ASV users: the everything ASV thread.

[Kody]

ameriken I feel your pain! After having excellent AHI's 3. 4. 5.'s the last week, I come up with a 15. last night, WTF? I'm starting to think we should have a contest to see who can have the highest AHI's yet still be using their machines all the time. Sure people can have 0.5's and 1.0's without a problem but it takes real effort to go double digits, yet still be using your machine!

This was one of the worst yet for me. The only thing that looks good was after the 4 and a half hour mark, but I was actually awake during that period. I do have an appointment with the actual Sleep Dr. in another 3 weeks, so maybe he can help me out.

[ameriken]

ameriken I feel your pain!

Let my know how your appt goes.

You're PTB's look a lot like mine. However I was surprised at how high your pressure ranges are, I don't think I've ever seen mine jump around in such a high range like that for such a long period and stay up there. I hope mine is working right.

[ameriken]

Here's what I've been experiencing, I can't figure out why one day it's bad, then it gets great for a couple of days, then then goes so bad again. Great for me is any AHI that is not 2 digits. I don't get why I have such wide swings when nothing else changes from night to night.

TUES OCT 11:




FRI OCT 14:




SUN OCT 16:

[moresleep]

You have some leak issues, but it doesn't look like they are causing the problem. Did you eat, go to bed the same all nights? I find that little things like when I last ate, or when I went to bed can make a difference. Have you tried a non-FFM? I never did well with those...

[ameriken]

You have some leak issues, but it doesn't look like they are causing the problem. Did you eat, go to bed the same all nights? I find that little things like when I last ate, or when I went to bed can make a difference. Have you tried a non-FFM? I never did well with those...

Yeah, leaks aren't the issue, at most I may have 30 or 45 minutes of leaks but most nites I have no problem. As far as I know, everything else is the same. I'm thinking about recording everything I do and take during the evening and at what times. I take fish oil and niacin at night, but I don't see how those will affect it. Also gotta watch my evening coffee. But I just don't see how it can swing from one end to the other and back like that.

As for a non-FFM, no, I'm a big mouth breather, gotta have the FFM.

[Kody]

Wow ameriken your right our bad ones do look a lot a like. However you seem to have a lot of the (PB) periodic breathing things going on. What exactly does that mean or indicate?
When you had the 6. compared to the 17. Did you notice a big difference in how you felt?

I did recall when my last 15. AHI I did end up drinking a 20 ounce Coke a few hours before bed, maybe your coffee is causing the same thing? Another similar thing, I also take a 1400 mg fish oil supplement, but in the morning. Maybe it's the Fish Oil? damn those Salmon!.... Maybe John will be around to give you some insight or advice on this, hang in there.

[ameriken]

I didn't drink any coffee last night and ended up with an 8 (not that coffee is or isn't part of the problem). I don't know what the PB thing is or what it means. I remember one night seeing a solid red bar. I do feel it when I hit 16, but it's not far worse than a 7 or 8. And regardless of my AHI, I still wake up every morning with a groggy feeling and it takes me a good while before I come out of it.

One thing I've noticed is on a couple of bad nights and you can see it in 2 of the reports above, is I would have a decent AHI, then I'd wake up for a potty break, go back to bed and then my AHI's skyrocket. Which makes me wonder if something in my sleep position might be affecting this, perhaps before I wake up I'm in a good position then when I go back to bed, I'm in a different position. I have no clue.

[Kody]

I also had an 8 last night as well and woke up with a huge headache, but no headache with a 15 the other day, nothing makes sense. I do believe that sleep position does have a lot to do with it, at least in my case I know it does. I can get under a 5 if I can sleep on my side. However my back hurts too badly the next day for that to be a permanent solution. Are you on your back all the time, or switch back and forth? It sounds like you really need a sleep study done with an ASV if there's any way you can get that done. I need the same thing, never had one with an ASV, and I think I will suggest it when I see the Sleep Dr. next visit. At least in a sleep study they have a camera on you, then you would know if your sleep position correlates with your events.

[ameriken]

I also had an 8 last night as well and woke up with a huge headache, but no headache with a 15 the other day, nothing makes sense. I do believe that sleep position does have a lot to do with it, at least in my case I know it does. I can get under a 5 if I can sleep on my side. However my back hurts too badly the next day for that to be a permanent solution. Are you on your back all the time, or switch back and forth? It sounds like you really need a sleep study done with an ASV if there's any way you can get that done. I need the same thing, never had one with an ASV, and I think I will suggest it when I see the Sleep Dr. next visit. At least in a sleep study they have a camera on you, then you would know if your sleep position correlates with your events.

I prefer both sides and that is where I normally sleep but I think I occasionally roll onto my back.

I already had 2 sleep studies done, one on a CPAP it did nothing (centrals), and on the second study I spent the whole nite being titrated on the exact same machine, which is why they ordered this one. The reports states that I did well on it. So, I don't get why I still have these problems.

I have the same issues: wake up with a headache on a 5 or 6 and not with a 16. It probably has something to do with the length of the apneas. A 16 with very short apneas may be better that a 5 with really long apneas.

