(02-01-2020, 10:29 AM)SarcasticDave94 Wrote: My sage advice for the day: set this by feel and not so much by the numbers. I myself don't see a number on these charts that demands adjustment. Feel for various aspects should be your guide to hone in after those initial dial-in adjustments. If possible, change 1 setting and review if better or worse. A better means keep and worse means revert to what was previous.

I'm not suggesting not checking OSCAR charts. I went by feel only and when it felt off I looked at charts to see why.

(02-01-2020, 10:29 AM)SarcasticDave94 Wrote: My sage advice for the day: set this by feel and not so much by the numbers. I myself don't see a number on these charts that demands adjustment. Feel for various aspects should be your guide to hone in after those initial dial-in adjustments. If possible, change 1 setting and review if better or worse. A better means keep and worse means revert to what was previous.

I'm not suggesting not checking OSCAR charts. I went by feel only and when it felt off I looked at charts to see why.

(02-01-2020, 12:17 PM)Geer1 Wrote: My gut feel with the periods of decreased respiration rate and increased expiration time are that they are a different stage of sleep that normally has a lower minute vent. The breathing seems fairly continuous and not troubled, the reason for higher pressures is because the respiration rate is slower. What I believe is happening is that the minute vent is trying to naturally drop so the machine increases its pressure, then the brain says no I don't need this much air and it slows down the breathing to try and compensate. The respiration rate falls and eventually so does the minute vent as the machine will allow it (since target minute vent is 90% of some previous set time) and then pressure slowly decreases.

I haven't watched enough ASV patients charts but I imagine if my theory is correct that this is a regular occurrence. If it isn't a semi normal occurrence it might be worth looking into. Maybe search up some other members ASV charts and see if they do the same thing.

I am curious what an ~5 min view of January 31 around 15:30 looks like (try to get a bit of the good breathing before and then a chunk of the disruption), show mask pressure graph instead of pressure for that view. Those seem to be your trouble areas and I wonder if they are central apneas the machine is working to stop or what they are.

Have you ever tried recording yourself sleep? I learned a lot doing that.

(02-01-2020, 02:09 PM)RayBee Wrote:

(02-01-2020, 10:29 AM)SarcasticDave94 Wrote: My sage advice for the day: set this by feel and not so much by the numbers. I myself don't see a number on these charts that demands adjustment. Feel for various aspects should be your guide to hone in after those initial dial-in adjustments. If possible, change 1 setting and review if better or worse. A better means keep and worse means revert to what was previous.

I'm not suggesting not checking OSCAR charts. I went by feel only and when it felt off I looked at charts to see why.

I'm with Dave.

I got to the point where it seems like nothing I did would get me to the all-elusive Zero AHI number.  Then I finally realized that that was not the goal.  Feel as good-as-you-can and comfort is the goal.  For me, a pressure over 17 cmH2O would always result in aerophagia with miserable results.  So I had to play with my max EPAP and PS settings to limit my max IPAP at 17.  I played around with settings within my personal comfort limitations and have struck a balance.  But targeted as Dave said, by feel, not numbers.  I feel great no matter what the AHI numbers are.  I occasionally get a cluster of events in the first 10 minutes when I go to sleep (I see sleep when my Resp rate settles down), maybe a few more events if I reposition myself during the night, and sometimes more when I wake up.  So the numbers for me are not necessarily a good representation of efficacy.  But I know what is SWJ and account for it accordingly.  When I deduct the SWJ from the equation, my AHI averages 2.0+/-.  Not bad when I came from 40.0.

Another note...  I found that the headgear can slowly stretch out over time which causes more leaks.  Seems to be a fine line to balance proper headgear tightness in regards to mask comfort, nagging headache (too tight) , and cushion leakage (too loose).

And also, like Dave, I look more closely at the numbers and charts when something starts to go south.

All the best!  

(02-01-2020, 10:30 PM)JoeyWallaby Wrote: Yes I have recorded myself before but not recently. I don't know about that theory, high PS was maintained by the machine on Jan 29 from 16:25 to 17:55, so a full sleep cycle.