(09-18-2017, 04:29 PM)Spy Car Wrote:

(09-18-2017, 03:58 PM)Sleeprider Wrote: Bill, be sure to read up on the ASV titration protocols.  The results you get[video=dailymotion]https://www.youtube.com/watch?v=JmCJjDOjYQQ[/video] will depend on how the machine is setup.  You need to ensure the EPAP min is sufficient to control most OA events, it does not have to control H or FL.  Go back through your APAP use and decide what that needs to be.  The EPAP max should control nearly all OA events.  Pressure support in the titration protocol generally ranges from 3-15.  You can vary that based on your results.  If you are normally comfortable at 3 and it doesn't make CA worse, then that should be fine.  Keep a relatively high PS max so there is support there for hypopnea and flow limitation.  You already know of my strong preference for the Aircurve 10 ASV in ASVauto mode. Don't get tested on something not set to auto mode.

Titration protocols? 

Most of my time on APAP I've been around 7 min/11 max with an EPR of 3. At the least, these setting have been very comfortable for me. I've had some good therapy around this range, and some not so good.

I will ask for AutoASV. Any more thoughts? I feel a little bit out of my league here, and concerned about having one night (or 4 hours) to "do or die."

Bill

(09-18-2017, 05:00 PM)Sleeprider Wrote: For you, Mode ASVauto, EPAP min 5, EPAP max 8, PS min 3, PS max 15. 

Go to page 41 VPAP Adapt (ASV). 

https://www.resmed.com/us/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904r3_s9-vpap-tx-sleep-lab-titration_user-guide_glo_eng.pdf

Page 15 here Philips BiPAP Auto SV Advanced:
https://www.sleepapnea.com/downloads/1002159_Titration%20Protocol_RefGuide.pdf

Stuff:
http://www.masm.wildapricot.org/resources/Documents/2016%20mEETING/13%20-%20Understanding%20ASV%20Therapy%20-%20Morgan.pdf

wild card (this is okay,but takes a lot of patience):

(09-20-2017, 07:49 AM)kiwii Wrote: Just a thought... do you have difficulty getting back to sleep, or staying asleep, during the second half of the night?

If so, is it possible to request or insist on starting the night with the ASV? It would be a shame if they didn't have enough data because you couldn't get back to sleep, or stay asleep.

(09-19-2017, 09:41 PM)ckingzzzs Wrote: Bill,


I went through the same process.  A Second in-house sleep study with switching to asv to address centrals.  The study results are documented for insurance purposes to get the asv machine as its higher in costs.  One thing I learned with this sleep apnea stuff is the insurance game.  asv did the trick for me hope it works for you as well.