ASV patient with question for Sludge or anyone who can help

[jwerley]

I wish I knew what happened because I can hardly use this forum...It's just going nuts on me with ads popping up constantly and pages bouncing everywhere!! I have never had a problem like this! I ran a complete scan today and it came up clean, but it's not........

Palerider, that would be great if you could get my info to Sludge for his opinion, thanks and thanks for the settings advice, will try it tonight and let you know how it goes tomorrow.

Janice

[Pugsy]

Go get this little free program...get the updates and then run the scan.
It's great for removing bad guys causing all the pop ups.
http://www.filehippo.com/download_malwa ... ti_malware
No need to get the paid for version...it just has a few more bells and whistles.
The free version can still remove the bad guys.

[Sludge]

...ads popping up constantly and pages bouncing everywhere!!

What browser are you using? Is the pop-up blocker on? We may need to add an (some) additional blockers.

I don't think it's Dropbox (as long as it was downloaded from a good site). It does some synching, but if those are truly ads "IMHO" it's something else. What do you have for Anti-Virus?

[Sludge]

[Sludge]

A few extemporaneous thoughts:

• The change in how you feel may not have anything to do with SDB (I mean, great to exhausted with The Magic Machine set on at least some automatic parameters?)
• That said, if the feeling you have is "sleepy", that may be something we can work. If it is "fatigue", then maybe another avenue is required.
• The Magic Machine may not be the algorithm that might offer the most benefit for you (however, upload the new EPAP and ASVAuto files to see if the waveforms changed).
• See above images. The 0200 waveforms have been expanded. That event was a problem because the FL appeared to generate an arousal (and consequently could/should be classified as a RERA).
• Sleepiness is caused by sleep fragmentation (arousals) or insufficient sleep (Wake). It looks like you have a substantial amount of SWJ there. How much of the night do you think you actually spend sleeping?
• Do you have the Sleep Efficiencies from your sleep studies?
• Classically, the PAP approach to addressing obstructing SDB events if to fix obstructive events with EPAP and everything else with IPAP. It would seem that ASV technology can not do this in cases where FL is constant (it thinks that MV is stable).
• Will ASVAuto respond to FL in the absence snoring? Looking forward to seeing that, because sometimes FL can be fixed (immovable, like tiny nasal passages), and it would seem that there would be a limit there.
• Image #2 shows normal waveforms, flow visually corresponding to the ResMed "shark-fin" technology.
• Image #3 is the RERA. Note that IPAP has been/is sitting there like a log and ignoring it.
• Looking forward to interesting discussion, but until proven otherwise, "IMHO" you can't tighten a screw with a wrench.
• That said, if ASV proves to be an effective comfort measure (albeit an expensive one), then in the big scheme of things, who cares.

[jwerley]

Sludge...I have made many attempts to write this response/will get back to you when I get my computer debugged..........

Can't thank you enough!

Janice

[Jay Aitchsee]

Janice, if you have a PC, you might try going to Control Panel > Programs, sort the programs by date and look for new ones you don't recognize. Ones that have been added fairly recently could be giving you the problems. A lot of these ad things are "legitimate" programs that can be inadvertently downloaded when visiting a web site. Many anti Virus programs won't touch them because they are "legitimate". The way to deal with them is by "Uninstall Program".
If you're squeamish about removing programs, check the publisher and then Google it before taking action. I just went through my granddaughter's computer and found 3 or 4 such programs that were making her laptop nearly unusable with all kinds of pop-ups which Norton wouldn't touch. After getting rid of these "rogue' programs her laptop worked fine.
Jay

[archangle]

malwarebytes (malwarebytes.org) is a pretty good, free malware removal program. There is also a malwarebytes "chameleon" program that helps if you have a computer with an infection that trys to stop malwarebytes from loading.

Malwarebytes free is good because it only runs when you ask it to run, so it doesn't tend to conflict with other anti-virus programs.

Sometimes you can clean a windows machine with system restore to remove something bad, but a lot of malware tries to prevent that from working. Sometimes it will work if you start in safe mode.

[jwerley]

Thank you all so much for the advice...My Son-inLaw is helping me debug...there were lots of them...one left "WSE_Lasaoren". Have tried all suggestions....still working on it....