But regardless of all this, I have never woken up feeling refreshed and motivated and ready to take on the world. I do realize that age will slow me down somewhat, but I still shouldn't be feeling this fatigued.

I'll be interested in hearing how your sleep study goes and what they recommend. Ken

[moresleep]

Yeah, the AHI, while better than nothing, tells nothing about the length of apneas, obviously a very important factor in how we are doing. I suspect the industry prefers to obsfucate, requiring a full blown sleep study, with AHI, RDI and everything else, for the patient to get a more complete picture. One of these days, the logjam will break and we will be given the information that is our right.

PB=Periodic Breathing, marked by a repeating pattern of declining amplitude of breathing for several breaths or more, then back up, with the whole business repeating. While sometimes associated with serious heart and other conditions, it can also be caused by pressure, like all central phenomena, so if BP gets to be a problem, backing off the pressure a bit can help.

[Paper_Nanny]

Yeah, the AHI, while better than nothing, tells nothing about the length of apneas, obviously a very important factor in how we are doing. I suspect the industry prefers to obsfucate, requiring a full blown sleep study, with AHI, RDI and everything else, for the patient to get a more complete picture.

The machines that show wave form data show the length of the apneas. That wave form data is one of my favourite things about my machine.

Deborah

[moresleep]

Yeah, the AHI, while better than nothing, tells nothing about the length of apneas, obviously a very important factor in how we are doing. I suspect the industry prefers to obsfucate, requiring a full blown sleep study, with AHI, RDI and everything else, for the patient to get a more complete picture.

The machines that show wave form data show the length of the apneas. That wave form data is one of my favourite things about my machine.

Deborah

I want one of those! But, I believe the new machine still doesn't factor the length of the apneas into the calculation of the AHI, which I guess would require the major players to unite on what would essentially be a new standard. It would be easy enough to implement; just add another count for, say, each additional 10 seconds duration, with perhaps a sliding scale, as I'm sure a 60 second apnea is more than 3 times as hard on the body as a 20 second apnea.

[Paper_Nanny]

I want one of those!

The RT at my DME supplier is awesome!!

But, I believe the new machine still doesn't factor the length of the apneas into the calculation of the AHI, which I guess would require the major players to unite on what would essentially be a new standard. It would be easy enough to implement; just add another count for, say, each additional 10 seconds duration, with perhaps a sliding scale, as I'm sure a 60 second apnea is more than 3 times as hard on the body as a 20 second apnea.

No, it doesn't factor length into the AHI. That would be nice to have it factored in somewhere as a count, but at least with the waveform data, I can see if the apneas are long. I also like to go through and subtract from my AHI all the "post sigh" apneas I see on the waveform data.

I like having the waveforms. One thing I found interesting when looking at the length of my apneas is that I often have pauses in my breathing that almost but don't quite meet the criteria. It makes the criteria seem a bit more arbitrary, really. Same with hypopneas. There is such a minimal difference between what is counted and what isn't.

I also find it confusing as to what is counted as period breathing. Sometimes what is flagged as such looks like the graphs I have seen for that but sometimes, I don't see much similarity at all.

Deborah

[ameriken]

So here I am, the past few weeks trying to figure out why I've been having high AHI's. I've got one of the most expensive machines on the market and yet some nites I have a 6 or 7. Others an 8 to 10. And still others, I'll have a 15 or 16. I even had a 20 a couple of weeks ago. But NO 5's or under.

Earlier in this thread, it was recommened that I lower my Min PS and EPAP to try and increase my AHI. It didn't work.

So I put my setting back to prescription strength and that's where I've been at.

But 2 nights ago, I saw this:



Of particular note is the last hour where my PTB's flatline at 0...I'm not doing any breathing on my own whatsoever. Yet my AHI during that time is 0. I had an AHI of 6 for the night.

And that's when it hit me. The machine was acting as a ventilator and pressure support is at it highest, yet I had no AHI's during that time until my breathing picked up again and the pressure dropped.
------------------------------------------------------------------------------------------------------------------------------------------------

So last night, I decided to up my Min PS and EPAP. I upped my MinPS to 6 and my EPAP from 7 to 8.

And last night's report is a 3! I haven't had a 3 in months:



------------------------------------------------------------------------------------------------------------------------------------------------

That's not the whole night, I woke up about 6 am and pushed the Min PS up to 7 and EPAP to 9. (So Encore Pro broke down the night into 2 reports even though sleep was almost continuous). And below is my last 90 minutes until I woke up this morning,

No AHI's.



So, I am cautiously optimistic and hoping I am on to something here. I'm going to try this again tonite and see if this continues it to be successful.

[Kody]

Wow Ken that is great news!! We know this has been a continuing battle for you, hopefully you have found your optimal settings. The drop in your AHI's is amazing considering where you were coming from, now I'm jealous. I hope your also feeling better with less of the grogginess and the other symptoms you were having. Let us know your progress and how it's working out for you, very interesting results good luck.