Please help...do I need an ASV?
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Please help...do I need an ASV?
Hello all,
Please help.
After failure with CPAP for three months my Pulmonologist moved me to a BiPap.
Centrals have persisted and I do not feel rested.
Please see below OSCAR data.
Further, I suffer from atrial fibrillation and had a catheter ablation done two months before starting CPAP therapy. Four months after the ablation, atrial fibrillation has returned.
Do I need an ASV or should I continue with BiPap as my Pulmonologist feels that the Centrals will go away with time.
Thanks for looking.
https://imgur.com/a/yGVLhX8
https://imgur.com/H7zkedE
Please help.
After failure with CPAP for three months my Pulmonologist moved me to a BiPap.
Centrals have persisted and I do not feel rested.
Please see below OSCAR data.
Further, I suffer from atrial fibrillation and had a catheter ablation done two months before starting CPAP therapy. Four months after the ablation, atrial fibrillation has returned.
Do I need an ASV or should I continue with BiPap as my Pulmonologist feels that the Centrals will go away with time.
Thanks for looking.
https://imgur.com/a/yGVLhX8
https://imgur.com/H7zkedE
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
Additional Comments: O2 Ring |
Re: Please help...do I need an ASV?
I certainly wouldn't think that going to an ASV would be worth it for those few centrals.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Please help...do I need an ASV?
Who dropped your minimum Epap from 6 to 5? Why?
Why did you spend only one night on EPAP 6 - when the results look so good?
Has your pulmonolgist studied your graphs night by night?
Ditto for your cardiologist.
Did you have a sleep study? Did they say anything about positional apnea? That bunch at about 04:10 is impressive. Do you have them often?
Please post an image that shows your Flow Limitations graph.
Has your sleep at home with the CPAP been tracked with a professional pulse oximeter?
My first investment, if I were in your place, would be in a pulse oximeter supported by OSCAR.
That way, you can track your pulse and oxygenation and how they're affected by your obstructive and central apnea.
It could be (not saying it is, I don't have enough info) could be that you are simply not sleeping well, and the machine, faced with the typical irregular breathing of wakefulness, or tossing and turning, interprets that normal irregular pattern as "central apnea".
Why did you spend only one night on EPAP 6 - when the results look so good?
Has your pulmonolgist studied your graphs night by night?
Ditto for your cardiologist.
Did you have a sleep study? Did they say anything about positional apnea? That bunch at about 04:10 is impressive. Do you have them often?
Please post an image that shows your Flow Limitations graph.
Has your sleep at home with the CPAP been tracked with a professional pulse oximeter?
My first investment, if I were in your place, would be in a pulse oximeter supported by OSCAR.
That way, you can track your pulse and oxygenation and how they're affected by your obstructive and central apnea.
It could be (not saying it is, I don't have enough info) could be that you are simply not sleeping well, and the machine, faced with the typical irregular breathing of wakefulness, or tossing and turning, interprets that normal irregular pattern as "central apnea".
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Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023
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Re: Please help...do I need an ASV?
Thanks Palerider,
You and my Pulmonologist may be right.
Medicare qualification is >5 centrals/hour with less than 5 obstructive apneas/hour; leakage controlled. I meet those criteria. I have atrial fibrillation and I'm in apnea 15 to 20 minutes some nights. I'm also pre-diabetic so getting as close to zero AHI as possible is my goal. I delayed seeking treatment and plowed through life long after a border line sleep study.
Further, I did a sleep study with ASV and had just 2 centrals all night, no other events. Best nights sleep in memory.
Any further thoughts shall be appreciated.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
Additional Comments: O2 Ring |
Re: Please help...do I need an ASV?
Not necessarily, they may not be legitimate centrals.BreathFree wrote: ↑Tue Nov 08, 2022 6:43 pmThanks Palerider,
You and my Pulmonologist may be right.
Medicare qualification is >5 centrals/hour with less than 5 obstructive apneas/hour; leakage controlled. I meet those criteria.
Chasing zero is a game of diminishing returns. Strive to get under 1.5.
With a properly functioning ASV, you shouldn't have ANY centrals, it should prevent them outright.BreathFree wrote: ↑Tue Nov 08, 2022 6:43 pmFurther, I did a sleep study with ASV and had just 2 centrals all night, no other events. Best nights sleep in memory.
That said, a few centrals aren't stressful to the body.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Please help...do I need an ASV?
Before I started worrying about those few centrals I would first
1...make sure that those were real asleep centrals and not SWJ sleep/wake/junk .
2...I would turn off EPR (or reduce it) just in case it was a factor in the centrals (assuming real asleep centrals and not SWJ centrals).
I doubt it will change the results but there is a remote chance that turning off EPR will reduce real asleep centrals.
1...make sure that those were real asleep centrals and not SWJ sleep/wake/junk .
2...I would turn off EPR (or reduce it) just in case it was a factor in the centrals (assuming real asleep centrals and not SWJ centrals).
I doubt it will change the results but there is a remote chance that turning off EPR will reduce real asleep centrals.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
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Re: Please help...do I need an ASV?
All the centrals flagged here....I wasn't asleep. I know for a 1000% fact I wasn't asleep. Bad case of insomnia that night.
A more normal night for me is below.
A more normal night for me is below.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
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Re: Please help...do I need an ASV?
Thanks for your thoughtful insights Ozij!
https://imgur.com/eH1y6qN
https://imgur.com/upaRXt9
https://imgur.com/WLuTTSz
https://imgur.com/0hANcz8
https://imgur.com/b1Hrph3
CPAP Study of 9/27/2022, did not sleep long enough to go to centrals?
https://imgur.com/DL2gNza
https://imgur.com/NGetYW1
https://imgur.com/nnUSlL4,
https://imgur.com/7sL0gKS
https://imgur.com/vmEk1xR
ASV Study of 9/1/2022, near perfect nights sleep.ozij wrote: ↑Tue Nov 08, 2022 12:20 am
Who dropped your minimum Epap from 6 to 5? Why?
