ASV CPAP Suspected UARS

[jimmybkk]

Hello, after using a APAP for 3 months and wasn't able to get pass treatment induced central apnea and absolutely zero relief from APAP, I ended up buying a Resmed AirCurve 10 ASV I have received some relief with this machine but I have a question my flow rate, I'm basically trying to eliminate any flow restrictions and gain the highest sleep quality.


Thanks in advance

[Miss Emerita]

Congratulations on getting the machine you needed and on these outstanding numbers. Judging from the left panel, your flow limitations are fine, but could you re-post your chart after making a couple of changes: hide the calendar so more of the side panel is visible (click on the triangle next to today's date), and show the graphs for the whole night, rather than a zoomed in view.

Also, it'd be helpful to know how you feel during the day. When your numbers get this good, those subjective reports become especially important.

About flow limitations: the goal would not be to get to zero but to have infrequent and minor limitations. The occasion FL is part of most people's ordinary sleep. FLs are a problem when they are frequent, because then you're having to work harder to inhale for large parts of the night, which can leave you tired out during the day and can also disturb your sleep architecture (the sequence of sleep stages that you cycle through multiple times a night).

[slowriter]

I'm basically trying to eliminate any flow restrictions and gain the highest sleep quality.

Any is perhaps too high a bar to attempt to reach. The ASV algorithm should address this generally. How common do you see that kind of pattern?

[jimmybkk]

Thanks for the reply's

I have mild Apnea Moderate in REM, I'm treated at a EPAP of 4,it doesn't seem to go over 4.80 but I feel oxygen starved.

Reading through the forums FL seems to be common with ASVauto it's difficult get perfect, upon waking I feel fogged in the brain, But I may need more time for adjustment it's only been 1 month of treatment on ASV, it feels much better then CPAP. CPAP seemed to be causing more problems then it was helping. My AHI was anywhere from 9 to 15 on CPAP, Since switching it lucky to get over 1.5 AHI.

Can you notice anything in the left column that seems to be out of place ?

[Miss Emerita]

I'm treated at a EPAP of 4,it doesn't seem to go over 4.80 but I feel oxygen starved.

It looks like your minimum EPAP is 6, not 4. Your minimum pressure support (PS) is 4, but it is often much higher than 4 or 4.8. (PS is the amount by which your IPAP increases over your EPAP.) Could you clarify which aspect of your settings you think is the problem?

Reading through the forums FL seems to be common with ASVauto it's difficult get perfect, upon waking I feel fogged in the brain, But I may need more time for adjustment it's only been 1 month of treatment on ASV, it feels much better then CPAP. CPAP seemed to be causing more problems then it was helping. My AHI was anywhere from 9 to 15 on CPAP, Since switching it lucky to get over 1.5 AHI.

It's great that you're feeling better with the ASV; clearly you now have the right machine for your condition. Your FLs are not terribly dense, but the limitation is relatively great when they do occur. I would recommend that you leave this alone for now. After you've clocked some more time with the new machine, you can consider raising your IPAP a little bit, or your minimum PS a little bit, or both, just to see what happens to the FLs. But again, I recommend you leave it alone for now.

Can you notice anything in the left column that seems to be out of place ?

Well, since you asked ... Not enough sleep! I'm also not sure what we're seeing: two naps and a short night? Could you clarify?

[jimmybkk]

It looks like your minimum EPAP is 6, not 4. Your minimum pressure support (PS) is 4, but it is often much higher than 4 or 4.8. (PS is the amount by which your IPAP increases over your EPAP.) Could you clarify which aspect of your settings you think is the problem?

I have previously used the ASV with an EPAP of 4.

Well, since you asked ... Not enough sleep! I'm also not sure what we're seeing: two naps and a short night? Could you clarify?

My sleep is all over the place due to chronic insomnia.

HISTORY about myself I have been suffering from nocturnal frontal lobe epilepsy. I failed 6 medications, finally found a drug that semi-works after 3 years. I started looking at other things that can cause epilepsy so carried out a Home sleep study, I never showed any signs of sleep apnea prior to diagnosis, I've been diagnosed with borderline mild Apena by 2 labs, The last sleep test said I had 16 awakings and 39 arousals in 4 hours AHI of 7, zero RERAS with nasal and mouth detection on the last lab's test.

I've tried APAP at 7cms by myself all my obstructive were gone but the centrals continued.

Symptoms I experience extreme exhaustion, anxiety, depression, mood swings, insomnia, dementia-like feeling on short term memory.

