Newbie to CPAP

I forgot to post the good news. Insurance approved my ASV sleep study and I will be going in tonight. Not sure what is going on but I'm really nervous for this study. I think I have done to much reading and have freaked myself out over the whole ASV and heart problems study.

Would appreciate any advice or encouragement.

Freaking out is counterproductive, and you're too young (unless 1/1,000,000) for the cardiac issues already addressed, so just relax already, everything will be fine!

Farmboy wrote:Would appreciate any advice or encouragement.

You have to sleep at the study so make sure that happens - prob too late to say don't nap today.

Heart disease like cancer and strokes, etc. know no boundaries - not age, sex, ethnic group, religion - no boundaries.

Nothing like a little encouragement - your timing couldn't possibly be worse!

Julie,
No worries on guests post. Every forum has to have a couple of morons to keep everyone entertained. Thanks for your post

I had my ASV titration and meet with the sleep doctor tomorrow to go over the results. I have decided to stick with the ResMed brand and will be ordering the ASV machine myself through Second Wind CPAP, tired of waiting on insurance. Second Wind told me i could get the machine this weekend if the doctor writes the script tomorrow.

To make sure i order the correct machine, is the ResMed Aircurve 10 ASV what i need? Please anyone familiar with the names and functions of the machines chime in.

Make sure the Dr specifies the initial settings in the prescription. Also maybe discuss with him how he would like to progress with adjustments, since you will not be working with a DME to act as a go-between twixt you and the Dr. I would not mention changing the setting yourself necessarily until after you have the 'script in hand.

Farmboy wrote:To make sure i order the correct machine, is the ResMed Aircurve 10 ASV what i need? Please anyone familiar with the names and functions of the machines chime in.

Yes, that is the correct machine. I have the prior model for that machine in the S9 series which is called the Adapt.
Essentially the same machine but just different model names.

If you don't get the clinical/provider manual with the machine go here and request it.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

I got the results from my ASV titration and have a few questions.

1. At settings of 7/20/5/10/25 auto, they said near complete resolution of sleep apnea was observed. A residual AHI of 1.8 and a low 02 saturation of 89% was observed. I was hoping for better numbers but would like to hear some other opinions from some of you. Does the 02 saturation seem low and is there improvement on the AHI of 1.8?

2. The doctor did not explain the different pressures so what do these numbers mean, 7/20/5/10/25 auto.

Thanks1

Farmboy wrote: what do these numbers mean, 7/20/5/10/25 auto.

that means you don't have enough information yet.

Not sure what palerider is trying to say. Can someone clarify. These were the numbers sent in for the machine to be set at.

There are several different parameters and without each digit having an associated unit/parameter we don't know for sure what each one means and doctors don't always put in all the options or put them down in the order they are listed on the machine.

Some of the parameters.
Minimum EPAP
Maximum EPAP
Minimum PS
Maximum PS
and there might be a maximum IPAP (I can't remember and my Adapt is in the closet at the moment since I am using a different model so I can't verify.

If you go get the clinical manual for that machine you will see all the various parameters.

Making a guess

7/20/5/10/25 auto,

7 might be minimum EPAP
20 might be maximum EPAP
5 might be minimum PS
10 might be maximum PS (which is a bit unusual because normally for centrals the max is 15)
and maybe the 25 is max IPAP because that's as high as it would go.

All that is assuming the doctor writes like I would write but doctors don't always write like I would write.
This stuff is pretty important that no one guesses what the doctor means when he just gives numbers like that. He needs to say exactly which setting name belongs to each number.

PS is just the difference between inhale and exhale...for central treatment the PS increases rapidly and considerably in a relatively short period of time which makes a high IPAP...or burst of air which is usually what is done to kick start the body into breathing on its own when it has forgotten to breather.

This is for the Respironics ASV but the principles are the same
http://www.isetonline.org/yahoo_site_ad ... 190318.pdf
They have a couple more setting options than the ResMed ASV but the basics are pretty much the same.

This one isn't ASV alone but includes the regular bilevel machines (VPAPs) so it doesn't target centrals as much but it is ResMed.
http://www.resmed.com/assets/documents/ ... lo_eng.pdf

Pugsy,

As always thanks for the help. I will call my idiot doctor on Monday and ask what each number refers to. The way I posted the numbers is the same way he wrote the script. So I'm guessing the CPAP shop will be calling to verify the settings. Pugsy, did the 02 saturation of 89% seem low?

During my titration study they mentioned 88% as being their line in the sand. Like "so many minutes below 88%" for oxygen levels.
I don't think 89% is all that horrible especially if the time spent there was brief.
So it depends on what your baseline (while awake might be) and how long you were down there below 90%. You have to look at the whole picture and not just one corner of it.

In other words if your baseline was 98% and you spent 30 minutes at 88% that would may be more concerning than if your baseline was 94% and you spent 3 minutes at 88%.

I think I went down to 83% during my titration but for less than 2 minutes and the rest of the time I was above 88% and that's all they mentioned about oxygen during the titration.
Still a considerable improvement from the diagnostic study where I went to 73% and spent over half a hour down there.

If it worries you and you want to know for sure what your oxygen levels do once you are acclimated to the therapy you can ask the DME for an overnight pulse ox test or even buy your own overnight recording pulse oximeter if you want to be checking it often for some reason or other.
They make pulse oximeters that you wear on your finger all night that will record all night and you can use SleepyHead or the pulse ox software to review the data...anywhere from $50 to $100 depending on model and where you get it.

Got the pressures from my doctor today, tell me if these look correct.

Max Pressure: 25 cm H20
Expiratory Pressure: 20/7 cm H20
Pressure Support Max/Min: 10/5 cm H20
Rise: --
Backup Rate: Auto
I-time: --

I still do not understand how this machine works. Can someone try to explain this to a dumb old farmboy. Thanks for all the help.