Spy Car Bill's (Hopefully) Excellent ASV Adventure

[sonicboom]

I'm lead to understand that your machine does not track RERAs but is it capable of defining User Flags to track events that might not otherwise be called out as an event? In other words your AHI might not be telling the whole story. Keep trying and hang in there!

[ajack]

If that was my chart, I would start raising the max PS. I think that will help a lot. You have it limited to an equivalent max ipap16 with the max PS:9
you won't notice if you raise it 1cm every night.
When you have opened the PS, then I would think about raising the epap a touch

[Spy Car]

If that was my chart, I would start raising the max PS. I think that will help a lot. You have it limited to an equivalent max ipap16 with the max PS:9
you won't notice if you raise it 1cm every night.

Raising the PS would move it in the direction of the prescribed settings, and seems in line with Sleeprider's advice as well. I think I'm getting more used to higher pressures (and the P10s have helped), so I will raise Max PS to 10 tonight and see how it goes.

My only concern has been being awakened by higher pressures (as my sleep is often precarious). It does seem reasonable to try raising it slowly at this point.

Thanks,

Bill

[Spy Car]

I raised PS Max to 10 last night (and had times where I maxed out pressure at 20).

I positively hate it when the pressure gets this high as I feel blown up, I'm conscious that it is happening, and even if "sleeping" in a technical sense it seems like non-restorative sleep. Today feels like I slept last night (meaning no insomnia), but I'm not feeling especially refreshed.

The night was probably undermined by the P10 headgear slipping (twice?) leading to some leaks and awakening to fix it. I also caught myself with mouth leaks.

Unless urged otherwise, I will stay the course tonight (even though I'd rather turn the PS Max down) to see if a more secure mask placement leads to a better night's sleep.

I'm feeling more tired than the not bad numbers would indicate in isolation. Worse than the night previous.

Bill

[Sleeprider]

I liked it better at max PS 9. If for no other reason than you are more comfortable and slept better. We're not here for the numbers.

[ajack]

I would only raise the max settings one CM at a time and when you are use to the current settings. pressure is a shock at first, but you will get use to it and sleep through it. ASV are very hard to get use to compared to cpap and bpap.
when you are going to sleep and you get strong pressure, you blow hard and it resets the machine a bit.

It's not for the numbers, It is to make sure there is enough ventilation during a CA. The CA may not be counted as UA because every one is being treated, it's whether they are effectively treated is the issue. The machine will provide enough pressure if it isn't choked down. Resmed say if there are UA shown, they are obstructive.

For the UA and H numbers, you raise the min epap

[Spy Car]

So when I saw Sleeprider had enabled a move that my own will was strongly favored, I lowered the PS Max back to 9.

Much better. I did have an hour-plus first session of no sleep (and no events) that I feared would turn into a night of insomnia (as starting a night with no sleep most often means it doesn't get turned around). However, after that I got some pretty refreshing sleep.

So a much better state of mind and body today. If last night's type sleep was "the worst" sort of sleep I experienced and the best was what I experienced on 10/20, I would be a new man.

I appreciate the input @ajax. One bit of information for you on personal history is that on APAP I was able to use pretty low Max pressures to control events. Raising pressure only drove up CAs and messed with sleep. So I never got anywhere near Max pressures of 19, and for me (who is pressure sensitive) these pressures are requiring an adjustment already. Going to PS 10 made me feel "pressurized" and kind of unwell.

I do wonder about the advice by ajax to raise EPAP mins. My inner-intelligence was wondering the same thing, just based on my breath. Good idea?

I greatly appreciate the input. A pretty good night overall.

Bill

[Sleeprider]

Your EPAP min is already 7.0 and your median result is about 7.5 and the 95% is within 1-cm of that. I don't see much benefit for an increase at this point. Your event rate is excellent. Let's let well-enough alone for a while.

[Spy Car]

Your EPAP min is already 7.0 and your median result is about 7.5 and the 95% is within 1-cm of that.  I don't see much benefit for an increase at this point.  Your event rate is excellent. Let's let well-enough alone for a while.

OK. Everything is pretty comfortable now. There were a few brief moments last night where the "Ginger" to my "Fred" wanted to take the lead in our little dance, but it was minor. ASVs do not seem to like it when users take deep breaths. They react by responding with increased pressure.

Do my leaks look like mask leaks (not mouth leaks)? I may need to work out a hose system for the P10s. I'm surprised (and delighted) that after a fail using P10s with APAP (numbers always went up, usually near doubling) that they are the bomb with ASV.

Feeling human today. 

Thank you!

Bill

[SarcasticDave94]

Unless I'm missing something, at this point in settings, isn't it more a question of how do you feel? What setting combo makes you feel the best? The answer is "XYZ" makes sleeping feel the best...then that XYZ (fill in the blanks) is "your best combo" of settings.

Hope that makes sense.

Dave B

Great Friday y'all