Learning ASV

Hey everyone, especially ASV veterans!
An ASV rookie here.
I got my ASV machine less than 3 weeks ago, and the first couple nights were fantastic. I felt 20 years younger in the mornings and thought I solved my apnea problem for good. But my elation was short lived.
Every morning now I wake up more tired than I went to sleep. But why? My apnea is gone - see the screen shot attached. I've never seen such low AHI!

What's worse, I have this burning sensation in my chest in the morning, like my brochi and lungs are tired of all the breathing and overinflation. At first, that sensation was gone within an hour. Then couple hours. Today, it persisted all day long, as if I overexercised, and overexerted my lungs.
But where's the overinflation could come from? I use the machine at very mild settings: EPAP = 6, min PS =3, max PS = 8. Doctor prescribed max PS = 15, but at that level the mask was lifting off my face and farting, waking me up, so I reduced the max PS to the minimum.
Will this feeling of overexertion go away? Is this something that my lungs and bronchi just need to get used to?

And this fatigue - yesterday and today I feel as if I didn't sleep at all. Almost like in my CSA days. But the charts say I slept solidly, no apneas (except for an hour last night - I removed my mask and don't even remember it. Then woke up again and put it back on). Could it be that ASV keeps waking me up? I do find it hard to fall asleep with ASV on, that's why I set a 20min ramp. Otherwise I can't fall asleep. I find it annoying that ASV gives me 3-4 second maximum after I exhale before it insolently starts inflating me like a balloon. Could this keep waking me up during the night? Will I get used to that? Otherwise I'm between a rock and a hard place: without ASV I can't get a good restful sleep because of my CSA, and with ASV I can't get a good restful sleep because ASV pushes gusts of air into my lungs.

Please advise fellow sleepers - what should I do to make the ASV work, and feel good like I did in the first days?

My SleepHQ report from May 29

My SleepHQ report from May 28

My SleepHQ report from May 27

Please remove the SleepHQ images you attached to the forum, and instead paste a public link to the SleepHQ report, not to its image.

There are 2 reasons for this request:
People who want to help you can zoom in on your SleepHQ reports when you link to them - and understand far better what is going on with your therapy.

The other reason is out of courtesy to other users: Attachment space is at a premium on the forum, please leave it for those cases where attaching images is necessary - though as a rule we recommend using an external image hosting site for OSCAR images. A SleepHQ image is a real waste of forum attachment space.

You're new, you're not aware of those facts -- that's OK. But please please correct the mistake: link to your reports and delete the attachment, through your user account.

Thank you.

ozij wrote: ↑

Tue May 30, 2023 8:41 pm

Please remove the SleepHQ images you attached to the forum, and instead paste a public link to the SleepHQ report, not to its image.

There are 2 reasons for this request:
People who want to help you can zoom in on your SleepHQ reports when you link to them - and understand far better what is going on with your therapy.

The other reason is out of courtesy to other users: Attachment space is at a premium on the forum, please leave it for those cases where attaching images is necessary - though as a rule we recommend using an external image hosting site for OSCAR images. A SleepHQ image is a real waste of forum attachment space.

You're new, you're not aware of those facts -- that's OK. But please please correct the mistake: link to your reports and delete the attachment, through your user account.

Thank you.

Thanks, I'd gladly replace the images with links to SleepHQ, but I don't know how. It looks like SleepHQ link sharing is a premium feature that requires a $150 subscription. Without the subscription, I'm in the same boat as Oscar users.
Meanwhile, 2 images above are 390kB together. That's _kilo_ bytes, not even mega or gigabytes.
May I please keep the images at least until someone responds to my questions? Then I'll delete them if 390kB is too much of a burden. I'd really appreciate your understanding.

Have never used SleepHQ, but until now, there was an option for free members to share single night pages publicly.
One and another one and another one, etc.

Are you sure that option for creatin a public link to a single night no longer exists? Zooming into your date is actually quite important.

Yup either a "Free Forever" account

https://home.sleephq.com/

or a free 2 week trial of the all-features account.

All right, I figured it out!
I deleted the images and posted SleepHQ links in the original post above^^^.

All insights and suggestions will be highly appreciated!

Hrapovick wrote: ↑

Wed May 31, 2023 6:29 pm

All right, I figured it out!
I deleted the images and posted SleepHQ links in the original post above^^^.

Yay!
Can you add an image of the night(s) on which you felt so much better?
In your previous thread you wrote:

Hrapovick wrote: ↑

Thu May 11, 2023 8:05 pm

Starting with the default settings in ASV auto mode tonight!

A comparison would help.

ozij wrote: ↑

Wed May 31, 2023 8:09 pm

Yay!
Can you add an image of the night(s) on which you felt so much better?
In your previous thread you wrote:
A comparison would help.

Sure. This was the night after which I felt like I found the holy grail of sleep
This one was a pretty good one too
It was downhill from then on.
Last night was okay but I can't say I woke up rested and refreshed.
What am I doing wrong?

In the first month or so, chest discomfort from breathing with cpap is not uncommon.
As your body adapts, you will get more comfortable.
It happened to me, too, so it can even happen with plain old cpap.

