[Treatment] Gamestar32 ASV Treatment Thread

[SarcasticDave94]

I think to combat the remainder Hypopnea might indicate an increase to EPAP Min. But if it necessary or not I can't answer.

If you feel it's necessary, edit EPAP Min to 7. Consider reducing Ramp as well, at least there's about a 20 minutes Ramp pattern at the beginning in the pressure chart.

How do you feel for this current setup? This is now you only number 1 focus, feeling better for the usage of ASV.

[gamestar32]

So far I feel decent with it. I think in terms of adjusting to the therapy I still have a little ways to go but each night feels notably easier.

I’ll eventually turn off ramp, but for now while I adjust I think it’s helpful.

In terms of whether those hypo’s are even an issue, that’s also hard to say. I imagine it’ll take a few weeks before I’m officially out of sleep debt. I woke up once last night at about 3 with no indication of an event in OSCAR, so I’m assuming it’s just a matter of me getting used to the machine on that front.

I’ll leave things as is for now and re-assess in a week or so. If I need to raise EPAP min a bit then I will. Thanks for all your help so far!

[SarcasticDave94]

Welcome.

Just keep an eye on events, correlation between any events that sneak in during Ramp especially.

Post in a few days if you like. Let's see the pressure requirement trend, because Max IPAP via lower EPAP Max or PS Max might be reduced to help comfort if your needs indicate there wouldn't be a hindrance to the therapy.

[gamestar32]

Morning Friends,

Sorry for the radio silence. I've been catching up on some much needed sleep!

I raised my EPAP min to 8 and that seems to be eliminating damn near all of my hypopneas. Had to readjust my mask a bit to bring the leaks down but as of right now I think I'm in a pretty good spot! I've attached pictures.

My only question now is about my breathing pattern in general. I look as some other folks' breathing and it seems much more uniform, whereas mine is still pretty erratic even without apneas. Is that just a person to person thing? I had a fair bit of periodic breathing prior to getting the ASV, so could it just be that that's the way it goes for me and that those are just bouts of periodic breathing the ASV is able to intercept? 


All told otherwise, I'm slowly feeling energy coming back to me! I know it's a process and I definitely have a few years of sleep debt to pay back, but we are on the way to recovery! Not sure if any further adjustments are necessary to try and get my score down to 0, but if we think it's worth a shot I'm open to suggestions.

[SarcasticDave94]

I would probably run it as is unless you're not comfortable. Getting events to zero may be a net loss situation in exchange for less comfort.

[gamestar32]

Right on sounds good. Any knowledge around my breathing question? It seems all over the place compared to many of the other ASV users I see here.

[SarcasticDave94]

I don't know how to describe or explain it. I've not gotten that far into respiratory graphs self taught 101 just yet. Due to playing hooky, I'm on forced coffee break as the dunce. I'm sure others have ideas.

[Jay51]

Your charts look ok IMO.  I have an S9 Adapt ASV.  My charts for tidal volume and minute ventilation spiked up and down and back and forth the entire time that I was asleep.  Yours look smoother than mine.  You have an 11.8 respiratory rate (at the low end of normal, but ok) and 580 tidal volume (that is good).  

My spikes were caused by me stopping breathing and the ASV upping pressure support to force breaths.  After I would breathe, the pressure support lowered and I would stop breathing again.  Then cycle repeated itself over and over.

My respiratory stayed fairly consistent though.  Around 14 or 15 or so.

[gamestar32]

Afternoon everyone.

So I was hoping this problem would go away, but it almost seems to be getting worse. Despite a consistent AHI of >1, I'm still waking up more than once throughout the night. The wake-ups don't appear to correlate with any spikes in leaks, at least not consistently. I have been finding a bad run of dry mouth for myself lately. Issue there is if I turn the humidity up past 3 I find I wake up with my face wet.

Based on some things I've read in other threads on here, it seems like a possible cause could be that the occasional spikes in pressure are waking me up. Is that a thing? If so, would I aim to lower my EPAP or my PS in order to combat that? I can post some more recent OSCAR charts later today, but they all look more or less exactly like the ones I've posted so far.

[gamestar32]

Edit: Despite a consistent AHI < 1*