Thoughts on new titration

[Hornnumb2]

Ok since Phillips is giving me the screw, I needed to get a new machine script. Did an online consultation and got the script but he wants to start me out at base setting and basically do a home titration. Making changes as needed and of course there will be a fee. Should I go along with the program or just set it back to my settings I have been using forever? I attached a few days for looking at. Thanks Michael

[ChicagoGranny]

I attached a few days for looking at.

Did not attach. Get a free account at a hosting service and post the links in this thread. imgur.com is a favorite free hosting site.

[LSAT]

If you have been using CPAP therapy for years and are sleeping well with a low AHI, there is no reason to do another sleep study. (Unless the doctor is affiliated with the sleep lab and needs a car payment).

[Hornnumb2]

Here is some data. https://imgur.com/a/SUwJmBx

[Miss Emerita]

Echoing LSAT — just use your tried and true settings. If you want help fine-tuning them, you can ask folks here.

[Miss Emerita]

Just saw your three charts. You’re doing well by the numbers, and if you’re feeling good too, I wouldn’t mess with success.

[clownbell]

Agree with Miss Emerita. If it ain't broke, don't fix it. You don't have a large leak problem, AHI is good and you are comfortable.

Two things I wonder about.

1) I don't know how to "translate" the settings from your Respironics machine to a ResMed, if that's what you got.

2) I notice your charts don't show flow limits, but maybe Respironics doesn't track that. The ResMed machines respond to increasing flow limits, and reducing flow limits may help in reducing hypopnea.

[ozij]

I disagree.

You're using an ASV, you're snoring a lot -- I don't think those are good results at all.

On doesn't get an ASV for garden variety sleep apnea.
If it were me, I would definitely prefer to be helped along by a pro in setting up my new, very different, machine to treat my special kind of sleep disordered breathing.

[Rubicon]

I disagree.

You're using an ASV, you're snoring a lot -- I don't think those are good results at all.

On doesn't get an ASV for garden variety sleep apnea.
If it were me, I would definitely prefer to be helped along by a pro in setting up my new, very different, machine to treat my special kind of sleep disordered breathing.

Good eye, o.!!

AHI is nearly useless in ASV. If breathing is absent, the ASV sends in breaths, then goes back and says "Oh look! Breaths! No problem here!"

Meanwhile, the underlying issue is still there.

The images show nearly constant ASV attacks:

[Rubicon]

And also, the now-infamous Red Line...

[Pugsy]

2) I notice your charts don't show flow limits, but maybe Respironics doesn't track that. The ResMed machines respond to increasing flow limits, and reducing flow limits may help in reducing hypopnea.

While Respironics machines won't give you a flow limitation graph data point like the ResMed machines do they will give you FL flags up on the events graph. So Respironics machines don't ignore FLs, they are just documented differently.
Look on the EVENTS graph....FLs are flagged like OAs, hyponeas, CAs, etc.

[Hornnumb2]

Yes went with a resmed machine, phillips will never get a dime out of me. I will need help with setting on the new machine. Thanks

[Miss Emerita]

Good catch, ozij! To the OP: yes, given that you're using an ASV, good professional help with your settings could be valuable. But keep an eye on the quality of the help you're getting. Ideally you will understand the reasoning behind the series of adjustments the sleep doctor will recommend. You may need to be a little aggressive to get that kind of information, but don't settle for "doctor knows best." And please come back here any time along the way!