Why did you spend only one night on EPAP 6 - when the results look so good?
Great point, I'll try EPAP 6 again tonight
Has your pulmonolgist studied your graphs night by night?
I'll ask, he has not suggested any changes, I've done it all with the help of those on this blog and Youtube, especially Jason!
Ditto for your cardiologist.
No, they just advised aggressive treatment of all apneas
Did you have a sleep study? Did they say anything about positional apnea? That bunch at about 04:10 is impressive. Do you have them often?
Please see three attached via IMGUR, 2nd and 3rd lab Yes, every night, that's how the centrals show up, in bunches
We apology that I may not have the images in the correct order...
Please post an image that shows your Flow Limitations graph.
To follow due to ten link limit together with 1st home study
Has your sleep at home with the CPAP been tracked with a professional pulse oximeter?
My first investment, if I were in your place, would be in a pulse oximeter supported by OSCAR.
That way, you can track your pulse and oxygenation and how they're affected by your obstructive and central apnea.
Great idea, I'll do it.
It could be (not saying it is, I don't have enough info) could be that you are simply not sleeping well, and the machine, faced with the typical irregular breathing of wakefulness, or tossing and turning, interprets that normal irregular pattern as "central apnea".
May be...I have some restless leg syndrome as well, please see sleep studies
https://imgur.com/eH1y6qN
https://imgur.com/upaRXt9
https://imgur.com/WLuTTSz
https://imgur.com/0hANcz8
https://imgur.com/b1Hrph3
CPAP Study of 9/27/2022, did not sleep long enough to go to centrals?
https://imgur.com/DL2gNza
https://imgur.com/NGetYW1
https://imgur.com/nnUSlL4,
https://imgur.com/7sL0gKS
https://imgur.com/vmEk1xR
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
Additional Comments: O2 Ring |
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Re: Please help...do I need an ASV?
ozij wrote: ↑Tue Nov 08, 2022 12:20 am
(Continued due to ten link limitation...thanks again Ozij!)
Did you have a sleep study?
First home sleep study of 11/2/2021
https://imgur.com/XcvFsaq
https://imgur.com/aMio5ul
Please post an image that shows your Flow Limitations graph.
Last night...
https://imgur.com/HtxIzK9
_________________
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Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
Additional Comments: O2 Ring |
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Re: Please help...do I need an ASV?
Thank you...I'm running BiPap, no EPR,Pugsy wrote: ↑Tue Nov 08, 2022 7:40 pmBefore I started worrying about those few centrals I would first
1...make sure that those were real asleep centrals and not SWJ sleep/wake/junk .
2...I would turn off EPR (or reduce it) just in case it was a factor in the centrals (assuming real asleep centrals and not SWJ centrals).
I doubt it will change the results but there is a remote chance that turning off EPR will reduce real asleep centrals.
ResMed
AirCurve 10 VAuto
PAP Mode: VPAPauto
PS 5.0 over 5.0-24.0 (cmH2O)
I'll drop Pressure Support back to 4...should I drop EPAP to 4?
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Re: Please help...do I need an ASV?
Pugsy wrote: ↑Tue Nov 08, 2022 7:43 pmAll the centrals flagged here....I wasn't asleep. I know for a 1000% fact I wasn't asleep. Bad case of insomnia that night.
Point well taken, I'm sure that I'm asleep when the storm of centrals set in. They generally wake me up.
A more normal night for me is below.
Wow, .33, that's my dream!
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
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Re: Please help...do I need an ASV?
My home study showed 9 centrals per hour without therapy hardware and I was sound asleep
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
Additional Comments: O2 Ring |
Re: Please help...do I need an ASV?
Centrals don't wake people up, because they're *NOT* stressful, they're just your body not thinking it *NEEDS* to breathe for a few extra seconds.
Perhaps you should re-evaluate your assumptions.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Please help...do I need an ASV?
A PS of 5 is like EPR on steroids.BreathFree wrote: ↑Tue Nov 08, 2022 8:52 pmPS 5.0 over 5.0-24.0 (cmH2O)Pugsy wrote: ↑Tue Nov 08, 2022 7:40 pmBefore I started worrying about those few centrals I would first
1...make sure that those were real asleep centrals and not SWJ sleep/wake/junk .
2...I would turn off EPR (or reduce it) just in case it was a factor in the centrals (assuming real asleep centrals and not SWJ centrals).
I doubt it will change the results but there is a remote chance that turning off EPR will reduce real asleep centrals.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
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Re: Please help...do I need an ASV?
What pressures should I try... PS 0 IPAP 10 EPAP 10-25?palerider wrote: ↑Tue Nov 08, 2022 9:58 pmA PS of 5 is like EPR on steroids.BreathFree wrote: ↑Tue Nov 08, 2022 8:52 pmPS 5.0 over 5.0-24.0 (cmH2O)Pugsy wrote: ↑Tue Nov 08, 2022 7:40 pmBefore I started worrying about those few centrals I would first
1...make sure that those were real asleep centrals and not SWJ sleep/wake/junk .
2...I would turn off EPR (or reduce it) just in case it was a factor in the centrals (assuming real asleep centrals and not SWJ centrals).
I doubt it will change the results but there is a remote chance that turning off EPR will reduce real asleep centrals.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear |
Additional Comments: O2 Ring |
Last edited by BreathFree on Wed Nov 09, 2022 8:40 am, edited 1 time in total.