Mostly Centrals

[zzzk]

Here is an interesting article on asv effectiveness. Looks like the older machines do not correct the problem well (the s7?). the new ones, (ex the resmed aircurve 10 asv) appear help fix the problem. Looks like the tech is very complicated...

I'm going to continue because my centrals are so bad...

http://www.sleepreviewmag.com/2018/07/asv-studies/

[palerider]

Here is an interesting article on asv effectiveness. Looks like the older machines do not correct the problem well (the s7?). the new ones, (ex the resmed aircurve 10 asv) appear help fix the problem. Looks like the tech is very complicated...

I'm going to continue because my centrals are so bad...

http://www.sleepreviewmag.com/2018/07/asv-studies/

SERVE-HF was a disaster of a study, they used ancient equipment, and had deplorable "standards" of use, most of the people using the asv might as well have been not even using it.

If someone came in here and said they were using their machine like the typical user in that study, we'd have unanimous (except mogy) have jumped all over them and told them to use their machine all night, and fix their pressures!

I've got a link to an article, at home, about how crap SERVE-HF was... Plus, the number of extra people that died when "using" CPAP was nearly insignificant, stastically.

The S9 Adapt mentioned in the article and the air10 asv behave pretty much identically.

[Rhodesie]

I hope my husband has the same experience. His ASV machine should be arriving next week. After 6 months with a APAP, his centrals were not getting any better. Also reviewed his first sleep study which actually had a a bunch of centrals then.

[palerider]

I hope my husband has the same experience. His ASV machine should be arriving next week. After 6 months with a APAP, his centrals were not getting any better. Also reviewed his first sleep study which actually had a a bunch of centrals then.

Very low AHIs are common on resmed ASVs.

[zzzk]

Hello Palerider:

Sadly, my dr doesn't know much about asv, etc. My AHI dropped down to 0, do you think the settings are ok? My asv settings are:

auto aircurve asv
min epap 6
max epap 9

ps min 2
ps max 15

You recommended:

MinEPAP 8, MaxIPAP 25, MinPS 4 MaxPS 17

Shall I leave them the same? Or are they fine? thank you.

[Rhodesie]

I hope my husband has the same experience. His ASV machine should be arriving next week. After 6 months with a APAP, his centrals were not getting any better. Also reviewed his first sleep study which actually had a a bunch of centrals then.

Very low AHIs are common on resmed ASVs.

We are hoping. Pugsy looked at some of the husband's SH data and agreed an ASV machine should help. Our DME is nice but left us high and dry. Spoke with a colleague that supports a large sleep disorder program who also suggested this machine.

[palerider]

I hope my husband has the same experience. His ASV machine should be arriving next week. After 6 months with a APAP, his centrals were not getting any better. Also reviewed his first sleep study which actually had a a bunch of centrals then.

Very low AHIs are common on resmed ASVs.

We are hoping. Pugsy looked at some of the husband's SH data and agreed an ASV machine should help. Our DME is nice but left us high and dry. Spoke with a colleague that supports a large sleep disorder program who also suggested this machine.

The asv does a great job of handling centrals, as long as you don't tie it's hands by restricting the max pressure support.

[mrcrayola]

Excuse me for butting in, but what is the pressure support on a Dreamstation? I presume that would be in the therapy section, but I don't recall seeing it.

Thanks,

MC

[Pugsy]

Excuse me for butting in, but what is the pressure support on a Dreamstation? I presume that would be in the therapy section, but I don't recall seeing it.

Pressure support is nothing but the difference between inhale and exhale.

The term pressure support isn't shown on cpap/apap machines even though when we use any exhale relief feature we are creating a bilevel situation of sorts.

The actual term pressure support is only seen or inferred on the bilevel machines.

Example...when I use my AirSense 10 AutoSet with EPR set at 3...I am creating a situation where there is a 3 cm difference between inhale and exhale. This is essentially pressure support even though we don't call it that. When I set the pressure a 7 cm and turn EPR on and set it to 3 then I get 7 on inhale and 4 on exhale. Since I use auto adjusting pressures then as IPAP(inhale) goes up...it drags EPAP(exhale) with it. Always with a difference of 3 cm. So if my machine needs to go to 10 cm...then inhale will be 10 and exhale will be 7.

cpap/apap machines are limited in the pressure support..3 is the most we can get and even then it depends on the brand.

Bilevel machines offer a greater range in pressure support.

Sometimes pressure support can vary and when dealing with centrals it will vary a lot because it needs to. That's how it deals with things when someone has a central apnea and does breathe on their own and the airway is open.

[palerider]

Excuse me for butting in, but what is the pressure support on a Dreamstation? I presume that would be in the therapy section, but I don't recall seeing it.

Pressure support is "PS" on the Dreamstation, but only on the Bipap Auto, and the ASV. (there are a number of different dreamstations)

[mrcrayola]

Thanks, PR and Pugsy.

MC

[Jas_williams]

Hello Palerider:

Sadly, my dr doesn't know much about asv, etc. My AHI dropped down to 0, do you think the settings are ok? My asv settings are:

auto aircurve asv
min epap 6
max epap 9

ps min 2
ps max 15

You recommended:

MinEPAP 8, MaxIPAP 25, MinPS 4 MaxPS 17

Shall I leave them the same? Or are they fine? thank you.

I would leave you settings alone they seem to be working fine for you, hopefully overtime your sleep periods will extend and you won’t wake up every 2hrs

[palerider]

Hello Palerider:

Sadly, my dr doesn't know much about asv, etc. My AHI dropped down to 0, do you think the settings are ok? My asv settings are:

auto aircurve asv
min epap 6
max epap 9

ps min 2
ps max 15

You recommended:

MinEPAP 8, MaxIPAP 25, MinPS 4 MaxPS 17

Shall I leave them the same? Or are they fine? thank you.

That's pretty close to what I recommended... Let's leave it for a few days, and see how it averages out, The only thing that I might do at this time is to bump the minEPAP a little... just to even out the epap line... but, give it a few days and see how it looks.

[zzzk]

Hello Palerider:

Sadly, my dr doesn't know much about asv, etc. My AHI dropped down to 0, do you think the settings are ok? My asv settings are:

auto aircurve asv
min epap 6
max epap 9

ps min 2
ps max 15

You recommended:

MinEPAP 8, MaxIPAP 25, MinPS 4 MaxPS 17

Shall I leave them the same? Or are they fine? thank you.

That's pretty close to what I recommended... Let's leave it for a few days, and see how it averages out, The only thing that I might do at this time is to bump the minEPAP a little... just to even out the epap line... but, give it a few days and see how it looks.

Ok, thank you. Last night was ahi of .11, but it appears to be when I first put on the mask, so I think I was awake. I was able to sleep in one session for longer. Thank you again for your help.

[palerider]

Ok, thank you. Last night was ahi of .11, but it appears to be when I first put on the mask, so I think I was awake. I was able to sleep in one session for longer. Thank you again for your help.

You won't have zeros every night, so don't worry about that

Let's see how it is after a few days, and then see whether a little more minepap would help any.