ASV Help Needed - See Page 3 AHI from 1-4 up to 50+

[NJSleepless]

I am starting to get much more acclimated with my machine. The company would not replace my mask but sent me some nasal cushion for the bridge of my nose. Over the weekend I had two large leaks but the mask is not staying firmly in place.



I was wondering if anyone could explain what a patient triggered breath is. Also, is the leak % I have poor?

[Pugsy]

Patient triggered breath means you initiated the breath and not the machine.
When you don't breathe yourself, the machine will breathe for you.
98% of the breaths were your own. This is very good and can vary. The machine didn't do it for you except 2% of the time.

[NJSleepless]

Patient triggered breath means you initiated the breath and not the machine.
When you don't breathe yourself, the machine will breathe for you.
98% of the breaths were your own. This is very good and can vary. The machine didn't do it for you except 2% of the time.

Thank you Pugsy. I am really starting to get the hang of this. I feel pretty good although still not "perfectly" rested. Compared to before though I have to say this is amazing. I cannot believe I did not get treatment sooner.

[NJSleepless]

Update: I wanted to let everyone know that I am now fully acclimated to my machine. I have found the right Bi-Flex setting for myself, determined the correct humidity, have the mask fitting perfectly, etc. This forum has been such a great resource and I am so happy to have been able to learn more about my machine, the data output and how to understand it and the support you other forum members are willing to provide.


Question: I am going to my doctor after Thanksgiving, per my insurance company’s compliance requirements, to discuss my sleep therapy progress. My AHI has unfortunately risen as of late with my central apnea and hypopnea numbers on the rise. If I recall correctly the second study I underwent recommended adding oxygen therapy to my treatment so I want to investigate this further.

For those of you who have needed to add oxygen, did this require an additional study for you or was your DME able to just come over and set it up?

[rested gal]

What a great job you're doing, NJsleepless, working out your new kind of therapy on an ASV.

And what a fabulously good job (as always) JohnBFisher and Pugsy are doing to help you.

[NJSleepless]

What a great job you're doing, NJsleepless, working out your new kind of therapy on an ASV.

Thank you! Hopefully the addition of oxygen will alleviate any further issues. Overall though what a difference!

And what a fabulously good job (as always) JohnBFisher and Pugsy are doing to help you.

Seriously, thank you both. The information and resources that the two of you have provided me proved invaluable to understanding my treatment so much more effectively than anyone else has been able to (including my Dr.)!

[cflame1]

you may want to try something like:

http://padacheek.com/PAC_AntiLeak_Strap.html


Padacheek's got some really good things on her website for making stuff more comfy

[NJSleepless]

THIS IS WHERE I NEED HELP


Hey everyone, I am having some serious issues now with my sleep disorder and I suspect the machine is making things worse. As you can see from my earlier charts, therapy was going quite smooth. The past two weeks - downright terrible! I don't have a sleep doctor, I had my GP order the sleep studies and contact the DME. So I'm uncertain who to call regarding these new developments. All I know is that the pressure on my machine appears to have dramatically increased. When I awake in the middle of the night to use the bathroom it's blowing so much stronger than I'm used to.

I’m feeling very poor in the morning and throughout the day. What do I do to get my prescription adjusted? Call the DME, my GP or do I need to go in for another sleep study with my machine to have the settings adjusted?

Any and all advice is greatly appreciated!


I have the Wave Forms for this and several other nights with high AHI. I mean, last night was 50.7 - Up from 1-5. This is insane

[NJSleepless]

So I went from an AHI of between 1-5 and all of a sudden my condition deteriorated swiftly with an AHI of 50.7.

I cannot tell if it's my machine or if it's my health deteriorating in general. I am clueless as to what I need to do and how to handle this. My diet is the same, daily activity is the same, medications are the same. I'm at a loss. All I know is I feel terrible and these charts are quite alarming. Note: The averages are based on 30 days, not the default setting of 7 via the software.

EARLIER DATA IS PROVIDED IN THE POST BELOW.

[NJSleepless]

I have my data from my first month to compare with the above post and it's astounding how much of a contrast has developed below.

[NJSleepless]

Here is data from a month earlier to compare with the above charts

Please note that data averages are based on 30 days and not the 7 that was the default setting.

[ameriken]

NJ, I'm no expert, but a little experimentation on your part could yield some good results.

