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+--- Thread: New to ASV, new to SleepyHead (/Thread-New-to-ASV-new-to-SleepyHead)
RE: New to ASV, new to SleepyHead - tmoody - 04-05-2016
Update...
I hate to reply to myself like this, but I just noticed something else in the SH report. It says my PAP Mode last night was "Fixed Bi-Level." I didn't change that; the only thing I knowingly changed was EPAPmin, from 8 to 8.5.
Also, now that I consider once again the formula EPAP+PS=IPAP (I assume these are "min" values), I can see why changing EPAPmin without changing PSmin would change IPAPmin. But would it also change the PAP mode?
Maybe I should undo the EPAPmin change and bump the PSmin up a notch first. I'm definitely confused.
RE: New to ASV, new to SleepyHead - palerider - 04-05-2016
(04-05-2016, 09:19 AM)tmoody Wrote: I thought I changed just the EPAPmin, but this morning the SH report says both EPAPmin and IPAPmin were bumped to 8.5. Is that to be expected?
if you think about it, you'll see that it's impossible to have the higher pressure (ipap) lower than the lower pressure (epap).
RE: New to ASV, new to SleepyHead - palerider - 04-05-2016
(04-05-2016, 12:28 PM)tmoody Wrote: Also, now that I consider once again the formula EPAP+PS=IPAP (I assume these are "min" values), I can see why changing EPAPmin without changing PSmin would change IPAPmin. But would it also change the PAP mode?
probably just another of the many little bugs in sleepyhead that show up in the machine settings sections.
the general data interpretation is pretty good, but a lot of guesses were made in the machine settings area... I've seen stuff like raising the humidity setting makes SH report there's no humidifier attached.... and encore, the official software, doesn't show any 'humidifier attached' readout... so it seems the guess was wrong in that spot.
these kind of things aren't anything other than a source of confusion, they're not the kind of bugs that misrepresent the important stuff... the sleep data.
RE: New to ASV, new to SleepyHead - tmoody - 04-05-2016
(04-05-2016, 01:09 PM)palerider Wrote: if you think about it, you'll see that it's impossible to have the higher pressure (ipap) lower than the lower pressure (epap).
Yes, now that I do think about it, it's embarrassingly obvious.
In any event even though my AHI last night wasn't terribly high, I do feel a bit ragged today. Maybe after experiencing a bit of relief, I'm only now noticing what was an accepted way of life before ASV.
RE: New to ASV, new to SleepyHead - tmoody - 04-06-2016
Last night, I set PSmin to 1, leaving EPAPmin at 8, so IPAPmin was 9. My AHI crept up yet again, to 5.04, reported as 5.1 on the machine. There was just one CA. Periodic breathing 1%. No OAs. So once again, the AHI was almost entirely hypos.
Although some hypos were scattered through the night, there were two definite clusters, one at 1:30am and two more at 5:00 and 5:30. I don't know what was happening at 1:30 but I do know I woke up at 4:15 to go to the bathroom and, as usual when I wake up that late in the night, I had some difficulty getting back to sleep. So the cluster of hypos at 5:00 couldn't have happened long after I finally dropped off. The cluster at 5:30 wasn't that long before I woke up at 6:15.
I have no idea what all that might mean.
On a side note, this morning SH shows my data from two, three, and four nights ago as missing. Fortunately, I've kept the screenshots from those days. Last night was the fifth consecutive night of gradual increase in AHI, almost all hypos. It obviously isn't caused by pressure setting changes. The only change common to all five nights was changing the bi-flex setting from 2 to 3. I wonder if that's causing the AHI change. I guess I could try dropping it back to 2, or even 1, and see what happens.
RE: New to ASV, new to SleepyHead - palerider - 04-06-2016
(04-06-2016, 08:26 AM)tmoody Wrote: Last night, I set PSmin to 1, leaving EPAPmin at 8, so IPAPmin was 9. My AHI crept up yet again, to 5.04, reported as 5.1 on the machine. There was just one CA. Periodic breathing 1%. No OAs. So once again, the AHI was almost entirely hypos.
I think it's going to take a more pressure support to help you through the hypos, I run 5 myself. I'm NOT recommending you just set yours to 5, simply because that's what I'm comfortable with.
but, I do believe that more PS would reduce your hypopneas. that's the recipe that i've always heard. epap for obstructive apneas, pressure support for hypopneas after that.
