ASV Help Needed - See Page 3 AHI from 1-4 up to 50+

ameriken wrote:When you say you were choking, did it happen just that one time? Did you fall asleep ok and sleep well until then? Was this the only night on this machine? I sure as heck hope you don't give up and if it happens again, try not to keep the mask off. Start it up again and use the ramp feature. The ramp lowers the pressure for aobut 20 or 30 minutes to allow you to fall asleep and then it goes up to normal pressures.

If you can post your report, that may help in knowing what is going on. Hopefully some others will chime in as well.

I am very happy to report that this evening was much more successful and I only had one experience with the "choking" sensation. The first evening I experienced it numerous times, three if I recall correctly. I think what happened was I stopped breathing and when the pressure kicked in and I attempted in to inhale, the machine was "exhaling" so I was not getting positive pressure and felt like I was suffocating. It happened once during last night’s session about an hour prior to my waking up for the day and I was alert enough to realize what was going on, I held by breath and waited for the positive pressure to kick in and had no further incident.

I have to say that this is the first morning in a very long time where I actually feel rested!

JohnBFisher, your insight into the operation of the machine was quite insightful and I greatly appreciate it. I also will contact the hospital where my last studies were performed and request copies of the results to share. I know that I have two different forms of apnea (central being one; the other I do not recall but it was not obstructive).

Pugsy, thank you for the PM and the information on the software. I will look into this today and purchase the software. It is quite affordable considering were discussing our health and having that data without waiting to meet with my DEM does not make any sense to me. I was told I need to schedule an appointment within 31 days of receiving the machine with my prescribing doctor to discuss my sleep therapy per my insurance coverage requirements. The ability to bring the data with me would be helpful for obvious reasons.

I am so glad that I stumbled across this group. It is very reassuring to be able to talk with fellow patients and the education you folks have provided to me in this very short time has been invaluable. I can already tell that my machine works NOTHING like the AutoPap I had prior and I feel extremely optimistic that I will benefit for the therapy once I get used to the machine itself and tweak the settings slightly. The mask I am using is pretty good but I may need to upgrade from a medium to a large to prevent leakage. I had to tighten the straps pretty hard to prevent it last night and woke up with the bridge of my nose quite sore.

Ok, so I have uploaded my data into the software for the past two nights. Which information should I be sharing and what is the best way to do so in the forum or in PM? How would you folks advise I proceed? Thank you for your ongoing support and assistance.

The nightly daily detailed reports. If using Pro...the ones with the graphs that I sent you examples of in the PM.
Those trend summary numbers graphs are useless at this point.

Let's see if I did this right... if this is the wrong data please instruct me on which to provide and thank you again in advance.

Night 1:



Night 2:




Night 1 & 2 Comparison

That is the correct report. Good job. Now wait for the other ASV users to comment and some of them may turn a little green with envy. About all I know to tell you is the AHI is quite good. We like less than 5.

Pugsy wrote:That is the correct report. Good job. Now wait for the other ASV users to comment and some of them may turn a little green with envy. About all I know to tell you is the AHI is quite good. We like less than 5.

Pugsy is right....green with envy is correct .

Your PTB's are phenomenal. I've been working at this for 4 months and finally got my AHI's down to 5 or less everyday. So, you're looking really great.

We've got one of the best machines out there and it gets the job done so long as the settings are correct for our individual breathing. Here's mine from last night (I've got the 'older' version of the machine, basically the same functions but the reports are a bit different). It looks like my body decided for almost the whole night that it didn't want to breathe. That's when our machine becomes a 'ventilator'.

ameriken wrote:

Pugsy wrote:That is the correct report. Good job. Now wait for the other ASV users to comment and some of them may turn a little green with envy. About all I know to tell you is the AHI is quite good. We like less than 5.

Pugsy is right....green with envy is correct .

Your PTB's are phenomenal. I've been working at this for 4 months and finally got my AHI's down to 5 or less everyday. So, you're looking really great.

We've got one of the best machines out there and it gets the job done so long as the settings are correct for our individual breathing. Here's mine from last night (I've got the 'older' version of the machine, basically the same functions but the reports are a bit different). It looks like my body decided for almost the whole night that it didn't want to breathe. That's when our machine becomes a 'ventilator'.

Thank you so much ameriken! Obviously my data is only covering two evenings with the first lasting less than 2 hours so it will be interesting to see what it looks like once I have been using it for a week/month/etc. I have to say that after my short experience the first night and with my poor response in general to treatment with my first machine I was extremely pessimistic. But waking up this morning feeling refreshed the way I did was nothing short of a blessing.

Since age 16 (I am now 33) I have never felt well rested. In fact for years I have been teased by my friends and family because when they would ask me how I felt my answer was always "tired" or "fatigued". Today, even with the grey skies and constant rain here on the East Coast, I can say with complete confidence that I feel sharp, on point and generally good. Not 100% rested but good considering!

I think I need to tinker with my RAMP settings a bit. I used the feature once this AM when I awoke for no apparent reason but I was unable to fall back asleep. I intend to go to bed a bit later tonight to see if I can get a deeper sleep this evening.

The only complaint I have as of now is with my mask. It left a mark across the bridge of my nose the entire day and it was quite sore this morning. I think I would be better off with a full face mask and plan to call my DME Monday to discuss this. I had it strapped pretty darn tight last night with minimal leakage when awake. But I have a strange nose size; narrow and small but long as far as height and during my first short evening treatment it was leaking near my eyes as well as my chin.

