[Treatment] ASV settings for treatment of complex sleep apnea

[JoeyWallaby]

These charts Jan 28 to Feb 1 were Min EPAP 5, Min PS 4

http://www.apneaboard.com/forums/Thread-...#pid332036
http://www.apneaboard.com/forums/Thread-...#pid332060

[Geer1]

Maybe try EPAP 6, PSmin 3.5 for a bit?

The minute vent doesn't appear that bad viewed that way, 7 would be your higher days and the 5.5 that I saw must have been one of worst on ASV. The CPAP one was what really caught my eye.

The sleep study results were interesting, too bad it was such a disturbed and short period kind of limited data. I wonder if a titration study would tell anything (if you can get one). It is easy enough to see when the issues are occurring but its just not possible to determine what is causing them without the extra data like EEG, belts etc.

Any issues with insomnia, anxiety etc?

[JoeyWallaby]

I can't get a titration study. I have some anxiety and have had issues with sleep for a long time. Nocturnal bruxism as I've mentioned (which was still present last night, despite not being present when using BiLevel before), still having some aerophagia, GERD has mostly subsided since using BiLevel and ASV. I hold my breath during the day often, it's a bad habit I've been trying to break.

I'm going to start recording my sleep soon, maybe tonight. The machine seems happy to increase PS but hesitant to increase EPAP, so I think I'll increase EPAP before PS. I don't feel much support with Min EPAP 4 and PS 3, I had to check the exhaust port on my mask last night to check if it was even turned on. I might try EERS again sometime.

[geauxdbl]

Have you been able to video yourself while asleep? Some of your events look like they happen during an arousal, and might be breath holding during movement.

They also look a little like Catathrenia, which I don’t fully understand yet, but have read is sometimes associated with bruxism. The question then becomes which came first, the arousal or the flow stoppage?

[JoeyWallaby]

Setup tonight

[geauxdbl]

Good luck!

[SarcasticDave94]

My suggestion is if changing settings, do it one at a time. It may take more than one night to see if it works. You're in need of building a trend.

I'm sorry if I forget things, but overall how does ASV make you feel? Are you more or less rested? Other symptoms ASV settings could address? Not being a crabby old dog, but it seems the thread is posting lots and making circles in the mud, AKA we're not gaining ground it seems. I probably missed what problem(s) you're chasing.

[Geer1]

I believe he is chasing not feeling good/feeling like he slept poorly and that he keeps trying different settings but hasn't noticed any correlation between ASV settings and how he feels.

You can sort of see when he has a good night or bad night by looking at the charts but ASV muddies up the data so it is hard to tell what is going on (either arousals or machine is fighting apneas).

Dave is right and maybe best bet is to spend a few days slowly increasing either EPAP or PS alone and seeing if you can draw any correlation between improving or worsening sleep. Maybe start with EPAP in the offchance obstructions are forcing machine to work harder. Keeping a sleep diary might be helpful as there might be only slight correlations muddied up with good night vs bad night that has nothing to do with breathing (insomnia, anxiety etc).

[SarcasticDave94]

FWIW I set my EPAP Min just below my median EPAP, just below meaning no more than 2 below median.

[JoeyWallaby]

From looking at video and audio recording, nothing interesting really. These marked events are just breath holding when rolling over. Feel okay today, I might just slowly increase Min EPAP and Min PS, maybe up to 6 and 4.