ASV, EncoreBasic, Slowly learning

[krb39]

Hi all,


Edit: Following Pugsly's suggestion, I have put ASV in the title. Also, although I was using sleepyhead when I wrote this, thanks to Pugsly I am now making good use of EncoreBasic. So I changed the title to reflect that.



Back in November I was diagnosed with sleep apnea and knew nothing, Now I know a little, but not much. It seems clear that it is best to know as much as possible. So I am back with questions.

I started with a CPAP but I now have a BPAP, the Respironics BiPap asv. I have had the asv for about five weeks and I will be seeing the doc on Monday. The DME provider gave me some free software to read the smartcard but it doesn't work on my Windows 7 with 64 bit technology. I am not sure why, but it doesn't. I found the Sleepyhead site and downloaded that. It works very well when it works, but it is erratic. It sometimes says that there is no data available. Sleepyhead has a FAQ page that explains how to correctly point the import button, but I seem to be doing that since it sometimes, in fact usually, imports and reads the data. But for Monday, Wednesday and Thursday this week, it hasn't. Tuesday it did.

Edit: At least for me, Encore Basic is working very well. Sleepyhead works well when it works, but there appear to be glitches.

Anyway, I want to be as prepared as possible when I see the doc. From the data I do have, it seems that my OAs are gone and my CAs are much reduced. I have hypopneas, but they are fading also, an index of 2 or 3, one night it was below 1. I now have FL (Flow Limitation) issues. I am not very clear on just what FL events are.

Other questions:
What is FL and should I be concerned?
Any thoughts on how to get the Hypopneas to go away completely? I am not sure, but possibly drinking cocoa before going to bed helps. I am not claiming this as fact, but it might be so.

[Pugsy]

SleepyHead is problematic for the PR S1 ASV machines.
Try EncoreBasic...it's essentially what the DME gave you (well probably a little better) but it will install on your 64 bit computer without any hassle.

Look in Uncle Bob's signature line for where to fine it.
memberlist.php?mode=viewprofile&u=38643
Be sure to read the Help section because it tells you how to use the software.

Check out this link for what you can expect to see
http://www.healthcare.philips.com/pwc_h ... _Guide.pdf

FLs are Flow limitations...reductions in air flow that don't meet the criteria to be one of the named apnea events.
Either not enough reduction or not long enough duration or whatever.

Can't comment on the hyponeas...something you need to talk to your doctor about and/or maybe a thread with images of the EncoreBasic reports and get some input from the guys that really know their ASV stuff.
It depends what they are (central or obstructive) and how many and some other stuff that I don't understand.
Include the term "ASV" in your subject title to get the attention of the guys who can help with ASV material.

Once you get the EncoreBasic detailed reports and if you want to post an image of the detailed report and don't know how this thread explains how.
viewtopic.php?f=1&t=81072&p=737779#p737779

[krb39]

Pugsy,

Thank you very much. I downloaded it and it works. I need to explore it a bit before I can ask an intelligent question, but for starters I am able to see that indeed the card has the information on it from the nights that sleepyhead could not find it.

One thing I want to get at: When I had my CPAP autoflex the minimum pressure was set at 6cm. The asv is set at a minimum of 12-10 (Inhale-exhale). Of course I am happy to see my AHI go down. The last two days were 1 point something and 3 point something. But if possible , I would like to have the minimum pressure set down. Partly this is a variant on my general idea that you don't take heavier doses of medication than you need, but also there are practical issues. There is less of a leakage problem at a lower pressure, the mask stays in place more easily and so on. I never had a lot of trouble adjusting to either the CPAP or the BPAP, but of course there are some problems and I imagine that a lower pressure would lessen these problems. But I want what I need. So I have to learn a bit here.

Anyway, this data and the graphs help. If I keep at it, I guess I will come to understand it, at least somewhat.

Thanks again.
Ken

[Pugsy]

When you get your thoughts settled and understand a bit of what you are seeing and not understanding a lot more why don't you start a new thread and make the title something "Review my ASV reports" that ASV mention will catch the eye of our ASV guys who really know their stuff and can explain things and you can talk to them about what you want and why and see what they say. So you can then ask your questions and get answers to your specific needs from the guys that use this type of machine. I am not good a ASV stuff beyond some real basic stuff and we don't have whole lot of ASV users who are active here.

