ASV users: the everything ASV thread.

[Starlette]

We ALLL have a love/hate relationship with this hobby from hell.

[jedimark]

Ken and Kody,
Respironics machines are set at the factory to GMT and there is no way to reset the internal clock. It runs off of a battery and as the battery ages the machines gradually loses time. It has been a common situation with Respironics machines for a very long time.

There is a device that plugs in behind the SD card slot on System One's, where you can reset the clock, flash the firmware, etc..

I doubt us mere mortals can gain access to one though..

[NJSleepless]

Can anyone tell me what the black dots represent in this chart?




Also, I am truly in dire need of advice from the ASV community. I have posted the details in my old thread - 4 posts total - (viewtopic/t65791/viewtopic.php?f=1&t=70 ... 53#p658853) and am extremely thankful to anyone who can help me.

I hope everyone had a wonderful Thanksgiving and are healthy and well.

[jedimark]

They mark pressure changes.. not sure which ones on ASV.

[backsavekkk]

yeah?

[NJSleepless]

They mark pressure changes.. not sure which ones on ASV.

Thank you jedimark.

[pharm30]

~2 weeks of 100% compliance, at least 6 hrs sleep/night!!
cut up one of my old pad a cheeks and put a strip on my nose and seems to work pretty good.
Had a couple AHI 3 days.

Still would love to take a nap most afternoons though.

[pharm30]

Don't know what is going on, very frustrated.
Had over 3 weeks of 100% compliance, avg AHI around 3, avg 6-7 hrs sleep a night.
The last week or so, nothing has changed, but I can't sleep. only 2 of last 5 days with >4 hrs with machine.
Last night I took an Ambien before bed, woke up with mask off, have NO recollection of taking it off.

I'm still not understanding this machine - I turn it on and breathe with it no problems for a couple min. Then all the sudden it starts cutting off my
exhales and increases the pressure on the inhales while I'm still awake and breathing normally. I don't get it.
Then checking out the graphs, a couple places show increased pressures where there are no correlating H/OA/CA marks... That is what is waking me up at night.

[teknomom]

Pharm30, As I understand it the data readout doesn't show "treated" OA,H,CA. When your pressure goes up like that it is treating an event, so there will be no corresponding event marker. The graphs show only "untreated" events. On my machine I show no event markers when the pressure is the highest but that is when my patient triggered breaths are lowest.

When I mask up, I start having central apneas long before I feel like I'm going to sleep, so the machine may be detecting the onset of CA events and trying to treat them. This may not be your experience but transitional central apneas are common.

I'm sorry about the insomnia and unconscious mask removal. I haven't had to deal with that - yet.

[ameriken]

Don't know what is going on, very frustrated.
Had over 3 weeks of 100% compliance, avg AHI around 3, avg 6-7 hrs sleep a night.
The last week or so, nothing has changed, but I can't sleep. only 2 of last 5 days with >4 hrs with machine.
Last night I took an Ambien before bed, woke up with mask off, have NO recollection of taking it off.

I'm still not understanding this machine - I turn it on and breathe with it no problems for a couple min. Then all the sudden it starts cutting off my
exhales and increases the pressure on the inhales while I'm still awake and breathing normally. I don't get it.
Then checking out the graphs, a couple places show increased pressures where there are no correlating H/OA/CA marks... That is what is waking me up at night.

Pharm....can you post one of the reports that shows the increased pressure but no related H/OA/CA?

Remember...in order to be scored as an H/OA/CA the event has to last 10 seconds or greater. The ASV intervenes far earlier than that to clear the apnea before it reaches that 10 second mark, so the reason it doesn't score it on your report is because the machine increased pressure and cleared it before the apnea actually became an apnea, which means: it's working.

Another reason for the increase in pressure is your PTB's, or patient triggered breaths dropped and so the machine intervened again to keep you breathing by increasing the pressure. Again, if the machine wasn't increasing the pressure, then it isn't doing its job.

[pharm30]

How is everyone doing?

I had a good last couple months, with almost 100% compliance and AHI ~ 2.

Last week has not been good, not sleeping well, night sweats, having to get up to go to bathroom (hasn't been a problem since I started).
Last night the machine wouldn't adapt to my breathing or something, I laid awake for at least an hour, it kept increasing pressure every couple seconds, it was acting like I wasn't breathing at all or something. I turned off and on a couple times, didn't help, so I took it off.

I called the DME and they are sending me replacement mask.

[JohnBFisher]

... Last week has not been good, not sleeping well, night sweats, having to get up to go to bathroom ...

If these symptoms continue talk with your doctor about it. There are several things that can cause this. Again, if this continues, it should be investigated.

[pharm30]

Pharm....can you post one of the reports that shows the increased pressure but no related H/OA/CA?

Remember...in order to be scored as an H/OA/CA the event has to last 10 seconds or greater. The ASV intervenes far earlier than that to clear the apnea before it reaches that 10 second mark, so the reason it doesn't score it on your report is because the machine increased pressure and cleared it before the apnea actually became an apnea, which means: it's working.

Another reason for the increase in pressure is your PTB's, or patient triggered breaths dropped and so the machine intervened again to keep you breathing by increasing the pressure. Again, if the machine wasn't increasing the pressure, then it isn't doing its job.

question about the PTB's - I am having more and more difficulty using the machine after several months of good compliance.
The last couple days I have set up my phone camera and vidotaped the display on the machine while I am lying wide awake breathing normally.
I have a minute or two of normal breathing - pressure ranges from 5-6 exhale to 7-8 inhale. Then all of the sudden, the machine jumps up to 12-13 pressure for a second, then back down to 5 or so, then cuts off my exhale and jumps back up to 10-12, and repeats. I am fully awake at this time.

I look at the corresponding graphs and my PTB and it starts at 100% and over that same time, PTB line drops steeply to the 70% 's.
Does this mean the machine is not detecting my breathing? Back up rate is 12 bpm, I usually average 15-17 bpm during the nights.
This has happened about 5-6 times in the last two weeks while trying to get to sleep. I've only been able to fall asleep and stay asleep >4 hr about 4 times in the last two weeks.
I have called the DME - they were supposed to come out today to look at my machine - of course there was a problem and didn't show up.
They called me ann hou

[pharm30]

(continued from previous post) the DME called me an hour before they were supposed to show up - the lady started asking me questions because she couldn't find my paperwork to give to the tech and had no idea what machine nor settings it was supposed to have.
When the tech didn't show up, I finally go ahold of him - he had no idea why he was coming to my house, the lady had not told him anything about the problems I mentioned. after I told him what was going on - he asked me if "anyone had ever explained to me how ASV machine worked?" I told him I have been following all my data since I have had the machine, that's how I noticed things seem to be different in the last couple weeks.
He said he wouldn't have another one because they are "special order"....

Last night the machine actually broke the seal on the nose of the mask and blasted air into my eyes, first time that has happened that I remember.
So, does this sound like a machine malfunction or is it all in my head?
I was doing very well, sleeping decent for months. Starting to feel tired and cranky again.
Getting very frustrated.

[JohnBFisher]

... Last night the machine actually broke the seal on the nose of the mask and blasted air into my eyes, first time that has happened that I remember. So, does this sound like a machine malfunction or is it all in my head? I was doing very well, sleeping decent for months. Starting to feel tired and cranky again. Getting very frustrated. ...

Sounds as if the mask might have been too tight and it led to the mask failure. Lots of leaks and interruptions due to the leaks will make your sleep anything but ideal. Sounds as if it is time for a new mask. An ASV unit does tend to wear out masks. That constant pressure change will make matters worse until you get a new mask. Hopefully that's all it is.