ASV Success, But ...

I’ve been on ASV for about two weeks. In that time, my SH results show ZERO Obstructive and Central Apnea’s, and ZERO Cheynne-Stokes. This is incredible, and very, very different from my first two years on CPAP. My AHI has not been over 5.00 even once. Again, incredible.

I see the occasional Unclassified Apnea, usually under 1.0, so I’m not concerned about that. But each night I have Hypopneas and Leaks. The Hypopneas average 2.5, the leaks average about 4.0. (Leaks are usually under 2, but I had leaks over 10.0 a few times.)

If I felt great, I would ignore the leaks and Hypopneas, but I feel exactly the same as always: exhausted. Now, I have fibromyalgia and chronic sleep issues beyond apnea, so the fatigue may be due to that. I’ll be seeing my doctor next month, but until then, here’s the question:

Should I keep trying to bring down my leak numbers? Is there a method for bringing down the Hypopnea numbers as well? (I won’t adjust the pressure, because it’s harder on an ASV, and anyway, the other numbers are ZERO.) Or should I just be happy - delighted - with my new results and let it go?

Thanks, all.

I'd wait to talk to your doctor about the other issues (that do sound like they could definitely have an impact).

Where are you getting these numbers from? Off the machine LCD screen or using SleepyHead?

If off the machine LCD screen...unless the leaks are waking you up you can safely ignore them. Those numbers are actually really low if they are from the machine's LCD screen.
They aren't necessarily high when using SleepyHead but if using SleepyHead I would want to know which statistic you are reporting.
Off the machine I already know what statistic it is reporting.

Yes, sometimes more pressure can reduce the hyponeas you are seeing. With the ASV machine...would depend on what settings you are using but if in typical setup for central treatment the only real option is more EPAP minimum unless for some reason the doctor has limited PS which I wouldn't think they would have done if you are using ASV for centrals and if I remember right you are.
Didn't you end up with Complex Sleep Apnea...where you had both obstructive and central sleep apnea?

If you will post all your settings I can maybe get an idea if more pressure would help and then you could talk to your doctor about changing the pressure if that is how you prefer to handle it.

Though I will be honest...I doubt that lowering the AHI will be that magic bullet you yearn for in helping how you feel.
You are like me...you have other issues that just screw with how you feel and how you sleep besides the sleep apnea.
But I don't blame you at all for wanting to at least try something to see if it helps or not...because that is what I would do and have done. I learned it wasn't the magic bullet but I know that I at least tried and leaned a lot while trying.

I glance at the machine screen sometimes, but otherwise all my data is from SleepyHead. My doctor based her decision to get me tested for Complex Sleep Apnea on the Sleepyhead printouts I showed her.

The data I put in the post above is not from the graphs, but from the box of different color stripes below the orange AHI banner, upper left. Also in that box:

PAP Mode: ASVAuto
Min EPAP 4.0
Max IPAP 32.0
PS 0.0-17.0 (cmH20)

Humidity Level is 5, btw

The graphs mean little to me, other than the Event Flag, which I understand, and the Leak Rate, which shows very low all night long except for one spike all the way to the top, and one spike halfway to the top (this is last night; my leaks were only .05, Hypopneas 2.32.)

My screen grabs are not great, but I’ll try to post one if it would help. I make them in vertical mode, so I can see a bit of the Session Information, so the graphs are squashed.

Thanks.

Hyponea hourly average of 2 to 3 not bad. Is there any clustering? Do you wake up often?
Will it help how you feel if you reduce them? Dunno. In all honesty...probably not.

If you can get a screen shot that shows the AHI and Statistics on the left and on the right....Events, flow rate, pressure and leak that might help get an idea if more EPAP would help or not.

Your max PS shows that IPAP can go up if needed so that means the only thing left to maybe change would be minimum EPAP and the need for that really depends on what EPAP does when the hyponeas are happening.
It works just like if you were using EPAP for plain obstructive apnea prevention. Minimum helps hold the airway open and prevent the collapse in the first place instead of trying to fix it after it happens. EPAP is used for the obstructive side of things and PS added to EPAP treats the central side of things with the big burst available if the machine needs to breathe for you when a central happens.

Your settings are pretty much the default settings. If it were me I would probably consider EPAP minimum increase from 4 to 5 or 6 and see if that helps with the hyponeas. Something to talk over with your doctor.

Thanks, Pugsy. You’re the best.