Janice

[jwerley]

A few extemporaneous thoughts:

• The change in how you feel may not have anything to do with SDB (I mean, great to exhausted with The Magic Machine set on at least some automatic parameters?)
• That said, if the feeling you have is "sleepy", that may be something we can work. If it is "fatigue", then maybe another avenue is required.
• The Magic Machine may not be the algorithm that might offer the most benefit for you (however, upload the new EPAP and ASVAuto files to see if the waveforms changed).
• See above images. The 0200 waveforms have been expanded. That event was a problem because the FL appeared to generate an arousal (and consequently could/should be classified as a RERA).
• Sleepiness is caused by sleep fragmentation (arousals) or insufficient sleep (Wake). It looks like you have a substantial amount of SWJ there. How much of the night do you think you actually spend sleeping?
• Do you have the Sleep Efficiencies from your sleep studies?
• Classically, the PAP approach to addressing obstructing SDB events if to fix obstructive events with EPAP and everything else with IPAP. It would seem that ASV technology can not do this in cases where FL is constant (it thinks that MV is stable).
• Will ASVAuto respond to FL in the absence snoring? Looking forward to seeing that, because sometimes FL can be fixed (immovable, like tiny nasal passages), and it would seem that there would be a limit there.
• Image #2 shows normal waveforms, flow visually corresponding to the ResMed "shark-fin" technology.
• Image #3 is the RERA. Note that IPAP has been/is sitting there like a log and ignoring it.
• Looking forward to interesting discussion, but until proven otherwise, "IMHO" you can't tighten a screw with a wrench.
• That said, if ASV proves to be an effective comfort measure (albeit an expensive one), then in the big scheme of things, who cares.

Hello Sludge:

Finally getting back to you....my computer is up and running again (all cleaned up).

To answer some of your questions: My feelings during the day are definitely sleepiness. Also one side of my nares has a deviated septum so maybe that could cause some blockage.

I uploaded the last two nights, 10th and 11th....On the 10th used ASV Auto with settings of: Min epap 6, max epap 9, Min ps 4, max ps 12. I didn't have a good night, lots of wake ups and feeling like I was just half asleep. Last night I used straight ASV with settings of: Min epap 8, min ps 4, max ps 11. That worked better for me. I feel more rested today and not as sleepy.

On the only sleep study that I have here, my sleep Efficiency was 83.8% before Cpap and 96.5% after. However it is an old test and things could have changed.

Another concern is the nocturia I have had lately....that tells me that treatment is not optimal. It seems to me that there has been a change of some kind and my therapy needs to be adjusted accordingly. No new meds, or anything else I can think of other than aging to bring on these changes??

So to sum it up I feel that I have lots of fragmented sleep and little or no Rem sleep. I also believe that the fl are causing arousals and light sleep. I plan on keeping the Epap turned up to 8 for the next week or so and see how I feel....(always open to other suggestions)

The screw and wrench scenario? Please explain.....not too bright.... Are you saying that I should not be on ASV?

Let me know what you think, or if you need further info...Thank you for your time!

Janice

[Sludge]

Sure, upload the latest data to see if

• Sleep is better (although this is a REAL rudimentary way to try to quantify sleep).
• Arousals are reduced (again, taking a little artistic license here).
• FL is reduced (and that we CAN quantify).

[jwerley]

https://www.dropbox.com/s/0yw188p11ylm9 ... d.zip?dl=0

Hope I did this right........

[Sludge]

That looks like the 11.9 file...can you add the 10th and the 11th?

[jwerley]

https://www.dropbox.com/s/0yw188p11ylm9 ... d.zip?dl=0

Try this one sludge.....Sorry..... trying to overcome a learning curve with Dropbox......Let me know if you received the last two days.....Thanks!

Janice

[justinjustin]

https://www.dropbox.com/s/0yw188p11ylm9 ... d.zip?dl=0

Try this one sludge.....Sorry..... trying to overcome a learning curve with Dropbox......Let me know if you received the last two days.....Thanks!

Janice

Janice I'll be really interested to see how you develop. I looked at your data and you're almost my twin on ASV settings, nightly data, waveforms and flow limitations. I'm also fatigued/sleepy despite using the ASV, often even more than when I don't use any PAP therapy.