UPDATE

I just had a Titration last night over 7 hours I woke up after 5 hours and they still wasn't finished. They really took their time with this one the doctor prescribed, me 12cm CPAP, I'm suspecting a UARS component in there, I asked them to get rid of all flow limitations. I feel I had made a mistake and not gone bilevel but ill give it a try first over the next few weeks.

Im currently living in Thailand so experimenting in LABS is cost-effective if I do fail straight CPAP, the Doctor is a professor that was trained in the USA.

[thellra2]

Any chance you are handy with electronics? For ~$60 in parts you could help the airbreak dev team be able to change $300 CPAP machines into an ASV for help with the covid19 crisis.

[jimmybkk]

I know you're wanting to extract the firmware, I've already bricked an APAP trying to unlock it.I'm sorry in my current health state, I won't be opening it. I asked for the firmware on their forum in desperation while my ASV was coming into Thailand, my post was deleted.

[thellra2]

As far as I know no one has asv firmware.

Patched Vauto is floating around.

Edit: What do you mean by 'bricked' do you still have it?

[slowriter]

I just had a Titration last night over 7 hours I woke up after 5 hours and they still wasn't finished. They really took their time with this one the doctor prescribed, me 12cm CPAP, I'm suspecting a UARS component in there, I asked them to get rid of all flow limitations. I feel I had made a mistake and not gone bilevel but ill give it a try first over the next few weeks.

Im currently living in Thailand so experimenting in LABS is cost-effective if I do fail straight CPAP, the Doctor is a professor that was trained in the USA.

Did they not titrate you on ASV, and/or compare ASV and CPAP, given that's the machine you have?

That'd be what I'd ask for.

[jimmybkk]

No idea im pissed off, I should have walked in demanding a titration on ASV.

The weird thing is when I was doing the titration at home on an APAP my EPAP would hardly move over 4cm so set it at 7cm all the obstructive events were gone but central flagged events still existed, in the lab managed to find I needed 12CM of pressure, and the central flagged events were then gone, I would have never found this pressure.

If im needing 12CM of pressure for CPAP, what should I set the EPAP too on ASVauto mode with a PS of 4. I just looked over my data I used an EPAP of 10CM and got a 0.00 AHI on both nights but when its set to 8cm im getting AHI of 0.5 on average basically I feel like im doing this blindfolded because in the lab they seem to be able to see data I can't see.

I got the printout from titration, it had RDI for each CM they went up im really struggling to get any quality sleep right now, catching the underground subway is a mission.

But im definitely getting relief with the ASV,

I have been using a watch to monitor my sleep, I know sleep apps arent 100% correct because they don't measure brainwaves but ive gained about 15% more sleep quality.

[jimmybkk]

As far as I know, no one has asv firmware.

Patched Vauto is floating around.

Edit: What do you mean by 'bricked' do you still have it?

The mainboard is cooked I turn it on pressure goes up as high as it wants, comes up with an ERROR on the screen then pressure cuts out.

[thellra2]

As far as I know, no one has asv firmware.

Patched Vauto is floating around.

Edit: What do you mean by 'bricked' do you still have it?

The mainboard is cooked I turn it on pressure goes up as high as it wants, comes up with an ERROR on the screen then pressure cuts out.

Hrmmm, I'd try flashing it again, maybe with your backup, if you can't catch it before it shuts itself down like that, you may need to disconnect the blower while you flash.

The power chip is set to make the whole machine freakout if pressure above 30CM happens for more then like a second or something.

[slowriter]

If im needing 12CM of pressure for CPAP, what should I set the EPAP too on ASVauto mode with a PS of 4.

The ASV is designed to continuously vary the PS, often quite dramatically.

Set the min EPAP so you don't have any obstructive events, let the ASV handle the rest.

Default is min PS of 4 and max of 15.

Is that what you're you have set?

If yes, it may raise the PS at times above what they titrated you for in CPAP.

[jimmybkk]

Update on the ASVauto, Im 35 years old male fairly fit prior to Sleep Apnea, I woke up with stabbing heart pain on ASVauto, my left arm was fully numb but came back quickly I've had pins and needles and numbing in the left arm and heart pain that lasted 7 days, that's mostly fading away now what happened IDK but it hurt. I had 35 hours of monitoring in the hospital with no abnormal heartbeats I couldn't push the ex-pat insurance any further for checking as I hidden what really caused it. Doctors started to look at me like it was all in the head but I just had to accept it. Just a warning to others these can be dangerous, I haven't touched it since back to CPAP mode with no issues at all with CPAP mode.