I got my ASV machine less than 3 weeks ago, and the first couple nights were fantastic. I felt 20 years younger in the mornings and thought I solved my apnea problem for good. But my elation was short lived.
Every morning now I wake up more tired than I went to sleep. But why? My apnea is gone - see the screen shot attached. I've never seen such low AHI!

The night of the holy grail does not have the same machine settings as do the other two nights. And each of those had different settings too.



https://sleephq.com/public/62b8381f-403 ... ba9763bf70

• Max epap 8.0
  Max ipap 16.0
  Min epap 4.0
  Min ipap 7.0
  Mode ASVAuto
  Ps max 8.0
  Ps min 3.0
  On

https://sleephq.com/public/a9a1fd8f-234 ... 94770621f1

• Max epap 8.0
  Max ipap 17.0
  Min epap 4.0
  Min ipap 7.0
  Mode ASVAuto
  Ps max 9.0
  Ps min 3.0

Hrapovick wrote: ↑

Thu Jun 01, 2023 6:44 pm

Sure. This was the night after which I felt like I found the holy grail of sleep
This one was a pretty good one too
It was downhill from then on.
Last night was okay but I can't say I woke up rested and refreshed.
What am I doing wrong?

ozij wrote: ↑

Thu Jun 01, 2023 9:28 pm

The night of the holy grail does not have the same machine settings as do the other two nights. And each of those had different settings too.

https://sleephq.com/public/62b8381f-403 ... ba9763bf70

• Max epap 8.0
  Max ipap 16.0
  Min epap 4.0
  Min ipap 7.0
  Mode ASVAuto
  Ps max 8.0
  Ps min 3.0
  On

https://sleephq.com/public/a9a1fd8f-234 ... 94770621f1

• Max epap 8.0
  Max ipap 17.0
  Min epap 4.0
  Min ipap 7.0
  Mode ASVAuto
  Ps max 9.0
  Ps min 3.0

The following, a another set of setting was posted on someone else's thread:

Hrapovick wrote: ↑

Mon Jun 05, 2023 7:44 pm

I too started my ASV therapy recently. The doc prescribed EPAP 5, min PS 3, max PS 15. Mornings were terrible with these settings.
I'm still trying different settings, but found that lower max PS work better for me. My current settings are
Max epap 6.0
Min epap 4.0
Mode ASVAuto
Ps max 8.0
Ps min 3.0
and a 20 minute ramp.

Last night I slept like a baby and look forward to another one. Here's my SleepHQ

The first thing I would ask is:

What evidence do you have that you have CSA?

Rubicon wrote: ↑

Tue Jun 06, 2023 3:47 am

The first thing I would ask is:

What evidence do you have that you have CSA?

I swear I have it Your Honor, just ask Fatty the Doc and his pretty nurse Molly! They gave me this prescription "EPAP 5 min PS 3 and max PS 15", based on a sleep study they sent me to, and I have all them papers to prove it! I dindu nothing wrong!

For the last 8 years, I was on Resmed AutoSense 10 Autoset. At first it worked nicely - it did stop my snoring and OA. But in the last year or so I found it wasn't making any difference. Was I using it or not, I still felt like crap in the morning, maybe even crappier with the machine than without.
Because Resmed disconnected my machine from the cloud (I heard, Resmed dropped all older CPAPs when mobile networks migrated to 4G), I couldn't even check numbers on myAir. Somehow it occurred to me (read somewhere?) that my horrible mornings could be caused by low oxygen during the night.
So I got blood oxymeter and low and behold - my O2 was falling precipitously during the nights, even with the CPAP on. I dug deeper and found SleepHQ, which helped me look into my sleep numbers.
So here's one of my nights on AutoSense. If that's not CSA, I don't know what is.
I printed it out, went to my PCP, he looked at it, said "holy shit!" and sent me to a sleep lab, they did an overnight titration study and confirmed that ASV is the way to go.
I just started my med insurance plan with a new job, and I have a full $4,000 deductible to go. A local respiratory vendor quoted $4,600, and the nurse said "These people are the best, they can get you a machine real fast, 6-8 weeks if you're lucky, and you'll have it!"
Then I saw this slightly used Aircurve ASV on Craigslist for $700. The decision was easy.
But because I didn't buy it through official channels, I'm on my own and have to tinker with settings myself.
At max PS 15 (even during the sleep study), the mask (Resmed F20) was flying off my face and farting, which woke me up more times than all prior apneas combined. And when the mask didn't lift, I felt like a frog blown through a straw. So, I reduced PS it to the minimum.
Was that a bad idea? At least I don't have these CA's on my SleepHQ charts anymore - here's my last night, and my oxygen drops are almost gone. I still feel tired in the mornings though and I wonder why?

Hrapovick wrote: ↑

Tue Jun 06, 2023 7:43 am

So here's one of my nights on AutoSense. If that's not CSA, I don't know what is.

It ain't, but the only way you're gonna learn is if you figure it out yourself.

I still feel tired in the mornings though and I wonder why?

See above.

Rubicon wrote: ↑

Tue Jun 06, 2023 8:17 am

It ain't, but the only way you're gonna learn is if you figure it out yourself.

I'd appreciate a bit more information please. What is it then?