ASV Titration study a disaster(my opinion)

[Larsdad]

Hello All,
After my sleep apnea diagnosis late last year, I had been using a DreamStation 2 with nasal mask and wasn’t improving my AHI numbers with majority being Centrals. Sleepy Dr ordered a titration study using an ASV machine,( it was a Resmed, probably one of the newest ones since the hospital had to reconfigure their lab because of the respironics recall and they were set up with those )
The study was done at the sleep lab. At the techs suggestion, I used a full face mask to start.(told tech I usually used nasal mask and taped my mouth shut.worked for me) Don’t know what pressure they started with but I could not fall asleep. It seemed like every 3r or 4th breath the machine would puff a large volume of air and that’s all I could think about.Kept awake for at least 45mins to an hour. I dozed off a couple of times but would wake up with the increased pressure that sporadically came. Finally Tech came in and wanted to go to a different face mask type saying the other one was leaking and causing the problem. Second mask was no better, same issues, same waking up. Third mask was a nasal type. Probably felt more comfortable with it than the other 2 but my mouth would open and cause problems. Tech came in and used some kind of elastic device around my chin and top of head to keep mouth shut. It was not comfortable at all and with machine puffs of air struggled to get to sleep again but finally did. At the end, the tech said she had problems adjusting the machine because it was sensitive to mask leaks and would try to compensate. Also said the tape probably would have worked better than whatever she used..
Epilogue: I went home to get some sleep.

For those of you who use ASV, what does this study sound like?
I will be interested to see how this report comes out because my initial reaction is , if this is ASV it’s not for me..

Thanks,
Larsdad

[readingteacher]

I'm sorry your titration study was so miserable, but then sleep studies are frequently uncomfortable and challenging!

My initial sleep study results showed complex apnea (both obstructive and centrals). Due to insurance requirements, I had to start on a CPAP. It took care of the obstructive apnea, but like you, not the centrals. I was still exhausted, to the point that I thought I might have to stop working. My doctor ordered a titration study for ASV.

I have been on an ASV since April. It's a world of difference! My AHI dropped from 10 - 18, to between 1 and 2 every night. I feel so much better.

It's too bad the technician did not give you the option of using your own mask and mouth tape that was working well for you. I took my own nasal pillow headgear and tape to my titration study. I cannot use a full face mask due to a severe TMJ issue. My technician also said that ASV is sensitive to leaks, but she let me use my own gear with the caution that if there were leaks, she would come put a FFM on me. That was not necessary, as no leaks. I am still using the same model nasal pillow and mouth tape with my ASV. I think if you are not having leaks with the CPAP, it is likely that your usual mask will also work with the ASV.

It's also too bad that the technician did not let you fall asleep on straight CPAP before she started the ASV mode. That's what mine did. Was my night in the sleep lab wonderful? No! But I was able to get several hours of sleep so they could get good data.

With my ASV at home, I use the ramp feature to fall asleep. I know that no ramp is suggested as best since you are not getting treated during the ramp time. But I need that "quiet" steady time without the machine puffing at me to fall asleep. I started at 30 minutes ramp and gradually decreased the time. I have settled on 15 minutes of ramp. (I tried 10 minutes but it was not enough for me.) Most of the time, even if I'm not fully asleep after 15 minutes, when it starts ASV mode it doesn't bother me because it starts off gently.

I honestly am not aware that the ASV machine is working during the night. I am sleeping! The way I know it is working is because my AHI is so low, and I feel so much better.

Don't give up on trying an ASV based on that miserable night in the sleep lab! If ASV is what you need, it can be life-changing, or at least life-improving. It takes some getting used to, but I found it much easier to switch to ASV than it was to start CPAP as a new user.

[Deborah K.]

My husband had a titration study in order to get a bipap machine. He was completely miserable the whole night and felt like he hardly slept. BUT they apparently had good test results anyway, and he has felt tremendously better since using his machine. Hang in there!

[Respirator99]

In my (not so) humble opinion titration studies are a scam - a great way for docs and sleep labs to make a lot of money without producing usable results. You're in a strange bed, in a strange environment, with 19 probes and electrodes all over your body: just relax and sleep normally! Lots of luck with that.

Now that the ordeal is over, it's time to take control and get the ASV working for you. The results of a well-tuned ASV are extremely good, with AHI in my case dropping from over 60 to consistently below 1.0. But the ASV does take some getting used to initially, and there are a couple of tricks to learn.

Use whatever mask works best for you - you don't need any specific mask for an ASV and your technician was wrong to try and force one on you.

You can use the ramp function (as described above) but I found the transition from ramp to therapy pressure was sometimes abrupt and would wake me, so I prefer not to use the ramp.

The Resmed ASV will attempt to follow your own breathing pattern. So when you start up the machine it's important to breathe slowly and evenly and allow the machine to synchronise. If you hold your breath or breathe unevenly the machine will try to correct the rate by giving you a strong puff of air - if this happens, just blow back hard and the machine will reset its rate. This might happen a couple of times, then the machine will back off and try to re-synchronise. You'll soon get the hang of it and be sleeping like a baby.

It's very unlikely the prescribed pressures from the titration study will be optimal. This is where Oscar comes in - use the prescribed settings as a start and monitor your results with Oscar. Upload the daily charts here and members will be able to give you some specific advice for adjustments.

[Sheriff Buford]

There a lot of people in this forum that will attest that their sleep study was a nightmare.... they didn't sleep... etc... Try to move on and concentrate on proper treatment. Your Oscar reports will indicate if you have sleep apnea or not.

Sheriff

[chunkyfrog]

Medical testing of any kind is rarely agreeable, and never pleasant.
We just grin and bear it.
And hope for accurate results, requiring the least trauma possible.
We can all imagine worse things than a sleep study.

[Larsdad]

Thank you so much for all your support and input on my experience, it’s appreciated!


Until I have an appointment with the sleepy dr I wont know what will be recommended. I will try to report back on anything of interest.

[ChicagoGranny]

I will try to report back on anything of interest.

Thank you.

Please stick to this thread so that members can easily follow your history.