ASV HYP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Uncle Flapp
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Location: Arizona

ASV HYP

Post by Uncle Flapp » Tue Sep 30, 2014 7:49 am

I know there has been some discussion on this in the past but I still can't help but wonder if I should do some tweaking. On ASV, my AHI consistently averages over 4 and HYP makes up 3.5 of that. Do y'all think it is worth cranking up the PS in an effort to lower those numbers? Is the juice worth the squeeze?

I appreciate your opinion.

- Flappy

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Dreamstation ASV. UPPP in 2007; Untreated AHI 84

JDS74
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Joined: Sun Jan 23, 2011 2:57 pm
Location: South Carolina

Re: ASV HYP

Post by JDS74 » Tue Sep 30, 2014 3:42 pm

I get similar numbers and I tried the PS increase to see if the hypopnea rate could be lowered.
The increase did nothing at all.
OTOH I just got my most recent PSG report.
AHI was 0.6 with zero hypopneas at a time when my machine was reporting lots of them.
My conclusion is the Respironics BiPap ASV is hypersensitive to something that gets reported as hypopneas and if OSAs are controlled and centrals are well managed, then just ignore the hypopnea reports

For the last two months, my CSAs have averaged about 1.5 per hour while the hypopneas were all over the place from 2 - 12 per hour. Since you are getting CSAs at about 0.6 per hour and (I assume since you dudn't mention them) your OSAs are at or near zero.

All that sounds great!

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.

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Uncle Flapp
Posts: 247
Joined: Thu Nov 14, 2013 2:24 pm
Location: Arizona

Re: ASV HYP

Post by Uncle Flapp » Tue Sep 30, 2014 8:28 pm

Thanks for chiming in, JD, I always appreciate your input.

Last 30 days my OAs averaged 0.30; CAs 0.31. As you and I discussed previously, my PTBs remain low (60's) but with CAs under control that tells me that the machine is doing its job. It's hard for me to let go of the HYP numbers but if they really are phantoms I may have to. I wonder if PR will eventually release some sort of firmware update.

- Flappy

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Dreamstation ASV. UPPP in 2007; Untreated AHI 84

JDS74
Posts: 3397
Joined: Sun Jan 23, 2011 2:57 pm
Location: South Carolina

Re: ASV HYP

Post by JDS74 » Wed Oct 01, 2014 5:10 am

Uncle Flapp wrote:Thanks for chiming in, JD, I always appreciate your input.

Last 30 days my OAs averaged 0.30; CAs 0.31. As you and I discussed previously, my PTBs remain low (60's) but with CAs under control that tells me that the machine is doing its job. It's hard for me to let go of the HYP numbers but if they really are phantoms I may have to. I wonder if PR will eventually release some sort of firmware update.

- Flappy
With your OAs not zero, then a small increase in the Min EPAP might be in order. PS likely would not have any effect on HYPs.
My original prescription was for Min EPAP of 9.0 and I was still having a few OAs.
Chatted with my doctor and got the go ahead to play in the range of 9 to 11.
Moved up 0.5 cm at a time and things got better up to 10.0 and no improvement after that so I backed down to 10.0.
Even so, an OA of 0.3 means one every three hours and that is a great number.

I'm thinking of experimenting to see what pressure numbers might affect the HYP numbers but first I need to finish my SpO2 data collection. I have SpO2 values daily for the last two months and just got my machine oximeter installed and working.
So, 30 more days of data collection with that and we'll see where to go from there.

Moving PS from 7.5 to 8.0 seems to have increased my SpO2 average but I only have a few days data - not enough to be sure considering the variability night to night.

Speaking of firmware, its been quite a while since this version was released so maybe checking is in order. I had ACCBIO upgrade my 750 before I got the 960 and that went well.

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.

JDS74
Posts: 3397
Joined: Sun Jan 23, 2011 2:57 pm
Location: South Carolina

Re: ASV HYP

Post by JDS74 » Wed Oct 01, 2014 6:52 am

I just had an email conversation with my sleep doctor and she agrees with me that the hypopneas are likely the result of unstable breathing on my part. Ignoring them is fine with her.

Have you tried setting your backup rate to 10 and then looked really closely at the breathing data paying particular attention to any variations in breath to breath rate? Mine jumps around a lot. That's what I think contributes in my case.
I don't suggest you keep it at 10 but just for one night to collect some sata.

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.

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Uncle Flapp
Posts: 247
Joined: Thu Nov 14, 2013 2:24 pm
Location: Arizona

Re: ASV HYP

Post by Uncle Flapp » Wed Oct 01, 2014 8:20 am

JDS74 wrote:With your OAs not zero, then a small increase in the Min EPAP might be in order...Even so, an OA of 0.3 means one every three hours and that is a great number...
...Have you tried setting your backup rate to 10 and then looked really closely at the breathing data paying particular attention to any variations in breath to breath rate?
It is interesting what a difference a day can make. Last night my AHI was 2.17: 0.0 OSA; 0.5 CAs. Not a record but close.
Suppose I could increase the EPAP 0.5 to see if it makes a difference long term. My settings are still at the entry-level of EPAP 6-15, PS 6-15, BPM auto. Average EPAP over the last 30 days is 6.58.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Dreamstation ASV. UPPP in 2007; Untreated AHI 84

JDS74
Posts: 3397
Joined: Sun Jan 23, 2011 2:57 pm
Location: South Carolina

Re: ASV HYP

Post by JDS74 » Wed Oct 01, 2014 10:49 am

With numbers like you are getting, I wouldn't fiddle at all. Just keep track for a month or so and then revisit the issue.
Your numbers are really good. Now how are you feeling in the morning or late in the day? If that's good, just keep on.
If not , then start looking at sleep hygiene and other issues that can cause poor sleep. For example, chronic pain will do a real number on how you feel in the morning. Stress at work can do the same. Stuff like that.
Cheers

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.