Does anyone know of a good full face mask? I don't know if a DME can provide any brand or if they contract with specific providers only. If I had to purchase one on my own I would like to investigate options but I will speak with my guy first and see what they have to offer. I will post the as soon as I hear.

ameriken wrote:Your PTB's are phenomenal.

I apologize but I do not know what PTB stands for. I did check the CpapWiki definitions and could not locate it. Thank you guys for assisting me in the terminology as well as my treatment.


If anyone has suggestions regarding the RAMP settings I all all ears.

NJSleepless wrote:

ameriken wrote:Your PTB's are phenomenal.

I apologize but I do not know what PTB stands for. I did check the CpapWiki definitions and could not locate it. Thank you guys for assisting me in the terminology as well as my treatment.


If anyone has suggestions regarding the RAMP settings I all all ears.

The wiki is missing quite a bit of basic stuff. Anyhow, the PTB is Patient Triggered Breathing, meaning your lungs are trying to take in air. It's in the right hand column on your report. When it drops low, it means your body is not even making an attempt to take in a breath. You've got a high % of PTB's which is a good thing, it means that 97% of your breathing is on your own, not because of the machine.

What are your current ramp settings?
At what pressure and for how long?
What is it that makes you think it needs adjusted? Too low, for too long? Too high, for too short of a time period?
You don't even have to use it if you don't want/need to. It is available for your comfort only..so whatever you feel is wrong, is adjustable.

NJSleepless wrote:The only complaint I have as of now is with my mask. It left a mark across the bridge of my nose the entire day and it was quite sore this morning. I think I would be better off with a full face mask and plan to call my DME Monday to discuss this. I had it strapped pretty darn tight last night with minimal leakage when awake. But I have a strange nose size; narrow and small but long as far as height and during my first short evening treatment it was leaking near my eyes as well as my chin.

Does anyone know of a good full face mask? I don't know if a DME can provide any brand or if they contract with specific providers only. If I had to purchase one on my own I would like to investigate options but I will speak with my guy first and see what they have to offer. I will post the as soon as I hear.

You might want to give the Resmed Quattro FX a try. It's the only mask I've used. It's not perfect, but it mostly handles the high pressures that the machine can push up to. Yes, it does leak from time to time, and you do have to fiddle with it sometimes to get a good fit, but but like I said it should do the job. Finding a mask can be trial and error. At least this is a good mask, worth a shot.

Just as a note to the OP (NJsleepless?), I do not think there is a ramp feature on this machine. Since you have problems with central apnea, it needs to support your breathing from the "get go". A ramp feature would disable the machines ability to support your breathing. So, while it might have a "RAMP" setting, it would only be valid if the machine was acting as just a CPAP and/or BiPAP unit. The moment you enable ASV mode, it will disable the RAMP function.

NJSleepless Welcome to the forum and congratulations on starting out so well with your machine. A lot of us had, and are still having a hard time dialing in the correct settings along with fairly high AHI's. Looks like your going to do pretty well with your machine if you stick with it. The correct Mask is a big factor also, so make sure you get one that will work for you. As for the ramp setting I have never used mine, found with the ASV there was no need to compared to a CPAP machine, it was very comfortable breathing with it when I turn it on. Keep up the good work and positive attitude and you will be fine, good luck.

I did not know that in ASV mode no ramp would be offered. Might be what OP was wondering about needing adjusting. Perhaps he thought it should be available and isn't.

JohnBFisher wrote:Just as a note to the OP (NJsleepless?), I do not think there is a ramp feature on this machine. Since you have problems with central apnea, it needs to support your breathing from the "get go". A ramp feature would disable the machines ability to support your breathing. So, while it might have a "RAMP" setting, it would only be valid if the machine was acting as just a CPAP and/or BiPAP unit. The moment you enable ASV mode, it will disable the RAMP function.

Pugsy wrote:What are your current ramp settings?
At what pressure and for how long?
What is it that makes you think it needs adjusted? Too low, for too long? Too high, for too short of a time period?
You don't even have to use it if you don't want/need to. It is available for your comfort only..so whatever you feel is wrong, is adjustable.

I do have a RAMP feature on my machine and the setting is 2. I feel it is too low and I am going to adjust it. I'm frankly not even certain if it helps. I have used the feature twice to see how it operates but find that it has no real therapeutic benefit for me. I have no issue starting the machine in full operational mode and falling asleep. Maybe putting it at the maximum setting in case I wake up in the middle of the night may be helpful?

Thank you Kody for your encouragement. Sadly I failed last night and had to stop treatment due to the mask. I have not had a chance to look at the data and am uncertain how long my treatment was - I will upload the information this weekend.

The pressure on the bridge of my nose was too much (I have adjusted the straps each of the three nights I have used the machine and now have a bright red nose bridge that is sore to the the touch. I am going to call my DME right not to see about a replacement. I think a full face mask is my best option at this point.

ameriken wrote:You might want to give the Resmed Quattro FX a try.

I am going to see if they offer this through he provider. If not I will try what they have to offer first and then if that fails I will purchase one on my own. I will post what options they have to offer once I speak with them today.

Thank you all again and I appreciate any other feedback, insight or support that can be offered.