ASV - trying not to get excited

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
tuzacat
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ASV - trying not to get excited

Post by tuzacat » Sun Sep 07, 2014 6:44 am

I have been on Pap therapy for a while now - about 5 years - and I have seen some improvement but I have never had the significant change in my levels of daytime tiredness that I'd hoped for. Started with a pressure of 10 on straight Cpap but after a while went to 13 on Bipap. Still had all sorts of issues staying asleep. About a month ago I went for another study and did not sleep at all the entire night. The respiratory therapist wouldn't let me tape my mouth as I usually do because he was worried about liability. When the doctor found out he had me come back at no charge for a redo and told them they needed to let me tape. That was last night - I made sure I took extra drugs so I would actually sleep. Apparently I got 2.5 hours of real deep sleep. The therapist said I needed an ASV machine. Inspite of only getting 2.5 hours of sleep I feel more rested today than I have in a long time and my pain levels have dropped a little. I also don't feel all jittery as I usually do when I wake up. I don't know if this is the result of taking extra Flexeril and Sonata last night or because I fell into a deep sleep. I am really thankful that they found something and hopeful that the ASV therapy will result in some positive changes in my other health issues. I know it may or may not help but getting some real unfragmented sleep couldn't hurt! I just wanted to share because I KNOW you folks would truly understand.

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Sir NoddinOff
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Re: ASV - trying not to get excited

Post by Sir NoddinOff » Sun Sep 07, 2014 10:21 am

ASV can fix a lot of problems for some people. I sure hope it's what you need and you get some relief from your daytime stupor and especially that you experience consolidated sleep all night long. Good luck and keep us posted

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Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: Sleepyhead software v.0.9.8.1 Open GL and Encore Pro v2.2.
I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.

tuzacat
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Re: ASV - trying not to get excited

Post by tuzacat » Sun Sep 07, 2014 11:07 am

Thank you! Fingers crossed!

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Uncle Flapp
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Re: ASV - trying not to get excited

Post by Uncle Flapp » Sun Sep 07, 2014 11:56 am

I went from aPAP to Bi-level to ASV. What a difference! I used to wake up every hour or two (when a series of CAs occurred) but now average over 6 hours of uninterrupted deep sleep. Very happy with my PR 960.

- Flappy

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M'ohms
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Re: ASV - trying not to get excited

Post by M'ohms » Sun Sep 07, 2014 2:15 pm

I have the same history and results as Flappy.

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AutoSV 960 with heated hose. Settings: EPAP Min-12, EPAP Max-17, PS Min-5.5, PS Max-13, Max Pressure-25, Rate-Auto, Rise Time 1. Use Sleepyhead and Encore Pro.

tuzacat
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Re: ASV - trying not to get excited

Post by tuzacat » Tue Sep 09, 2014 5:29 pm

Thank you Flappy and M'ohms for telling me that! I know it might take some getting used to since when the machine was adjusting itself it felt like it was puffing at me and it kind of startled me. Falling asleep initially might be problematic but I'm willing to work the problem for some precious sleep.

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archangle
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Re: ASV - trying not to get excited

Post by archangle » Tue Sep 09, 2014 5:44 pm

Tuzacat, are you using SleepyHead or Encore to read your CPAP data? If not, get SleepyHead and start checking your data. Do you have a lot of central apneas? What's your AHI, CAI, and pressure?

For some people, ASV is a major pain in the neck until your brain decides to stop fighting the machine about when you should breathe. After that happens, it's a miracle for many people. If you go to ASV, just be prepared to tough out the adjustment period.

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justinjustin
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Re: ASV - trying not to get excited

Post by justinjustin » Tue Sep 09, 2014 8:08 pm

archangle wrote:Tuzacat, are you using SleepyHead or Encore to read your CPAP data? If not, get SleepyHead and start checking your data. Do you have a lot of central apneas? What's your AHI, CAI, and pressure?

For some people, ASV is a major pain in the neck until your brain decides to stop fighting the machine about when you should breathe. After that happens, it's a miracle for many people. If you go to ASV, just be prepared to tough out the adjustment period.

How long was your adjustment period? I'm coming up on week #8 and it's torture. Multiple awakenings, air swallowing, fatigued all day.

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Additional Comments: Complex Sleep Apnea, mainly CSA, with UARS. RDI of 30 w/o xPAP.

letsride
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Re: ASV - trying not to get excited

Post by letsride » Tue Sep 09, 2014 8:16 pm

I adjusted to the ASV on the first day! Life is very good now.

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Last edited by letsride on Tue Sep 09, 2014 9:52 pm, edited 1 time in total.

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archangle
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Re: ASV - trying not to get excited

Post by archangle » Tue Sep 09, 2014 8:57 pm

justinjustin wrote:How long was your adjustment period? I'm coming up on week #8 and it's torture. Multiple awakenings, air swallowing, fatigued all day.
Luckily, I'm not on ASV myself.

There's a link to a youtube video in my signature line that has a suggestion to reduce air swallowing.

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Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
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Additional Comments: Also SleepyHead, PRS1 Auto, Respironics Auto M series, Legacy Auto, and Legacy Plus
Please enter your equipment in your profile so we can help you.
Click here for information on the most common alternative to CPAP.
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Tonk
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Re: ASV - trying not to get excited

Post by Tonk » Mon Sep 15, 2014 2:51 am

M'ohms wrote:I have the same history and results as Flappy.
I am hoping that I will get the same results, too.

Straight CPAP 9.5cm for 7 yrs (Respironics M-Series) - I took the card in occasionally to be read & sent to Dr, but no contact from sleep doctor based on the reports. Over time, I wasn't feeling as well & noticed that my AHI was over 11 again, despite CPAP, so I made an appointment to see the Dr.

