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+--- Thread: New User - First night with ASV was bad (/Thread-New-User-First-night-with-ASV-was-bad)
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New User - First night with ASV was bad - geepers - 11-10-2024
HI all,
First timer here. Been using a TAP mouthpiece for some time but still have fatigue. Two home studies and an in-clinic study later and I got a shiny new Resmed Aircurve 11 ASV Thursday. Have been fighting a cold so did not use it Thursday night but tried Friday with Airfit P30i nasal pillow mask
Had a rough go of it. Wore it for 4:45 but ended up having to demask a couple times, remove hose a few times and finally just gave up and put my mouthpiece back in to actually get any sleep
Pressure at high end (20) ended up forcing exhalation through my mouth as my mouth woudl fill up with air. First hour I wore my pulseox and my sat dropped below 85% three different times triggering a vibration warning in the first hour, so ended up taking that off also after the first hour or so.
Cut high pressure to 18 and that may have helped a little but my AHI went from about 26 uncorrected to over 30 while wearing the Airfit.
Was planning to try a chin strap tonight so see if that helps
Screen cap of Thursdays data from OSCAR. Help appreciated
Settings
Mode Vauto
Max IPAP 20
Min EPAP 6
PS 6
Ti range 0.3s-2.0s
Trigger Med
Cycle Med
Ramp time 20min
Start EPAP 4
Climate control Auto
Tube Temp Auto
Mask setting Pillows
B/V filter off
THx
Geep
RE: New User - First night with ASV was bad - SarcasticDave94 - 11-10-2024
A few things...
This OSCAR chart says VAuto. You have Positional Apnea patterns, you're probably chin tucking.
Ramp is a hindrance. You started/restarted therapy 5 times, and Ramp took time away from treatment.
The Central Apnea story is what? Post your detailed sleep study report. We need to know about the CA.
PS 6 is probably too high, especially in light of CA.
If this is a VAuto, run Trigger High or Very High. If it's ASV, we'll need to see associated charts.
BTW VAuto is a bilevel without backup breath rate and can't treat CA. ASV is another bilevel with backup breath rate, and does treat CA.
RE: New User - First night with ASV was bad - geepers - 11-10-2024
First off, many thanks for the quick reply.
Sorry to be the newb but I am totally new to this so some of the stuff you are saying is a bit over my head.
When you say associated charts for ASV, what do you mean?
tried attaching the PDF of my sleep study but wouldn't let me saying it is a file format that is not allowed
RE: New User - First night with ASV was bad - SarcasticDave94 - 11-10-2024
PS
1. IF you were expecting an ASV to treat Central Apnea. No sorry, you didn't get one. This is a VAuto. The settings tell us this. So again, you were expecting ASV to treat Central Apnea? Call your DME and get it swapped. They have you the wrong machine.
Have you done an echocardiogram in prep for ASV? No, then your probably in the progressive CPAP/BPAP/ST/ASV path. Now, if I'm accurate, deep assessment from you is required. Is this working to treat CA? NOPE. There's a point you'll need to cross and say that's it. Demand ASV, if that's what you were supposed to be issued.
2. IF you were supposed to be on VAuto, disregard what I said above for now.
RE: New User - First night with ASV was bad - SarcasticDave94 - 11-10-2024
I'm thinking you'll need to attach screenshots for now. Focus on the table with events and count on the test.
The associated with ASV aspect, it seemed at first read you thought you had ASV, but posted a VAuto chart.
I think you do not have ASV but VAuto only. They're separate, very different, machines.
RE: New User - First night with ASV was bad - geepers - 11-10-2024
[attachment=71770 Wrote:SarcasticDave94 pid='536133' dateline='1731264806']PSAppreciate the feedback .
1. IF you were expecting an ASV to treat Central Apnea. No sorry, you didn't get one. This is a VAuto. The settings tell us this. So again, you were expecting ASV to treat Central Apnea? Call your DME and get it swapped. They have you the wrong machine.
Have you done an echocardiogram in prep for ASV? No, then your probably in the progressive CPAP/BPAP/ST/ASV path. Now, if I'm accurate, deep assessment from you is required. Is this working to treat CA? NOPE. There's a point you'll need to cross and say that's it. Demand ASV, if that's what you were supposed to be issued.
2. IF you were supposed to be on VAuto, disregard what I said above for now.
I assumed this was ASV. Guess i have some reading to do on the differences between ASV and VAuto etc.
I'm clueless why this particular machine was suggested. No ECG
Added graphs and table from sleep study
chart
other charts
RE: New User - First night with ASV was bad - SarcasticDave94 - 11-10-2024
Was there a chart that said Obstructive Apnea were X amount, Central X, Hypopnea X, etc.?
Second, were you told the doctor would be ordering a machine to treat Central Apnea?
RE: New User - First night with Vauto was bad - geepers - 11-10-2024
(11-10-2024, 01:56 PM)SarcasticDave94 Wrote: I'm thinking you'll need to attach screenshots for now. Focus on the table with events and count on the test.
The associated with ASV aspect, it seemed at first read you thought you had ASV, but posted a VAuto chart.
I think you do not have ASV but VAuto only. They're separate, very different, machines.
I dont know why but yes, thought ASV. My bad . I think when they called to tell me what i Was getting they said ASV? Sorry for the confusion
(11-10-2024, 02:05 PM)SarcasticDave94 Wrote: Was there a chart that said Obstructive Apnea were X amount, Central X, Hypopnea X, etc.?This one?
Second, were you told the doctor would be ordering a machine to treat Central Apnea?
[attachment=71776]
And no she didn't specifically state Central. She's been saying Obstructive since day 1.
RE: New User - First night with ASV was bad - SarcasticDave94 - 11-10-2024
OK, this is the Titration, where they attempt to find "the correct pressures". Did you have any report from the sleep study, without CPAP machine and mask, yet measuring sleep?
You have some to high Central Apnea, but so far it's while on machine.
You had a post some months ago that said you had Central Apnea from a 6 year old test. Something like that. Still have that test? It's still relevant BTW.
RE: New User - First night with ASV was bad - geepers - 11-10-2024
(11-10-2024, 02:25 PM)SarcasticDave94 Wrote: OK, this is the Titration, where they attempt to find "the correct pressures". Did you have any report from the sleep study, without CPAP machine and mask, yet measuring sleep?Unfortunately don’t have that study. I’ll have to look though the other report. Thanks for all your help so far
You have some to high Central Apnea, but so far it's while on machine.
You had a post some months ago that said you had Central Apnea from a 6 year old test. Something like that. Still have that test? It's still relevant BTW.