Here's a couple of things you might want to try, which I had success with.

My minimum settings from titration were

MinEPAP=7
MaxEPAP= 18
MinPS=5
MaxPS=18

Note my max EPAP and PS are 18. It looks like at night your pressure is pushing the higher limits, I wonder if they're not high enough? I wonder if bumping both the maxEPAP and maxPS to 18 (like mine)and allow the machine to give you more support on the high end when you're having apneas and hypopneas?

Also, you might want to consider higher minPS. A month ago my AHI's were increasing from 3 to 10 to the 10 to 20 range. I bumped my minPS from 5 to 7 and minEPAP from 7 to 8 and that pretty much solved my AHI problem, I haven't had a 5 or over since I made the change.

I'm wondering if our bodies adjust to the machine somewhat and then we later need higher pressure. But short of that, if this keeps up I'm wondering if there is something wrong with the machine itself and it's just not delivering the pressure you need? But again, assuming the machine is ok, if it were me I'd be looking at the higher pressures.

Let us know how it goes!

[NJSleepless]

This is excellent advice Ken. MY concern is that I am still in the trial/compliance stage of my insurance and am uncertain if I can change the settings without violating the trial period. I am absolutely going to investigate this further though.

My current settings are:

MinEPAP=8
MaxEPAP=15
MinPS=5
MaxPS=15
MaxPressure Setting=25 (not sure what this falls under for settings)
BPM=Auto

[ameriken]

My current settings are:

MinEPAP=8
MaxEPAP=15
MinPS=5
MaxPS=15
MaxPressure Setting=25 (not sure what this falls under for settings)
BPM=Auto

I hear ya. Give it a try when you get the first chance. You might want to do it 1 at a time and see what is comfortable and just experiment with it. I noticed if I go too high on the minEPAP, then my PTB's drop off. So, it's just a matter of experimenting little by little and watching the reports. I was amazed when I saw 1's and 2's on my AHI's. In the past month that I changed it, I haven't had one day with over 5 and I've only had 2 or 3 days right at 5. Everything else was in the 1 to 4 range!

My original and new settings are

MinEPAP=7 8
MaxEPAP=18 20
MinPS=5 7
MaxPS=18 20
Max Pressure=30 30

[Mr Bill]

...
The only complaint I have as of now is with my mask. It left a mark across the bridge of my nose the entire day and it was quite sore this morning. I think I would be better off with a full face mask and plan to call my DME Monday to discuss this. I had it strapped pretty darn tight last night with minimal leakage when awake. But I have a strange nose size; narrow and small but long as far as height and during my first short evening treatment it was leaking near my eyes as well as my chin.

Does anyone know of a good full face mask? I don't know if a DME can provide any brand or if they contract with specific providers only. If I had to purchase one on my own I would like to investigate options but I will speak with my guy first and see what they have to offer. I will post the as soon as I hear.

Hi and welcome to the forums. I just wanted to comment on this one thing. Its tempting to put your mask on too tight. If you have a nasal mask like mine, the looser and still able to hold pressure, the better. The pressure actually makes the seal, not the tightness of the strap.

Secondly, now that your AHI's are dramatically worse; is this since changing to a full face mask? If you mouth breath it can decrease the effectiveness of your therapy. Of course if you can't help mouth breathing, full face is better than nothing.

Here is a link to one of my recent nights...
viewtopic.php?p=615607#p615607
As you can see my pressures are quite low. My doctor insisted on trying oxygen because my mom has mild CSA and oxygen did the trick. But at all pressures, oxygen made my AHI's worse. But it would take a sleep study to determine that.

I notice a lot of vibratory snores. I wonder if that is in your throat (and thus fixable by pressure) or in your sinuses? Lots of snores makes me think maybe not enough support pressure. But keep in mind that increasing support pressure can increase central events in a CSA patient. Thats why the ASV has low setting and a wide range, its supposed to give you just enough support to clear your airway without causing more central events.

Nutty as this sounds, I can only sleep well on my back since getting my ASV. I have far more hyponeas if I sleep on my side. Your ASV will totally take care of OSA events that might be more likely from sleeping on your back, so give it a try.

Keep posting how you are doing.

P.S. Are you adjusting your humidity? Some people like it really humid. Others like myself find that increasing humidity causes sinuses and airway to stop up. So, try varying your humidity.