Old User all new equipment and ASV settings

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
SeekSleep
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Joined: Sat Apr 27, 2013 8:24 pm

Old User all new equipment and ASV settings

Post by SeekSleep » Fri Sep 17, 2021 7:17 pm

Back in the 2013 timeframe I became a new member, initially with a Phillips bypap machine and the transitioning to a S9 ResMed VPAP adapt due to being able to get my numbers down especially the central apneas. With the help of this forum, I eventually got my numbers down to under 1 more often than not, and things just worked. I had no issues till the S9 started crapping out. It had been telling me motor life exceeded for quite some time, then a couple sensor failures and a hard crash that dumped everything and corrupted the memory card. Luckily the DME still had ASV machines available, so I have a new Aircurve 10 ASV, but the only settings I have are the original they set up the S9 to originally. I never copied over my Sleepyhead data when I changed computers several years back and being as how things were looking good, I never felt the need to install or use it on my new machine so I don't even have the old sleepyhead data to get the settings from. I had changed things from the original sleep study settings significantly, based on input I learned from this forum but don't remember what I did.

So far my AHI numbers with the old settings are 1.3, 0.27, 0.00, and 12.17 No complaints about the first 3 nights, the 4th obviously shows room for improvement. It's almost all hypopneas but I'm not sure what it's telling me. To those who understand the readings does this look like mostly obstructive type apneas and suggest maybe I set the starting EPAP higher? I do remember that previously I went to ASV auto instead of just ASV, so that is one of the first things I'll do. I also switched masks from a Quattro to an F-20 and need to get the leaks down, but don't think that is what drove the hypopneas.

Suggestions

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Pugsy
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Re: Old User all new equipment and ASV settings

Post by Pugsy » Fri Sep 17, 2021 8:28 pm

The 4th night something changed so you needed more EPAP. Most likely sleep position.

Switch over to Auto ASV mode.
Keep minimum EPAP at 4 but add maximum EPAP at 10.
The machine can then auto adjust EPAP upwards if needed.

Right now in just the ASV mode EPAP is fixed and while it works well probably a good bit of the time....it can't increase EPAP when needed.
Changing to auto ASV will let it change if needed.

Other settings you can leave alone if the machine will let you.

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SeekSleep
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Joined: Sat Apr 27, 2013 8:24 pm

Re: Old User all new equipment and ASV settings

Post by SeekSleep » Fri Sep 17, 2021 10:28 pm

Thanks Pugsy, As I recall, you played a major role in getting me on a very effective autopilot my first time around. I've switched to Auto ASV and made the other changes you recommended. To the best of my recollection that's what I did before other than I think I had my EPAP min set to 6.

The breathing pattern from last night looks like what I used to get when I rolled over onto my back although it's generally Obstructive Apneas. I'm normally a side sleeper mostly due to all the years I was untreated for the sleep apnea and would get thumped by my wife when I rolled onto my back. I tend to snore loudly when I do. What confused me this time around is that although the breathing pattern looks like my normal obstructive apnea pattern, I'm getting Hypopneas instead. In reading up on the forum this evening, I'm thinking the hypopneas are just a result of having just enough pressure to not be fully obstructed. I'll give the new settings a few days to do their thing and see how things settle in.

Thanks

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Pugsy
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Re: Old User all new equipment and ASV settings

Post by Pugsy » Fri Sep 17, 2021 11:34 pm

Did you know that there can be a potentially fine line between a flow reduction that gets a hyponea flag and an obstructive apnea?

The definition for hyponea is a flow reduction of 40 % to 79% that lasts at least 10 seconds.
Obstructive apneas are flow reductions of 80 to 100% that last at least 10 seconds.

For all we know those hyponea flags you see might be 75% reduction in air flow. For all general purposes that really not that big of a difference between 75% and maybe 82%.
Doesn't really matter...treat them the same.

You might end up needing a little more minimum EPAP if you still see those clusters very often. If you do then just increase that minimum EPAP to 5 or 6. No big deal.

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SeekSleep
Posts: 120
Joined: Sat Apr 27, 2013 8:24 pm

Re: Old User all new equipment and ASV settings

Post by SeekSleep » Sat Sep 18, 2021 11:20 am

Thanks Pugsy, I'm afraid I didn't know anything about hypopneas. When I started on the BIPAP, life was just dealing with tons of apneas, both obstructive and Centrals, the only hypopneas were during sleep transition which the sleep doctor said is normal. After battles with the insurance company, a third sleep study and finally getting the ASV machine, the transitional hypopneas went away for the most part, at the expense of an insistent machine sometimes keeping me from falling asleep right away. The machine after minor adjustments did a good job of controlling the apneas and I pretty much quit learning about how it all worked and just enjoyed that it did. No more morning headaches, and sleep became refreshing. With the change of machines, and loosing the settings that had worked so well for me I became interested in the mechanics of it all again, and hence started trying to understand hypopneas which I didn't deal with before.

Last night went well with the new settings, only 2 hypopneas one during the early sleep transition period and the other when it appears I moved position since the mask started leaking significantly at the same time even though there were no pressure changes yet. For now I'll give it a week or two before making any changes since things always vary from night to night. Thanks again for the suggested setting changes.

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