In January he ordered a replacement CPAP machine - APAP 8.5 - 20 cm range. AHI still averaging 10.10, but Respironics System One, so I could SEE my own data using SleepyHead. I also got a CMS50E Oximeter. No wonder I felt like C**P all the time - lots of desaturations.

Finally, in April he ordered a BiPAP titration and I was put on Respironics Auto BiPAP at EPAP 8 IPAP 21 PS 3-8 in early May. That has brought my AHI down to 8.71. The Sleep Study Analyst said that he couldn't tell what the best settings were for me - on that night I had two sweet spots in pressure. Better than CPAP, but... Some nights have been AHI under 3, but I've been over 20, too. Some nights mostly OA, some nights mostly CA, most a wild mix - especially in REM.

In August we finally did a BiPAP-ASV titration. They told me that I "responded very well to ASV" and we're waiting for the insurance company to approve it. I slept the night through during the titration, which is a good start, but did use zolpidem 5mg to get to sleep. And my SpO2 readings must have gotten Dr's attention, too, since he wants me to do an overnight oximetery after I get on the new machine. (Yeah... I TOLD him SleepyHead & CMS50E showed poor sleep! and had even shown him my graphs on my laptop.) I've wondered if I might need oxygen in addition to ASV.

I'm hoping that I will be able to get an AHI of 1-2 (or less!) and to keep from desaturating so much. With CPAP/BiPAP, when I hit REM sleep, I stop moving air, my SpO2 drops into the mid 80's and my next breath may not occur for 30-50 seconds. Big breaths to recover, then repeat again, and again. Tiring!

Wish me luck!!! (on insurance approval & positive response to ASV).

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Ladyflower
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Re: ASV - trying not to get excited

Post by Ladyflower » Mon Sep 15, 2014 8:24 am

I started right off on an ASV since my sleep study showed mixed apnea. Since I was just starting out, it was a bit of an adjustment. Partly I was trying to adjust to having something strapped to my head/face that I wasn't used to. It also took me a few days to get used to the feel of the air being pushed into my nose! It would wake me just as I was drifting off to sleep when it would forcefully blast some air and startle me. But, I adjusted pretty quickly and now I barely even notice the air anymore. Really, there are times I have to pull the nasal pillows back to make sure the machine is working! I never get woken up anymore (unless I try to roll over and pull on my tubing.) I've been using it faithfully almost every night for 6 months now. (With the exception of a few nights when I was so stuffed up from being sick that I couldn't use the mask. Then I snored so bad it just pissed off my husband! )
Machine: Resmed S9 VPAP Adapt ASV
Mask: AirFit p10 Nasal pillow mask, DreamWear Nasal Mask

tuzacat
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Re: ASV - trying not to get excited

Post by tuzacat » Mon Sep 15, 2014 4:50 pm

Archangel, I have been monitoring my data for several years now with Encore Basic. That's how I knew my AHI was going up. I finally decided to go back to the Dr. when I realized how badly fractured my sleep was getting again and I was mostly having other events - very few Obstructive events. As I said to the doctor, the data doesn't show that I frequently wake up after several hours of sleep and lie awake for the rest of the night. I used to have an AHI between 1.5 and .3 with once in a blue moon a 0. Now, it's usually over 2 and occasionally over 5. If it's much over 1 though I just don't feel that good. One thing I have noticed is that in spite of the fact that I use a chinstrap and I tape the machine is registering a ton of snoring.

Last night was a pretty good night for me at my current settings. 13/10. AHI was 2.4. CA1.8,OA.3,H.3,VS 3.6, RE .5.

The sleep study was a little over a week ago, I haven't heard back from the Dr.'s office yet so I left a voicemail today. The respiratory therapist was the one who told me I qualified for the ASV machine. I just ordered a new mask Airfit N10. I am hoping with a new mask and the new machine I'll start to feel rested.

Tonk, I sure hope you get some resolution soon! Letsride and Ladyflower, I am hoping to have a similar experience!

Tuza

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M'ohms
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Re: ASV - trying not to get excited

Post by M'ohms » Mon Sep 15, 2014 5:39 pm

tuzacat wrote:Thank you Flappy and M'ohms for telling me that! I know it might take some getting used to since when the machine was adjusting itself it felt like it was puffing at me and it kind of startled me. Falling asleep initially might be problematic but I'm willing to work the problem for some precious sleep.
I made myself think of it this way--when the pressures start to fluctuate (before I fall asleep), I take comfort in knowing that the ASV is there and taking good care of me! I am always amazed that I actually sleep through the ASV's most dramatic activity.

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Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Additional Comments: Supplemental oxygen at 2.5 lpm
AutoSV 960 with heated hose. Settings: EPAP Min-12, EPAP Max-17, PS Min-5.5, PS Max-13, Max Pressure-25, Rate-Auto, Rise Time 1. Use Sleepyhead and Encore Pro.

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Ogeo
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Re: ASV - trying not to get excited

Post by Ogeo » Mon Sep 15, 2014 9:00 pm

I am 11 days now on my AutoSV. I went straight to it having failed a CPAP and APAP in my titration studies. My pressures are high and I never had any trouble with the feel of the air blast. In fact, I like the air flow as it makes me feel like I'm getting air in my lungs for the first time. What I'm having problems with is finding a mask that I can use with such high pressure. Inhalation is running around 21-22. I've tried 4 different masks now and just got my pad-a-cheek in the mail today so will try that tonight. I usually start the night off good but by the middle of the night, I'm waking up with air in my eyes or leaking around the area on the side where the attachments are.

Enjoy your ASV.

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