Understanding Pressure Sup. on my P.R.S.O Bipap AutoSV adv.

sleepinglass wrote: up from 2 to 3 and my readings are worse. My AHI up from 0.5 to 1.66.

I have a different ASV machine but if it's any help I stopped worrying about changes as tiny as 0.5 to 1.66 in AHI which statistically are right at the border of what mass produced machines can resolve. For me it became a question of how did I feel the next morning and, more importantly, how was I responding to the pressure changes during the night. Example: If I set my PS min too low at say, 3.0cmH20, I get a weird warbling on the initiation of inhale which also shows up on my flow line. Another example: If I set my EPAP too low I get a 'lurch' in my inhale flow line which I can also feel when I breathe in. Very discomforting. If I set my EPAP too high my mask likes to buckle and whistle (yes, I'm looking into different masks). I'm not suggesting you will have my specific problems which I just mentioned but I am suggesting that you widen the scope of your inquiry. More to the point, one should start to get a feeling for the parameters of the ASV therapy within the bounds of comfort and efficiency... not solely in terms of small AHI fluctuations. IMHO

Sir Nod that is certainly a lot of food for thought.

Numbers do not mean much to me, as I am still a novice at interpreting them. Some people on this forum have some seriously heavy numbers. I know that I do not fall into that category,so I think I am fortunate that I do not have much to worry about, except for feeling exhausted pretty much all the time and do not feel at all refreshed in the mornings.Just hoping that this will not have serious health repercussions later on in life, as this has gone on for many many years now, often surviving on 4-5 hours sleep a night.

I wonder if I form part of a group of 'invisibles ' whose numbers are not 'juicy enough' to be taken seriously by the medical profession, so just end up being unceremoniously put on the ignored, un-listened to, 'don't make a fuss now', 'scrap heap'. Has anyone else thought that?

Unfortunately I do not do sleeping pills,so I shall just have to continue riding this out.
Quitting is not an option either!

So it may be an interesting experiment to try,as things will either get better or continue to be bad, can't get much worse. I reckon settings may be on the low side as I have tried PS 0,1, 2 & 3 so possibly tonight I may try 4.5 to see what happens and leave other things unchanged:
Epap min 7
Epap Max 15
PS min 4.5
PS max 15
Max pressure 25
Rate auto

I'm pretty shattered,so it will be interesting to see what happens. So appreciate the forums support right now. Thank you.

Geez! Give yourself and the machine a break! It took you YEARS to reach the point that you needed the intervention .. and you expect it to be instantly 'fixed'. Give me a break! It's time for a few reality checks.


Reality One: IT TAKES TIME TO ADJUST TO ASV THERAPY!!!! Yes, I'm yelling. Get it into your head that it will take MONTHS for you to fully adapt to the therapy. You will have a bit of an up and down until then. And hey, even after that you might have some bad days. But it TAKES TIME!!

Reality Two: Any AHI score of 5.0 or less is considered normal. So, at 1.66 you are doing well. DO NOT CHANGE ANYTHING ELSE!!

Reality Three: Lots of people seem to think they aren't getting the full capability of their machine unless their AHI is 0.0. And that's just plain BOGUS. We are ANALOG critters. We will always have some nights where are scores are higher. And others when they are low. It's the AVERAGE score over a long period of time (at LEAST one week, and preferably one MONTH) that lets you know how you are doing.

Reality Four: It takes more than one night to see how well you are doing with the settings changes.

Reality Five: Doctors don't actually make as much as you would think per patient. They have to run a lot of us through to make the money. And they also know that it takes time for you to adjust to the therapy. Right now, your doctor just wants you to be complaint and learn to live with your ASV unit.

Reality Six: You've gotten older. You will never feel like you did in your 20s. So, don't expect this will be some fountain of youth. But it should help you start to feel more alert during the day. Driving is one time when you should notice it. If you don't fall asleep at the drop of a hat, you are regaining your ability to function.


So, please stop expecting an instant miracle. Go watch TV, if you expect life to be like that.

John

Reality Six: You've gotten older. You will never feel like you did in your 20s. So, don't expect this will be some fountain of youth.

You are a real buzz kill. I thought for sure a few days on my new ASV and I WOULD BE 20 AGAIN!

I also expected it to cure my arthritis, bursitis and grow my hair back on top of my head, instead of my ears and nose.

Thanks John, I appreciate your input. I take on board everything you say, a few of the bits and pieces do not apply to me as I am not in the US but all the same, thank you..

However, my view is, that I just want to learn as much as I can about Pressure Support on the AutoSV, because I am not feeling that great on it. So I would like to fine tune it, in such a way,so as to begin to feel better,otherwise it will go back to sitting in the wardrobe, where it has been gathering dust, for over 12 months!

Not too bothered about the numbers, as you quite rightly say, at this stage, because they are low anyway. And Yes you are quite right John, I would like to feel better yesterday but I do understand that I need to be patient,but I am young and being patient is on my ''to do'' list.

My sole aim is to learn form others on this forum, more experienced than myself, who have been on the AutoSV journey, who have learnt form their experimentation and are happy and willing to share their experiences/expertise/strategies, so I can learn for their mistakes and successes, if at all possible.

Thank you to the people who have PMed me, again I really appreciate you taking the time to do so and for the support.

Sir NoddinOff your sharing your experience of ASV with me, even though it is a different machine has helped me HUGELY, as I adjusted the pressure support last night to 4.5 and I slept much better and feel much more refreshed today and more compos mentis, which is a MASSIVE leap forward, in my view.

So i know I am going in the right direction! Just by making these very small adjustments, forum members input can offer invaluable help,ideas and food for thought.

Thanks again for all your kind support.

sleepinglass, I am one thousand percent in agreement that you need to be your own advocate. If I overreacted, it is because we had a flood of people recently who worried about not having an AHI of zero. As long as you remain data based, worry about the overall tend and accept that "good enough" really is good enough, then you will do well. Stop when you don't understand .. ask away. We WANT you to be successful.

Thank you for your patience and explaining. For someone who wants to become their own health advocate and work toward better sleep, we are more than happy to help.