RE: New to ASV, new to SleepyHead - tmoody - 04-06-2016
(04-06-2016, 12:55 PM)palerider Wrote: I think it's going to take a more pressure support to help you through the hypos, I run 5 myself. I'm NOT recommending you just set yours to 5, simply because that's what I'm comfortable with.
but, I do believe that more PS would reduce your hypopneas. that's the recipe that i've always heard. epap for obstructive apneas, pressure support for hypopneas after that.
Thank you. Since the change of bi-flex from 2 to 3 is the thing that corresponds to the beginning of this 5-day stretch of increasing AHI, the first thing I'm going to do is put that back to 2, and leave PSmin at 1. I know that may be pointless, but just to satisfy my own curiosity... I've searched on here and found that some people do see changes in AHI from changing flex values, but there's no pattern to it.
Then I'll experiment with increasing PSmin and see what happens to the hypos, not to mention the other odds and ends.
RE: New to ASV, new to SleepyHead - DeepBreathing - 04-06-2016
Hi tmoody, you've been getting some conflicting advice here, which is probably not unusual. The important thing is to make your changes gradually, one at a time, then don't touch the dial for a week. If you make changes every night you'll never be able to settle on an optimum therapy.
So look at flex, pressure support and EPAP, but one at a time and give each one enough time for your body to adjust before trying something else. I do agree with Palerider that ps should not be zero.
RE: New to ASV, new to SleepyHead - tmoody - 04-07-2016
(04-06-2016, 09:29 PM)DeepBreathing Wrote: Hi tmoody, you've been getting some conflicting advice here, which is probably not unusual. The important thing is to make your changes gradually, one at a time, then don't touch the dial for a week. If you make changes every night you'll never be able to settle on an optimum therapy.
So look at flex, pressure support and EPAP, but one at a time and give each one enough time for your body to adjust before trying something else. I do agree with Palerider that ps should not be zero.
Yes, I agree with this approach. I was getting a bit concerned about the five-day trend of AHI increase that started when I changed flex from 2 to 3. Anyway, last night I set flex to 1, and I'm keeping PSmin at 1, and I'll leave it like that for a while and see what happens.
Interestingly, my AHI last night was only 1.7, so maybe the flex setting was making a difference, or maybe not. At any rate, I'll leave it alone for a while.
There were no centrals last night, and only 14 hypos. Also, the number of Timed Breaths was the second lowest I've seen, at 28.37/hour, 236 total. The only time it was lower than that was a week or so ago, when it was 14.4/hour, or 123 total, roughly half as many. The AHI that night was 1.05, the lowest I've recorded.
I recognize that Timed Breaths are not a bad thing, just the machine doing its job. But it's interesting that the Timed Breath numbers seem to track the AHI to some extent, as if the nights when AHI is lower are nights when, for whatever reason, I'm not causing the machine to work as hard.
After nine years of "blind" CPAP use, I feel like a freshman.
Edit: I just noticed that about 50 of my Timed Breaths last night occurred while I was awake. I woke up at about 5:15 this morning, unfortunately, and after using the bathroom put the mask back on and tried to fall asleep. I knew I was unlikely to succeed at that hour, but I figured why not. So I just lay there for a while, and even read my Kindle for a while with the mask on. The SH data shows a big cluster of TBs during this period of about 45 minutes, and indeed I remember them. My breathing while awake and reading is not shallow, but I do tend to pause at the bottom of the exhalation, apparently longer than the ASV likes.
RE: New to ASV, new to SleepyHead - tmoody - 04-08-2016
Today's update...
AHI was 3.6 last night, with a couple of centrals sneaking through. I'm not going to make any adjustments, however, until I have a week's worth of data with the current ones.
There was one obvious change, however. I got one of those cpap pillows, filled with barley hulls, and last night was my first time using it. This morning, the machine reported a large leak and a mask fit of 97%. SH did not report a large leak. Since this is the first time I've seen less than 100% mask fit since I've been tracking data, even when I was using DreamStation (i.e., since last November), I think it's likely that the pillow had something to do with it. The pillow is much harder than a normal pillow, which is good in some ways. But I think it may push against the Swift FX straps, which are themselves pretty stiff, causing the nose pillows to shift. I'll keep an eye on this.
It's interesting, though, that the two centrals occurred pretty much exactly at the time when DreamMapper says I had the large leak, about a quarter past midnight. There are also pressure and mask pressure surges before, during, and after this time.
![[Image: VJFLdVHm.png]](http://i.imgur.com/VJFLdVHm.png)