try feels bad in some way, change it back to the prior setting and we'll explore other options. Even so, I am confident that changing to ASVAuto mode will be a nice change.

---

       



Welcome to the forum.
First congrats on your weight loss, that was significant.

Please be critical of how you feel, both when you wake up and thru the following day,  bathroom call is fine. But we are looking for clues/,symptoms

Do you need another skeep test?  No, it is obvious that both the ASV is doing the job and without it you would have significant apnea.

More info.  Please download the new version of OSCAR.  In your case we want to see 2 sets of charts, the standard chart you have already shown us, and the advanced charts which contains more 'advanced' breathing stats including both tidal Volume and minute vent which ASV controls.
View / Rested Graphs / Advanced sets these up, Standard restores them.

Your weight loss implies that you may be able to reduce your EPAP value which may help, or there is ASV Auto mode which alters the EPAP automatically. Have you tried either.

[SarcasticDave94]

OK, a few explanations due to my common use language, etc.: I call those like bonjour and Sleeprider the pressure gurus. They have been on PAP therapy and here long enough to look at chart stats and be able to suggest very accurate pressure settings. They are good at this.

Clinical menu/mode: I'll suggest getting the ResMed AirCurve 10 ASV in the CPAP Setup Manual link at the top black banner. It does need to be exact on make/model. It describes settings found there, but I can do a fairly good job at it as I have this same ASV. Hold the Home and control Knobs in at the same time for about 5 seconds. To change Modes: Click into the top selection of 2 choices, Settings. Mode is the first setting starting at the top. Click into Mode and it lists ASV Auto, ASV, CPAP. Highlight and Select ASV Auto by clicking that choice. This is done by dial turns and clicks as appropriate.

When you select ASV Auto, static one choice EPAP under ASV changes to 2 EPAP settings, Min then Max. Setting numbers are different here as well, so you can switch back to ASV and revert back to previous EPAP setting if needed. Scroll with the dial, moving down to EPAP Min and edit it to say 8.0. Once this number is clicked, dialed to the right number, and clicked again to lock in, scroll down to EPAP Max. EPAP Max, let's try 12.0. Click Home and then exit clinical.


PS let's go with a standard view Daily chart to see overall thx