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Asv and things are getting worse - addysnan - 01-08-2025
[attachment=73897][attachment=73898][attachment=73899]Hi, its been a while since I've posted. I've been on ASV for a few years now and up until 6 months ago things were going ok. The Last 6 months my AHI has gone through the roof and I am beginning to feel very tired and muddily. I dont know if HRT has any affect but that is the only thing different, that i now take.. Once every 6 months or so I see a sleep tech at the public hospital but it takes so long to get an appointment. After a 2nd sleep study the hospital changed my settings to BPM which did not bring my AHI down and at 15 BPM it was too much and couldnt sleep/. My AHI was up to 38 and after a month of sleepless nights and no change I changed it back to my old ASV settigs. Sadly that didnt help either so I adjusted again and the first night scored a 4.1 which I was pleased with. The second night it went up to 18 and the third night (last night)it went back down to 12. I am now so confused and I cant get into see the tech at the hospital, for two months. I really need some advice. Am I working with the wrong settings? Or have I messed it all up? I really am so confused and thought that epap was the settig to adjust for CA. I did notice I have alot of Hyponeas. Any help would be so appreciated. I have uploaded the first and second nights Encores scores and graphs.
RE: Asv and things are getting worse - addysnan - 01-09-2025
Please
is there anyone who has the time to look at my issues. I don't know what to do. I have tried calling Respirico and another so-called sleep centre but they will not adjust settings or even give me advice. I cant wait another 2 months and sometimes it gets rescheduled for a later date, so it could be even longer. I would so much appreciate any help. sincerely.
RE: Asv and things are getting worse - nh00 - 01-09-2025
I'm not an expert, but you're having a lot of leaks! Are you really using a nasal mask? Do you tape your mouth?
RE: Asv and things are getting worse - Expat31 - 01-09-2025
Hi,
Yes, I would say your leaks seem pretty significant. Suggest you read the mask primer and also look at this mouth breathing (leaking) solutions video.
A high level of leaks can cause considerable nighttime arousals, and also the reported AHI being inaccurate.
Stopping the leaking is probably the first thing to resolve before attempting anything else.
RE: Asv and things are getting worse - addysnan - 01-09-2025
Hi I have been using a full face mask for the past 2 years and i also tape my mouth . To be honest Im at my wits end with it all. Because I am with the public hospital sleep centre, it takes so long to get in to see a professional. Ive waited up to a year in the past and now its just as bad. I hope someone with some knowledge can help me because Im at the point where I dont know if its worth it, if I cant maintain a decent AHI. I dont care about numbers as long as Im below 5
Thankyou for taking the time to reply. It may be worth adjusting my mask straps. I do have them a bit looser than normal due to the straps indenting in my neck and now causing neck pain...
RE: Asv and things are getting worse - addysnan - 01-09-2025
Thanks for responding. Im doing what you advised thanks for the links plus researching interpreting oscar data,,,dont know how I will go but giving it ago lol... appreciate your time
RE: Asv and things are getting worse - SarcasticDave94 - 01-09-2025
The leaks are part of the issue, agreed.
Unfortunately a big issue is the Philips Respironics machine itself is slower to respond than the ASV I had used, the ResMed AirCurve 10 ASV.
I think to compensate for the PR reactionary method, you may want to increase EPAP Min to 9, being your median. That's where I'd consider starting an edit.
Honestly your best answer might be if you can swap to the ResMed. I've had one for 2 years from 2017-19, excellent therapy but my COPD got worse. The ASV didn't cause this increase, I had both Central Apnea and COPD combined already.
Mask, if it's causing discomfort or pain, this equals it's not a good choice for fitting you specifically. I've had great results with Fisher and Paykel Simplus, Vitera, and Evora Full hybrid, all full face and the first two with ASV at Max IPAP 25. Comfortable and at mostly consistent 10 L/Min, wasn't too bad.
PS, the only reason to keep the PR Auto SV is due to timing controls. ResMed is timing Auto pilot.
RE: Asv and things are getting worse - Expat31 - 01-09-2025
I think there could be something we are missing here relating to the leaking.
I am not clear what type of mask you are using. You say you are using tape, I assumed, perhaps incorrectly, that you are using either a pillows mask, or a nasal mask.
With a full face mask, taping is not usually necessary.
I wonder how you are using mouth tape.
Ideally the tape width should be 5cms wide, with sufficient length to cover generously the edges of your mouth, as these are usually weak points.
Fixing the tape is also very important. I suggest you curl your lips inwards first, then tape to get a better seal.
However, we still really need to see your settings, as in the left hand pane of the window, we only see as far as your statistics.
The basic way of taking a daily screen shot for this is to use the F12 key to take the screenshot. This will include (hopefully) the valuable information on the Daily Screen's left side, ie your actual settings.
It must be possible to stop these leaks, maybe you have the water humidifier leaking. Another possibility is that the hose has a bad endfit to the machine.
Are you aware of any air noises during the night?
Let us know what you think.
RE: Asv and things are getting worse - SarcasticDave94 - 01-09-2025
addysnan states in post #5 using a full face with tape
RE: Asv and things are getting worse - Sleeprider - 01-09-2025
Please update your version of OSCAR from 1.1.0 beta-a to 1.6.0. The new version will work much better and give us a better idea of your settings and issues, and even the correct machine identification.
I realize you are in Austria and may not have a good choice of devices, but the Philips Dreamstation Auto SV is a recalled device in the U.S.A. and has always been associated with inferior efficacy in ASV compared to Resmed Aircurve ASV. Another member, Dodger 6768 has a current thread with a Philips AutoSV and your charts have much in common. https://www.apneaboard.com/forums/Thread-dodger6768-Therapy-Thread Bottom line, you would be much better off with a Resmed Aircurve ASV or the European Lumis or Pacewave series by Resmed.
Your data shows evidence of positional obstruction that is affecting your therapy. There are clusters of obstructive events that arise from chin-tucking the ASV cannot resolve with pressure alone, and you will need to take steps to avoid the use of tall, firm or multiple pillows, or perhaps consider the use of a soft cervical collar. https://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea