ASV Titration

Hello fellow hosers. I will be having a ASV Titration in about a week. In the mean time the setting on my DS700HS aren't doing much to help me. Can any one help me with the formula for converting my setting to bipap auto w/flex. IPAP 9 EPAP 5 and Ramp 5. I feel like I'm drained, no energy or drive to do anything. HELP!!!!!!!!!!

You might try changing the subject line - you might get better responses. Your real question is about how to set your bipap, not about your titration.

Sorry I can't help you with BiPap settings!!!

Best of luck!
Barbara

qjosea wrote:Hello fellow hosers. I will be having a ASV Titration in about a week. In the mean time the setting on my DS700HS aren't doing much to help me. Can any one help me with the formula for converting my setting to bipap auto w/flex. IPAP 9 EPAP 5 and Ramp 5. I feel like I'm drained, no energy or drive to do anything. HELP!!!!!!!!!!

With only a week to go, I think I'd just wait it out at the current mode of operation (bilevel or bilevel with bi-flex.) If I were absolutely bound and determined to change something between now and the ASV titration night, I'd probably (and I'm picturing the "Daily Details" graph Pugsy kindly posted for you in another thread) .....

viewtopic.php?p=412080#p412080

.... I'd probably keep the machine in bilevel mode, but I'd raise the EPAP to 8 and raise the IPAP to 12. I'd set the bi-flex at whatever felt smooth to me (I personally like bi-flex at "3".) I'd turn ramp off unless I absolutely HAD to have it.

There is no formula for deciding what auto bilevel pressure settings to use, by looking at the bilevel IPAP/EPAP pressures -- especially if those bilevel IPAP/EPAP pressures weren't getting the job done anyway.

The main sleep disordered breathing issues that cause a doctor to think about switching a person to an ASV (Adapt Servo Ventilator) machine are:

1. persistent CSR (Cheyne Stokes Respiration, often associated with Congestive Heart Failure) which consistes of centrals during the waning phase of the CSR.

2. central sleep apnea -- apneas (cessation of airflow) not because of obstructions, but because brain is not sending "breathe now" signals in a timely fashion.

3. CompSAS - complex sleep apnea syndrome (also called CSDB - "complex sleep disordered breathing") -- an increase or persistent appearance of central apneas when CPAP (or autopap, or bipap) is used. Sometimes those subside as the body gets used to CPAP pressure. But if they don't, then an ASV machine is helpful.

Autotitration with the usual machines -- autopap or auto bilevel -- would be a mistake, I think, if an ASV is really what's needed. I'd leave autotitration out of whatever you decide to try with your present machine, qjosea, while you're waiting. I understand your frustration and desperation at this point. But if adapt servo ventilation is the type of treatment your sleep disordered breathing needs, turning on "auto bilevel" in your present bilevel machine might not be a good idea.

All that said...if I absolutely were going to set that machine for auto bilevel operation, I'd use these settings:

Auto Bilevel (Auto-titrating bipap mode)
Max IPAP 15.0
Min EPAP 8.0
Max Press Sup 7.0
Bi-Flex Setting 3
Autoramp time 0:00
Mask Alert Feature OFF
Auto Off Feature ON
Split Night Time - Off
Show AHI/Leak Feature ON
Patient Reminder OFF

With those max I/min E settings, the BiPAP Auto in "auto bilevel" mode will start out using 10 for IPAP and 8 for EPAP. It always will start out using only 2 cm more for IPAP than what the min EPAP is set for.

Good luck qjosea! Let us know how things go at your ASV titration.

Rested gal you are a savior. Thank you, I called the sleep study lab and they will put me on a waiting list in case any one cancels. I will keep you guys posted. The RT from Apria said that my doctor requested I get a bippa auto sv. I guess once the study is done they will go thru my insurance and request approval for that machine. I have Tri-care Prime and I am sure that whatever my doctor request I will surely get. What is your opinion on this machine, any sugestions on a different one. I really want this to work, it is really getting to me. I manage to get by on two to three hrs. of sleep, I don't know how long and what damage this is doing to my body. My trigliserites are 674 now, maybe it's a reaction of sleep deprivation I'm gong thru. Well enough said.