When you are ready to post an image of your nightly detail report and don't know how.
This thread explains it.
viewtopic.php?f=1&t=81072&p=737779#p737779

[krb39]

This is an experiment to see if I am posting a workable link. I have now downloaded the EncoreBasic and read the Smartcard. EncoreBasic allows me to save the results as .pdf, and I used Adobe's "Take a snapshot" and uploaded the results to Google docs. If all has gone well, one page from the EncoreBasic can be seen by clicking on the link below.

In fact, I am a pretty happy camper this morning. My indices seem to be continuing their downward trend. As mentioned, I think my main question right now is whether it would be wise to set the default inhale/exhale, now at 21/10, to be lower. I see the doc tomorrow and I will bring it up with him.


When I was diagnosed in November I knew nothing. I have seen on the threads that others have similar issues. I am thinking it might be helpful to some of them if I post a "what I have learned" thread. I will include the asv reference as you suggest.

This forum has been a great help to me.


Here is the link, I hope it works. I'll get it to insert later.

https://docs.google.com/folder/d/0B_ZDC ... sp=sharing

[Pugsy]

Let's see if the image will stick...so far in the preview it works.
Most of the forum members like to see the images straight away. That way we don't have to click on links.
You are using an ASV machine...it's a special machine and not many forum members are experienced with the reports from an ASV machine. If you would add "ASV" to your subject line then those members who are familiar with these reports would hopefully see it and stop by and offer their thoughts. Like take out the CPAP and replace it with "ASV report".

In general I would agree with you...looking pretty darn good...some large leaks but not a horrible amount. Leaks are a battle we never truly win. I don't see anything that needs work except the leak and you already knew that. Even then it isn't a huge problem. I would said keep on with the good work...looks really good.

I assume you are feeling better...sleeping decently and all that or you would have mentioned a problem???
When you have time could you add your equipment to your profile? That way we know at a glance what you are using.
See my equipment profile showing right below my message.

[old64mb]

As mentioned, I think my main question right now is whether it would be wise to set the default inhale/exhale, now at 21/10, to be lower. I see the doc tomorrow and I will bring it up with him.

You might be able to drop EPAP to 9, but I'd want to see your sleep studies before doing so. An EPAP of 10 seems to be completely taking care of your apneas, and it's also a low enough pressure that it shouldn't be contributing to leaks. You probably could also push up IPAP PSMin by .5 and then 1 cm later on to try to deal with the residual hypopneas, but a lot of people would be happy with your current sub-2 line there.

If you post a few more nights, we can take a stab at moving you off an auto backup rate.

Your leaks are a bit more concerning; the ASVs tend to slightly underreport them in comparison to other Respironics models, so when you're leaking on an ASV you're really leaking. Combine that with the VS line and you're definitely opening your mouth. It doesn't look like it's dramatically affecting your therapy results, but it's something I'd suggest you work on before tweaking other settings.

[JohnBFisher]

I personally would not change any of the settings at this point. Per the EncoreBasic report you have an AHI of 1.7, all of which is hypopneas. It takes several months for your body to become fully accustomed to the ASV therapy. As it does, you will probably find that your AHI will drop. Essentially the ASV unit helps train your body to breathe. If after another five weeks you find the same values, you might consider making changes.

But again, that's my own take on this. What's pretty clear from your report is that the ASV therapy is pretty effective for you. I hope you feel more refreshed and better able to tackle the day.

[krb39]

Definitely I am feeling better. No comparison really.
I will try to organize this better so that it's easier to see what's what. The data bounces around some so it takes more than a single snapshot to make much of it.

[krb39]

I just saw the doc and we talked about all of the leakage. Some other nights were worse than the one I posted, and so he prescribed a replacement mask (the soft part that contacts the face). I plan to scrub, or at least wash, my face before going to bed to get the oils off. Actually I have been doing that but I often forget.

Anyway, the general outlook seems to be good.

I wish the best for all, and I hope to post something informative later.

[JohnBFisher]

Once again, I highly recommend using a mask liner with ASV therapy. No matter what you do, the ASV therapy means the pressure will change pretty wildly .. and it's hard - if not impossible - for a mask to hold a seal when that happens. The mask liner helps reduce the leakage and reduces the sound that a leak makes. I find that I sleep much more soundly when I use a mask liner.

[krb39]

Sounds right, I will do it.