[Treatment] ASV settings for treatment of complex sleep apnea

[JoeyWallaby]

Changed settings back, woke up twice but managed to fall back asleep both times without taking off the mask. A lot of these unmarked arousals or something. Woke up feeling pretty decent actually, unlike yesterday where I felt terrible.

[mper6794]

Hi, Joey
long time....on this last night chart and many other previous ones, I have the impression your remaining arousals would be typical Catathrenias; have you ever investigate on this?
I am currently struggling with such events; easily spotted by audio-recording.

good luck

[JoeyWallaby]

Maybe, a Google search says bruxism and catathrenia are related. I'll start video recording again soon.

[geauxdbl]

Following for interest, as these waveforms match mine

[JoeyWallaby]

Slept good last night, didn't wake up once, felt good in the morning. I'm going to setup recording tonight.



Events from not last night, the night before (Feb 4)

---

[JoeyWallaby]

Not as many of those weird unmarked events last night

---

[JoeyWallaby]

Woke up after the data ends here, before I wanted to and couldn't fall back asleep.

[Geer1]

I was looking back at some of your old data, your sleep study attachment doesn't seem to be available anymore but I believe I saw comments that centrals were present in it I am curious if that is the case and if there was anything else of interest?

I am also curious if you take any medications that could possibly be affecting your sleep, if your believe you might have any other breathing issues(or other unexplained symptoms) and if you have been dealing with any doctors regarding these sleep issues?

I had stumbled upon this presentation a while ago and was just looking at it again as it gives some of the authors personal opinions on ASV titration (page 59).

http://www.masm.wildapricot.org/resource...Morgan.pdf

When flipping through it another thing caught my eye as one thing I noticed is that you have some nights where you have lower minute ventilation(reviewing your overview tab would make it easier to see this) and on one of his slides (page 47) it brings up a good point that these ASV machines are not capable of treating hypoventilation due to their algorithm to target 90% minute ventilation average from the previous 3 minutes (I believe this is where iVAPS would come into play).

I don't know if that is actually part of the issue but I do find it curious why sometimes you have worse nights and what really sparked this thought was from looking in your old thread and seeing how on CPAP/APAP you had some even lower minute volumes (4.6 on one I saw compared to what appears to be an ideal target of around 7).

Another thing I was curious about is if we would see any correlation between your personal thoughts on sleep quality and OSCAR data. How I was thinking about trying to collect that information is to leave your settings as is and to not look at OSCAR for say 10 days, during that time keep a sleep diary where you score sleep out of 10 and state any thoughts on the night (aerophagia, felt you woke up too often, just feel strange etc). I know with myself it is easy to get into the habit of checking OSCAR every day trying to figure out something that might explain what happened during the night but I think this sometimes leads us astray and wonder if a test like this might help pinpoint what it is about your sleep that makes you feel like you either slept well or poorly. 

Just some ideas and things to think about/look into.

[JoeyWallaby]

I don't have any breathing issues I'm aware of, I'm prescribed dexedrine 5mg twice a day for treatment of ADHD, of course I don't take it in the afternoon. I don't obsess over the data or anything like that, I do feel better on ASV than CPAP or BiLevel.

I can feel I was still grinding my teeth last night, despite using the machine, I think the Min EPAP and Min PS is just too low and should be slowly increased.

Minute vent ASV



Sleep study


Arousals, events and sleep stage together for clearer view


Old BiLevel charts

[SarcasticDave94]

You could increase EPAP Min to 6 if you think it'll help. You're aware most adults won't get enough air on 4 and IMO it's not therapeutic. Maybe that setting was tried before and I may have missed it and the results.