+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: Sleep test Titration with ASV (/Thread-Sleep-test-Titration-with-ASV)
Pages:
1
2
Sleep test Titration with ASV - 1Joyous1 - 04-05-2022
As I wait patiently for my dr to tell me what to do next, I have a question that I can’t find an answer to. My results from ASV titration to max ps 20, max epap 5, min ps 6, min epap 5, rate 10 bpm show 2 central apneas and 94 central hypopneas.
From what I understand, the Resmed ASV doesn’t record centrals because it stops them in their tracks. Why didn’t my sleep test do the same?
RE: Sleep test Titration with ASV - SarcasticDave94 - 04-05-2022
I'm only putting forth a guess, either the pressures were still not optimal or they used a Philips Respironics test machine, or it may be both. Get your detailed report and post it redacted here. I've used the ResMed AirCurve 10 ASV myself and it will successfully tackle Central and Obstructive events. The two years I could use mine I had treated reports between AHI 0-3. ASV isn't for me though due to increasing respiratory disease.
RE: Sleep test Titration with ASV - Rubicon - 04-05-2022
(04-05-2022, 12:25 PM)1Joyous1 Wrote: From what I understand, the Resmed ASV doesn’t record centrals because it stops them in their tracks. Why didn’t my sleep test do the same?
Was your sleep test done without xPAP?
ASV was originally designed to treat "chain centrals"-- central apnea begets hyperventilation begets central apnea etc. The ASV ameliorates this by gentle respiration through the apnea and little to no support during the spontaneous breathing until the chain breaks. These are forms of "central apnea".
So then people started to use it for "central apneas" (singular). And central apneas are often normal phenomena. A person has a central apnea, then ASV hammers it with a few breaths; the machine says "Oh look breaths" so doesn't score an apnea; meanwhile the patient (remember her?) is still stuck with the central apnea, although it's decorated with some machine breaths. Oscar, part of this conspiracy, dutifully reports AHI = 0 and everybody is happy-- ResMed has $$$, MD has $$$, DME has $$$, forum members who win the race to say "You need an ASV cause the word central came up!" are happy, and the patient is sitting there wondering why they still have sleep issues.
Oh.
I guess not everyone is happy.
RE: Sleep test Titration with ASV - 1Joyous1 - 04-05-2022
I knew you would want that and as soon as I learn how on this Mac, I will.
RE: Sleep test Titration with ASV - 1Joyous1 - 04-05-2022
test results
RE: Sleep test Titration with ASV - 1Joyous1 - 04-05-2022
continued... it's a shame that the lab and dr are getting the bucks but I look to you guys for answers. I can see who accesses MyChart and they, (RespTherapist and Dr) are still going in the file today.
RE: Sleep test Titration with ASV - Rubicon - 04-05-2022
Is there a graph showing the location of the PLMs?
268 spontaneous arousals is a LOT.
RE: Sleep test Titration with ASV - kappa - 04-05-2022
Calling this sleep study a "titration" when they only appear to have used a single setting is a bit disingenuous. More of an ASV trial with attended PSG.
Are your doctors doing anything to try and address the PLMs?
My observation of my own sleep data is that you have a leg movement (twitch, etc) which triggers arousal and brief hyperventilation (at least a big breath or two) which results in hypocapnia (as CO2 is washed out) and CA events. Having an ASV force you to breath at this point is likely to cause further arousal and sleep disruption. It's not just about AHI!
A graph with LM and heart rate would be useful...
RE: Sleep test Titration with ASV - SarcasticDave94 - 04-05-2022
This isn't much of a Titration process. Only a single setting tried the whole time. Lazy or incompetent.
RE: Sleep test Titration with ASV - 1Joyous1 - 04-05-2022
It was a Phillips Respironics Machine. The respiratory therapist and I were talking about all of the hospital’s ventilation machines being recalled and then Covid hit. They were scrambling to get exterior filters because they needed every vent they could get their hands on.