Newbie Self Diagnosis - In Denial - AHI Question

[ajack]

Just a quick statement, I saw it suggested in this thread that an ASV is the best machine for everyone. This is simply wrong. ASV are for central nervous system disorders. S, ST or I/A vaps etc. are better for some.

[Pugsy]

Just a quick statement, I saw it suggested in this thread that an ASV is the best machine for everyone. This is simply wrong. ASV are for central nervous system disorders. S, ST or I/A vaps etc. are better for some.

Actually ASV can be used for plain OSA and even UARS. Granted not common but there is zero reason why it can't be used for run of the mill obstructive stuff too. I did it myself for years and had great results.

You might want to read up a little bit on what Dr Barry Krakow does and says.

[palerider]

Just a quick statement, I saw it suggested in this thread that an ASV is the best machine for everyone. This is simply wrong. ASV are for central nervous system disorders. S, ST or I/A vaps etc. are better for some.

AS with everything ajack says... best to ignore... put him on the foe list.

One of the members of the forum here, an actual board certified sleep doctor, (OKCSleepDoc) told me he'd been playing around with ASVs and was trying to figure out how to get them approved for all his sleep apnea patients, because there wasn't *ANY* harm he could find for anybody using an ASV. (note, this doesn't necessarily apply to people with lung diseases, just sleep apnea patients.

[palerider]

Just a quick statement, (ignorant drivel...)

You might want to read up a little bit on what Dr Barry Krakow does and says.

Oh, ajack(ass) reads tons... he just doesn't *understand* any of it... just parrots back inappropriate things.

[ajack]

That doctor is also wrong. An ASV isn't suitable for hypoventilating people and those with some other both neurological and physical issues. all available on google.
The reason an ASV isn't for everyone is because it can't adjust to maintain a constant minimum minute ventilation over the long term. It mirrors the last few minutes and can cycle down to very low levels. Other modes can maintain a constant minimum minute ventilation or tidal volume.

https://www.youtube.com/watch?v=49hZ8G_r0IM

[palerider]

That doctor is also wrong.

Nobody with any sense cares about what you say... go back to your booze.

[ajack]

The only ones that should care are the ones believing half of the nonsense I see posted. It's not that hard to google OHS, as well as others and see that an ASV isn't suitable.

[marktheshark]

Hey pugsy, pale ....... Think Mark is going to be getting my ASV later this week, What do you think the settings should be to start? Have sent all clinical menus via email, just wanted to set pressures to something diff vs my crazy ass settings lol

Minepap 10, autoasv mode, defaults for everything else.

Howdy, so I got the new machine. Here is what I see that I hoped for clarification.

Is this exhale pressure?
Min EPAP
Max EPAP

And inhale pressure?
Min PS
Max PS
Or maybe I have these backward lol

Right now the default settings are: Min EPAP 4.0 Max EPAP 15.0
Min PS 3.0 Max PS 8.0


What I have been doing with cpap machine that I have is ramp set at Min 6.0 for 25 minutes then it goes to min 9.0-14.0

I have the manual but figured you all have more experience.

[Pugsy]

EPAP is the exhale pressure

PS is Pressure support or the difference between inhale and exhale.

So you have to add PS to EPAP to get what your IPAP is and obviously with these settings IPAP can vary

Only thing I would suggest...increase that minimum EPAP from the default of 4 to 6...and see what happens.
That will give you at least at the beginning of the night
6 exhale
and 9 inhale
The 6 plus the minimum PS of 3 equals 9 inhale which is similar to the 9 minimum you were using on the auto machine unless you were using exhale relief.
It's close enough to start with and should be fairly comfortable.

[marktheshark]

EPAP is the exhale pressure

PS is Pressure support or the difference between inhale and exhale.

So you have to add PS to EPAP to get what your IPAP is and obviously with these settings IPAP can vary

Only thing I would suggest...increase that minimum EPAP from the default of 4 to 6...and see what happens.
That will give you at least at the beginning of the night
6 exhale
and 9 inhale
The 6 plus the minimum PS of 3 equals 9 inhale which is similar to the 9 minimum you were using on the auto machine unless you were using exhale relief.
It's close enough to start with and should be fairly comfortable.

So I don't have to set the exhale setting, that's automatic if I read you right.

[Pugsy]

Minimum EPAP is the minimum exhale setting...EPAP can vary but won't drop below 6 if you set it at 6 like I suggest.
Think of it as being sort of like the minimum setting on the apap....needs to be high enough to give the machine a good headstart to where it needs to go. This machine will increase/change pressures faster than your apap but it still needs a good baseline to start from.

If EPAP goes up...it will push IPAP up.
If IPAP needs to go up it will drag EPAP up...
The difference is PS and it can also vary within the parameters set. I would be real surprised if your PS ever goes over 5 much.
When I was using this machine my PS ranged from 3 to 4 most of the time with only an occasional high burst to probably deal with a central which was rare since I didn't have many centrals anyway.

[marktheshark]

Minimum EPAP is the minimum exhale setting...EPAP can vary but won't drop below 6 if you set it at 6 like I suggest.
Think of it as being sort of like the minimum setting on the apap....needs to be high enough to give the machine a good headstart to where it needs to go. This machine will increase/change pressures faster than your apap but it still needs a good baseline to start from.

If EPAP goes up...it will push IPAP up.
If IPAP needs to go up it will drag EPAP up...
The difference is PS and it can also vary within the parameters set. I would be real surprised if your PS ever goes over 5 much.
When I was using this machine my PS ranged from 3 to 4 most of the time with only an occasional high burst to probably deal with a central which was rare since I didn't have many centrals anyway.

Got it, thanks!

[palerider]

Hey pugsy, pale ....... Think Mark is going to be getting my ASV later this week, What do you think the settings should be to start? Have sent all clinical menus via email, just wanted to set pressures to something diff vs my crazy ass settings lol

Minepap 10, autoasv mode, defaults for everything else.

Howdy, so I got the new machine. Here is what I see that I hoped for clarification.

Is this exhale pressure?
Min EPAP
Max EPAP

And inhale pressure?
Min PS
Max PS
Or maybe I have these backward lol

Right now the default settings are: Min EPAP 4.0 Max EPAP 15.0
Min PS 3.0 Max PS 8.0


What I have been doing with cpap machine that I have is ramp set at Min 6.0 for 25 minutes then it goes to min 9.0-14.0

I have the manual but figured you all have more experience.

Pretty sure Pugsy explained everything, but if you've got any other questions, ask away

[Jas_williams]

If you find your awake and just about to fall asleep and the ASV gives you a puff of air as your breathing rate has dropped perform a “blow back” blow hard at the machine and it will back off for the next 3 minutes during that 3 minutes try and breath smoothly and evenly hopefully you will be asleep by the time the ASV gets back in its stride.

[metsfan302]

How did ya do with the new machine? Hopefully a good sleep, might take a bit to dial it in, but boy does it really work for you and with you vs other brands n types.