ASV Machine?

So I finally got my ResMed Aurcurve ASV machine and used it last night. My numbers were way better (4.5 AHI) and I felt totally different this morning. I was able to wake up easily, compared to my old Resmed Airsense machine. The only thing I found odd is that breathing felt unnatural when using the machine, that is the only way I can explain it. Breathing out did not feel right, like it was forced or something, hopefully I can adjust to it. Is anyone else using this machine or an ASV machine?

Joel

That's because your breathing is kinda forced by an ASV. Unlike cpaps (on flex) or bipaps which change pressure in response to your inhalation and exhalation, ASV's attempt to maintain a rate and rhythm and volume for your breathing. It can and does change pressure without waiting for your cue. But most of us don't have a perfect rhythm, which makes it impossible for the machine to set up a perfect rhythm. Once you are asleep, the two come into better sync. It's like learning to dance together.

While you are awake, your breathing changes as you roll over, or sigh, or pause while thinking about something and a whole myriad of reasons (I have very irregular breathing while awake). It can make falling asleep with an ASV a bit of a pain at first. Just breathe over it, and the machine will try to adjust. For example, if the pressure drops while you are still inhaling, just keep inhaling and the machine will sense that and increase again. Sometimes it will up the pressure while you are exhaling. Keep exhaling and it will sense that and drop off the pressure again, so you can lose that blowing into a wind tunnel feeling. Ultimately you ARE in charge of breathing but the machine has to learn your rate over and over and over again, and adjust as your rate changes.

It will get easier for you as you adjust to the machine and just remember that you are in control. It's just that sometimes it tries to help you when you don't need help - it has no way of knowing that you are awake and slowing your breath rate for some reason - it thinks you are having an apnea event.

For what it's worth, they make really cool noises when you get frustrated enough to scream into a full face mask!

Bons wrote: . . . make really cool noises when you get frustrated enough to scream into a full face mask!

In ASV, no one can hear you scream.

VERY nice post, Bons!

That's very common. It'll take maybe a few days or a few weeks, then your respiratory system and brain with get with the ASV program. Stick with it.

Also something strange is happening with my nasal pillow mask. It is really starting to irritate my nose quite a bit, I currently have the medium sized pillow, should I go up to the large? Also my numbers were HORRIBLE last night, and I think it was because I woke up a lot due to the irritation of my nose.

I have also noticed that my breathing during the day 'feels' different. It is hard to explain, but I feel like the machine is doing something to my breathing, even when I am not using it. Has anyone else experienced something like this before? It almost feels like my heart rate or blood pressure or something are elevated also.

Odds are good that it is psychological. Sometimes when people start treatment we can get obsessed a bit with breathing and notice every nuance of every breath. Been there done that. Also our lungs get a bit of a workout and that might feel odd for awhile.

Have you had your heart checked ? SOMETIMES central apneas result from heart conditions. My sleep doc ordered a stress echo just to check (because I'm also often exhausted). A cardiac ejection fraction below a certain level makes ASV use prohibitive.

My OSA was quite severe with accompanying centrals, and during the first several months of auto-bilevel (not ASV) treatment, my day breathing changed quite a bit as well. It felt as if I were pausing way too long between some breaths when at rest. I assumed my body's CO2 set-point was adjusting for day breathing to accommodate the healing that was occurring at night. The sensation was accompanied by something akin to light-headedness, though never dizziness. It all went away after a few months. But nearly everything about my body changed during my first two years of treatment, which I took as a testament to just how bad off I had previously been without knowing it.

That said, though, I would never tell anyone to ignore any breathing/heart changes that he/she finds disturbing. Changes can be for the good or for the bad, and only a doc who knows your personal history and family history has enough info at hand to make an educated guess about what you are experiencing. For some, the healing that occurs with successful PAP treatment lowers the needed dosage for certain medications, such as blood pressure meds. So if you are on any medications at all, you don't want to hide anything that feels odd from your doc(s).

I am relatively young (30 years old) and am not overweight, I weight about 215 lbs. I take a medication at night that I believe causes my obstructive and central sleep apnea, and I do not have any heart issues or anything like that. I think I am going through what jnk went through when he started treatment, my body is adjusting to the ASV machine. It could also be a mental thing, who knows.

Can I ask what medication you are taking?

PEF wrote:Can I ask what medication you are taking?

viewtopic.php?f=1&t=106443&st=0&sk=t&sd ... 5#p1010944

If I experienced any daytime breathing changes while on Saphris, I would tell my doc, just to make sure it wasn't an early indication of some more serious side-effect, since "trouble with breathing" is listed as a Saphris major side-effect that requires immediate notification of doctor.

Thanks, jnk!

PEF wrote:Thanks, jnk!

Actually, thank YOU!

( . . . since my previous answer lacked due diligence.)

My numbers have been frankly, horrible on my ASV machine. Like last night they were 10.9. I do not know anything about the settings on an ASV, but I do know my minimum pressure is 5 and maximum is 10. The lowest my AHI has been on it so far is 4.5. What should I do with my settings to get better numbers? Getting my doctor to respond is like calling the White House or something, it takes so long, so I figured I would ask everyone here.

joeljjk11 wrote:I do not know anything about the settings on an ASV, but I do know my minimum pressure is 5 and maximum is 10. The lowest my AHI has been on it so far is 4.5. What should I do with my settings to get better numbers?

It's time to learn about your settings.

Go into the clinical setup menu and write down every setting you see and report back.
I am wondering what is "max of 10" because you can't treat centrals with a max IPAP of 10 so I am assuming something else is max of 10.
We can't tweak anything until we know what we are dealing with and understand it....so time to learn.

Also need to know what the AHI is made up of (each category) instead of just an AHI number. It's probably going to be apneas and hyponeas (or if using SleepyHead software UAs and hyponeas) since the Aircurve doesn't distinguish between OAs and Centrals and just calls them apneas.

I will let you know, I am at work now. What should I do about my breathing feeling odd? Is it because my CPAP had 16-20 pressure settings and the ASV is much less? Do I just have to adjust to the machine? Like right now my breathing feels strange and just not normal, almost like my heart rate is elevated or my blood pressure is off.

Joel