ASV Complex Sleep Apnea question

Never been titrated at a Sleep Lab for my ASV despite being on one for almost 8 months now. Reason being it was such a long process they just gave me the choice of a 3rd Sleep Study this time with an ASV, or give me the unit with "generic settings", and they would tweak it later, as necessary. At that point in time I took the later option because I was barley functioning any longer, and didn't want to waste any more waiting time. This was probably a big mistake on my part as the "tweaking" my machine part IMO never worked out. The machine at this point is basically in wide open settings, and after waking up the other day with an AHI of 12. thought enough is enough of this. One day it will be a 3. the next day double digits. I have experimented on my own raising epap, raising pressure support etc. etc. Without any better results.

So bringing this up to the Sleep Dept. people got a few questionable responses. One was "People on these ASV machines rarely ever get AHI's under 12". This was the second time she tried to feed me this B.S. I know for a fact that a few people on this board with the same exact machine as mine constantly get under 5's. After I mentioned that, she then said that "it's common for people with complex sleep apnea to have one night with a very low number, and the next night in double digits, there is no consitancy if you have Complex Sleep Apnea.

It does look like their going to approve me for a new Sleep Study on an ASV this time, so that is all I really wanted anyway. However I am wondering about what she said. Is it true that Complex Sleep Apnea patients rarely can obtain consistently low AHI's? I realize there's not a lot of us on the forum, but I would appreciate any response to this, thanks in advance.

Frankly, I think it depends on the underlying cause of the complex sleep apnea. If you are reacting to the increased pressure, then I would assume the reaction would be consistent. In that case, the therapy should be fairly consistent as well. If you have some other issue that complicates the picture, then I would expect the therapy would have some wilder swings in it as well.

I only have central sleep apnea. I get fairly consistent results .. until my neurological problem gets worse .. for whatever the reason. Then the AHI increases and the ASV appears to be less effective. Perhaps you will be able to find something that seems to help you predict how well you will sleep. Sometimes it can be done. Then you can add a note to your therapy log ... if you start to see a pattern, then you might try to avoid the triggers that seems to make it worse.

Just a few rambling ideas ..

Thanks again John for your input, I agree with your logic on this. No, there are no other issues involved, other than the Complex Sleep Apnea. Take no medications of any kind, and have no other medical issues. With the settings I have now, there are no CA's, or obstructive's, mainly LOTS of hypopnea's, which I believe are obstructive in nature since when I side sleep there are no events of any kind. When I flip onto my back that's when things go down hill fast. That being the case, if taken further I would think that it's a settings pressure issue that is not dialed in correctly yet. I know one night of Sleep Study titration is just a snap shot of that one night, but I'm hoping it will be a good base for new improved settings in my case. Thanks again for the response.

Kody wrote:... when I side sleep there are no events of any kind. When I flip onto my back that's when things go down hill fast. ...

When you schedule your sleep study, ask to talk to the manager of the sleep technicians. Then explain your situation. That should help them focus on helping you titrate away those hypopneas. They will try to make certain to minimize your hypopneas without causing too many central apneas at the same time.

I don't have the Advanced version of the ASV, but the earlier model. I rarely have an apnea with this machine, maybe one a week. My pressures are all over the place from 13-23 and the back up kicks in regularly, but rarely an apnea.

JohnBFisher wrote: When you schedule your sleep study, ask to talk to the manager of the sleep technicians. Then explain your situation. That should help them focus on helping you titrate away those hypopneas. They will try to make certain to minimize your hypopneas without causing too many central apneas at the same time.

Good idea again John thanks. If they know more what their looking to take care of in advance, it should save a lot of time.

OutaSync wrote:I don't have the Advanced version of the ASV, but the earlier model. I rarely have an apnea with this machine, maybe one a week. My pressures are all over the place from 13-23 and the back up kicks in regularly, but rarely an apnea.

Thanks OutaSync, that confirms what I already thought, that it is possible to have consistent low numbers even with an ASV. Hopefully I'll be there one of these days soon as well.

Hi Kody, I have CSA and unless I am sick my average is below 4 as you can see in my sig. I start feeling not rested if it goes to 4 and up. If it does go above 4, it means I have a cold.