Switched from ASV to Bilevel, Odd Cheyne Stokes Respiration Patterns, Any Thoughts?

[LennySleeps]

Hello everyone,
I have just recently tried out a bilevel machine (Resmed 10 Vauto) as I have experienced ongoing fatigue despite using my ASV machine for nearly three years with a consistently less than 1 AHI. My reasons for trialing this machine was because I wanted to rule out the possibility that the ASV algorithm was contributing to my ongoing fatigue as it fluctuates consistently, perhaps causing micro arousals. In turn I tried out this bilevel for the first time last night (I fell asleep without it on for most of the night sorry), and checked the data this morning to find an extremely odd respiration pattern and wondered if anyone had any experience with what it might be/what is causing it. I should mention I am 23 years old, fit and healthy apart from diagnosed obstructive sleep apnea via a home study a few years ago. I was initially put on CPAP however, following the emergence of some central events and a lack of relief from my fatigue I was put on ASV, which reduced these events but not the fatigue. Thanks heaps for any help or comments in advance!

[Jay51]

It seems like you had much better results with ASV than this current VAuto set up.  The only thing you can try is to increase the "trigger" to very high and see if it decreases the tremendous amount of CA's that you are having.  

Sorry to hear about the relatively bad experience with ASV; but this chart from the VAuto is much worse.

[LennySleeps]

Thanks Jay, yes you are right my data looks heaps better on ASV, I am now just becoming a bit depressed as it seems i will never completely feel normal as long as I am on ASV and was hoping bilevel would be the answer,  furthermore I am a bit concerned about this odd breathing pattern I have unveiled. Do you think this breathing pattern is worth seeking advice from a neurologist or is this relatively typical of a sudden change in therapy?

[SarcasticDave94]

What did your typical ASV charts look like? Settings? The ASV can be tuned to your needs.

[katbrat]

Your leak rate is very high. Have you tried working on that? There are lots of great videos on youtube that explain what can be done to make it better. Many times apneas are directly related to leak rate. Also have you tried using a soft cervical collar to keep your chin from dropping and blocking your airway?