evanms17 Therapy Thread

[Deborah K.]

I suggest that you set your pressure from 7.4 to 8.6. Your AHI, even though mostly CAs, is not at all high.  I very much doubt that you need an ASV machine. If you remove the calendar from the left panel, we can see at least some of your settings. We need to see your EPR setting and whether you are using ramp.

If you fix your chart we'll be better able to help you.  It's possible that you would do better with a Bi-level machine, but I can't see enough now to advise one way or the other.

[evanms17]

Thank you for that info! I have attached another screenshot with that section. Could any of this be contributing to my exhaustion or should I look elsewhere?

[SarcasticDave94]

The information needed to determine need for ASV is at minimum your diagnostic sleep study detailed report. You should have a copy, or you'll need to request it from the prescribing physician. Once you have it, you may post it here redacted of your personal info.

In the US, you can get the detailed sleep study by requesting it, and HIPAA law gives you the right to request and receive it. The table within the report that states events type and count and the diagnosis itself will help determine the state of your CA.

[evanms17]

I have been using cpap for a few years now with my average AHI being around 2, but still waking up very fatigued and vast majority of my events being CAs.

Last night I switched to an air curve 10 asv to see if this would help and my AHI dropped to 0.0 for the first time ever. Looking at this data are you able to tell if the machine was preventing any central apnea events or if I even need asv? Or is this machine just worse at picking up CAs than my airsense 11 autoset so it is not detecting them?

Thank you so much

[SarcasticDave94]

Well, a few things, you got a zero AHI. So, it's working. But, being a new thread, there's also zero context on your question regarding did switching to ASV work.

On the settings, I think you can safely make 3 adjustments. 1, you'll likely be more comfortable turning up EPAP Min to something like 6 or 7, as 4 is possibly a bit low for your comfort.

Second, on the EPAP Max, you can safely reduce it as well, maybe down to 12 or even 10. This chart had EPAP used as being between 4-5.82.

Number 3 is reducing PS Max, you'll not need a 19 here, and it'll be quite difficult to ever to reach PS 19. Your ASV will Max IPAP at 25. The circumstance to get PS Max 19 means the EPAP would only be 6 at that moment. So let's try a more reasonable 15 PS Max.

[evanms17]

Well, a few things, you got a zero AHI. So, it's working. But, being a new thread, there's also zero context on your question regarding did switching to ASV work.

On the settings, I think you can safely make 3 adjustments. 1, you'll likely be more comfortable turning up EPAP Min to something like 6 or 7, as 4 is possibly a bit low for your comfort.

Second, on the EPAP Max, you can safely reduce it as well, maybe down to 12 or even 10. This chart had EPAP used as being between 4-5.82.

Number 3 is reducing PS Max, you'll not need a 19 here, and it'll be quite difficult to ever to reach PS 19. Your ASV will Max IPAP at 25. The circumstance to get PS Max 19 means the EPAP would only be 6 at that moment. So let's try a more reasonable 15 PS Max.

Thank you for this! Here is some of the data from my Cpap for comparison.

I will make those pressure adjustments. It was definitely a little uncomfortable and I had a hard time falling asleep because it kept feeling like it was forcing me to take deep breaths while I was trying to fall asleep when I changed the cadence of my breath or took longer to breath.

[SarcasticDave94]

OK. The ASV did what it's expected to do. No more CA on the chart.

Try the edits and follow-up with an OSCAR chart and tell us how things felt. It should change something in one night.

[evanms17]

OK. The ASV did what it's expected to do. No more CA on the chart.

Try the edits and follow-up with an OSCAR chart and tell us how things felt. It should change something in one night.

So i think last night was better than the first, it was a bit more comfortable but it still felt like I had a hard time falling asleep because anytime i would slow my breathing it would crank the pressure and make me take a huge breath. I ended up having to enable ramp to fall asleep, then woke up once mid, night and had trouble falling asleep again but ramp allowed it. I never needed ramp with cpap or ever had any trouble sleeping with it. It also looks like I have some periods of real slow breathing like 6 breaths per minute for periods of 10 or so minutes. Is that normal or anything I shoudl change? overall less tired than with cpap so thats good. Still crazy low AHI instead of the 2-3 CSA AHIs ive always had with cpap

[SarcasticDave94]

You might be able to turn down EPAP Max again. Let's go to 10.

As for your slow breath and the ASV ramping things up, this is what it does to treat CA. Best thing to do is settle yourself in for bed, ready to mask up, but waiting a minute for your breath rate to slow a bit. The thing that's happening is that if you mask up with breathing fast, the ASV will pace that. Then if you slow it down, the ASV throws a flag and blows to get you back to where you were. The pace window is about 3 minutes of breath data.

Unfortunately that's about all you can do. This ASV has zero manually controlled time settings.

I would not set Ramp to 4 if you must use it. Make it 6 like the EPAP minimum. And make it for as short a duration as possible.

[evanms17]

You might be able to turn down EPAP Max again. Let's go to 10.

As for your slow breath and the ASV ramping things up, this is what it does to treat CA. Best thing to do is settle yourself in for bed, ready to mask up, but waiting a minute for your breath rate to slow a bit. The thing that's happening is that if you mask up with breathing fast, the ASV will pace that. Then if you slow it down, the ASV throws a flag and blows to get you back to where you were. The pace window is about 3 minutes of breath data.

Unfortunately that's about all you can do. This ASV has zero manually controlled time settings.

I would not set Ramp to 4 if you must use it. Make it 6 like the EPAP minimum. And make it for as short a duration as possible.

With those setting (based on feel) combined with your advice about waiting a few minuted to put the mask on helped immensely. It felt about as comfortable as cpap did and was a night and day difference between night one and last night!! Thanks!!!!

EDIT: attached wrong data please see next reply