Central & Obstructive - AHI always around 10 with ASV. Tweak Settings?>?

[Pugsy]

Bummer...looks like you were asleep and we can't blame the ugly on being awake and double bummer in that it looks like your EPAP was up around the 15 max mark.

I don't know what has changed to cause this new problem unless it is related to the added testosterone medication.

If you can't fix it by change in position (side sleeping or cervical collar) I don't know what else to offer. We have maxed out my limited knowledge.

In terms of how you sleep and feel....better, worse the same? If you couldn't see the ugliness...how would you be rating how you sleep and feel?

[Pugsy]

What is that short segment at 13:00? Were you asleep..short nap or just trying the machine?
If that segment was just a trying of the machine...turn that session off because it is making the stats worse and it is awake breathing stuff.

So unless you were napping for sure....
Scroll down the left side until you see the sessions and turn off that short session by clicking on it and changing it from green to red.
This will remove that segment of data from the statistics. It's elevating your overall numbers a bit.

[palerider]

only a more advanced ASV can use higher pressures. You may end up needing another titration for insurance

I did not know there were more advanced ASV's then the Resmed Aircurve ASV.

It's best not to listen to anything ajack says,

he's probably talking about hospital grade ventilators, not something you'd have at home.

[ajack]

I always sleep on my right side. /Sorry about the pie. I like pie , jk......

The Epap is topped out at 15 no? I cant seem to get it any higher

I did buy a cervical collar, i am going to have to get use to wearing it

ugg I guess no other machine goes above 15?

....
only a more advanced ASV can use higher pressures. You may end up needing another titration for insurance

I did not know there were more advanced ASV's then the Resmed Aircurve ASV. I just got my new Resmed Aircurve ASV this week, It is replacing the same exact model that I did get 3 years ago. I will def do some research. Most likely going to sell my used Resmed Aircurve ASV as I don't need 2 - just unsure what to sell it for, they are expensive

Yes, there are home units that go above 25cm.
You will note on your chart that the machine is at 25cm and there is little movement on the flow chart. Have to tried the collar and if you are getting a seal at 25cm. Until this is worked out there is little that I can advise. A case similar to your chart turned out that the guy had a FFM and a beard. it could never work.

[palerider]

I always sleep on my right side. /Sorry about the pie. I like pie , jk......

The Epap is topped out at 15 no? I cant seem to get it any higher

I did buy a cervical collar, i am going to have to get use to wearing it

ugg I guess no other machine goes above 15?

....
only a more advanced ASV can use higher pressures. You may end up needing another titration for insurance

I did not know there were more advanced ASV's then the Resmed Aircurve ASV. I just got my new Resmed Aircurve ASV this week, It is replacing the same exact model that I did get 3 years ago. I will def do some research. Most likely going to sell my used Resmed Aircurve ASV as I don't need 2 - just unsure what to sell it for, they are expensive

Yes, there are home units that go above 25cm.

There are no ASV machines that go above 25cm.

The Resmed S9 COPD, ST-A and the Aircurve 10 ST-A (I believe) go to 30, but they are not ASVs.

[metsfan302]

Ugg. Last nights sleep was pretty gappy lol if that is a word. I did take off my mask upon waking each time. Had 2 ok sections of sleep i guess mostly around 11:30pm - 1:45 and again 2:20ish am till getting woken up with what seemed mask just blowing tons of air at the end 4ish or so. Ugg. Getting 3 months worth of fresh P-10's hopefully today or Monday depending on the mail. I've used them for a few years no issues at all it seems to me - but i might go to the bin and try something else if needed. I can def try the collar again but when I did use it the other night saw no diff results on the graphs

Thanks Pale I saw your signature - I tried to look as I thought I had the most current / best asv

here are some screens of last night, does that resmed software show anything better or anything as ive only been using sleepyhead since finding out about it.

heck I dont even look online at the myair thing lol

Let me know what sections if any you need to see.... Shall I make an appt with a Pulmonologist as sleepR mentioned - is there anything he could do that my sleep dr cant? I am sure I could ask my sleep dr to send me to Pulmonary function tests or any other sleep studies I should ask her for etc??

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My Saga continues.... thought once I got the ASV years ago it was the final solution to the puzzle lol

[metsfan302]

Was just reading thru the 2 sleep studies I have had. I do not think I have ever had a proper ASV titration type sleep study. I think my last sleep study was only to show I fail on Cpap/Bi-Pap in order to get an ASV. Is my thinking correct?

Here are links to my sleep tests - Not sure if they provide anything of use

Orig Sleep Test Page 1


Orig Sleep Test Page 2


Latest Sleep Study Pg 1


Latest Sleep Study Pg 2


Latest Sleep Study Pg 3


Latest Sleep Study Pg 4


Latest Sleep Study Pg 5


Latest Sleep Study Pg 6


Latest Sleep Study Pg 7 - no clue what this showed even

[metsfan302]

Page 6 of the study - is that the bi-pap or ASV titration part?

[Pugsy]

This latest sleep study was regular bilevel titration and the recommendation was to have a titration on ASV.

[metsfan302]

Seems I should ask for one, wonder why my dr did need me too or want me to get one and just started me off with my orig cpap pressures?

Well last night I did set up my settings to the default start lvls but instead of the 5 min epap i used 6........  tired today more so then on the higher setting but here is what it looked like - just wanted to see what would happen and as predicted ugg....... guess just max my settings out or try a reg flat asv setting vs asvauto i dunno  

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[esel]

This is likely off the wall but may be worth a try...

Set Min EPAP 9 and PS 2 - 8. This will limit Max IPAP to 17. The reason for this is to see what happens when the pressure cannot go up too high.

On Feb 2 you had a couple of periods that looked better than the rest of the night. (20h10 - 20h50, 22h40 - 23h20, 24h10 - 1h00, 3h30 - 4h00). In these periods the pressure is between 9 and 11 cmH2O for the first 2 events and below 9 for event 3 and 4.

Just a thought.

Good luck

[metsfan302]

Well I thought I would try out the large pillow vs the medium last night and this is what happened,   i think a ton of leakage overnight. UGG No Clue What to Do now!

Last night I upped my Min Epap to - 13.6
min ps to 6.0 with a max at 11.4

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[metsfan302]

ugg, Seems my CMS-50D won’t work / transfer data without using the orig cable it came with. I tried using a diff mini usb to usb and my comp did not see the pulse ox. Going to have to dig deeper or buy another cable.

I guess I will have to find both an ENT dr and a pulmonologist this week. I also requested another sleep study from my sleep doc - however I doubt that they will be able to properly tritrate me with the pressures I seem to need - maybe. Going to have to look into this
drug induced sleep endoscopy (DISE) someone else mentioned

Thanks again those that have been helping along the way!

Let me know what I should set my asv to on the reg asv settings vs auto. Wonder why the pressures can go higher if not on ASVauto? Is there a diff brand besides philips or Resmed that is able to go higher? Wonder if Resmed or anyone could mod mine to go higher and damn it on me for being an odd ball that needs so much pressure. Getting so frustrated

[metsfan302]

Got an appt for the 13th - a ENT. Unsure what to expect or even what needs to be done if I am fixable lol.

Called the pulmonologist, They said it would be quicker if I got a referral from my general dr or sleep specialist..... going to do that today. Unsure what a Pulmonologist can do or does even but will see.

Also getting scheduled for an ASV Tritration - unsure what thats going to show/ do but atleast ill have it

[bwexler]

I would think a pulmonologist would attend to a Pullman car on a train to assure everyone gets a good night's sleep.