How difficult to adapt to asv

So far I've gone through 2 Sleep studies, the first one a split using a CPAP with no successful results. On the second one using a BIPAP they got me down to an AHI of 10, with Centrals driving the AHI numbers. After almost 3 months, my AHI average is right at 10 which is no real improvement since the start of the bipap usage. The sleep doctor was hoping I would show improvement with time. Now I'm heading back for a third night to try an asv machine and see if that works with the central apneas.

How difficult are the asv machines to get used to? I was so sleep deprived at first, even with the full face masks I found myself sleeping better and longer with the BIPAP than without, and have been 100 percent compliant even though the machine started sometimes wakes me up now that I'm not so sleep deprived. For those of you with complex apnea, did you find eliminating the Centrals as well as the obstructives was worth the trouble. My initial AHI was 102 and the bipap is definitely an improvement to my life. Should I expect anywhere near as significant of an improvement by trying take care of the central apneas and getting my AHI a little lower

SeekSleep wrote:So far I've gone through 2 Sleep studies, the first one a split using a CPAP with no successful results. On the second one using a BIPAP they got me down to an AHI of 10, with Centrals driving the AHI numbers. After almost 3 months, my AHI average is right at 10 which is no real improvement since the start of the bipap usage. The sleep doctor was hoping I would show improvement with time. Now I'm heading back for a third night to try an asv machine and see if that works with the central apneas.

How difficult are the asv machines to get used to? I was so sleep deprived at first, even with the full face masks I found myself sleeping better and longer with the BIPAP than without, and have been 100 percent compliant even though the machine started sometimes wakes me up now that I'm not so sleep deprived. For those of you with complex apnea, did you find eliminating the Centrals as well as the obstructives was worth the trouble. My initial AHI was 102 and the bipap is definitely an improvement to my life. Should I expect anywhere near as significant of an improvement by trying take care of the central apneas and getting my AHI a little lower

Not everyone adjusts quickly, but I did. I detested CPAP and it gave me horrible headaches from the centrals, but I adapted to my ASV quickly. Getting the mask to stay put without leaks was a big challenge, but the machine was not.

Good luck!

Regards, Nate

Hi SeekSleep: I've only been on my ASV since 6/21, but have found that it is wonderful. My machine is a Resmed ASV, and it is fully data capable, completely auto adjusts to every breath and drops the pressure on exhale. I haven't hooked up the humidifier and climate line tube yet, but it also adapts to room temp and humidity. I made my choice based on fine reports here. Btw I had to buy out of pocket and only cringed for a moment. I get it that I was dying a little each night. Far easier to adjust to than the testing machine I used. Best of luck to you! Have no fear you are on your way to a better life.

SeekSleep, are you looking at your data with the software? How long are your central events and how completely do you stop breathing? Just looking at the AHI number doesn't tell the whole story.

archangle wrote:SeekSleep, are you looking at your data with the software? How long are your central events and how completely do you stop breathing? Just looking at the AHI number doesn't tell the whole story.

I've been looking at my data with Sleepyhead, when I saw the sleep doctor last the stuff he talked to me about was a combination of Encore, and some other software that they had used with the overnight O2 sensor they had me use again.

My apneas seem to be all over the place time wise, and how tight together they are. With the CA events, I quit breathing completely for anywhere from around 12 to 45 seconds or so. I tend to get cluster of those every few hours. Every couple days I obstructive event clusters where I breath 4 or 5 breaths then quit for up to 45 seconds or so, then repeat. The software often shows those as mixed OA and CA events. I generally do that for anywhere from 30 minutes to an hour and a half or so. When they had me use the O2 sensor again, it showed my o2 level dropped down to 79 or so during the obstructive part of my sleep, and mid 80's during the CA clusters. The doctor mentioned that I would need a slight pressure boost to eliminated the Obstructive apneas as I seem to do them even sleeping on my side. I guess the problem with that is that my CA's go through the roof with any higher pressure, or at least it did during my BIpap trit. He didn't like my o2 level at all, but said at least it came up quickly when my breathing became more normal.

SeekSleep wrote:... How difficult are the asv machines to get used to? ... Should I expect anywhere near as significant of an improvement by trying take care of the central apneas and getting my AHI a little lower ...

The short answer is that it depends.

I've seen some people take to it without any problem. I personally found that it took about three months before it was pretty natural to me and I no longer fought with the ASV when falling asleep. But if you are patient and willing to stick with it, your body will adjust to the ASV therapy, even if you are one of the folks that struggle with it initially. I get a good night of sleep now. I would not without an ASV unit.

So, the longer answer is that even if you have problems you will adjust to the therapy and should regain great sleep.

I'm glad to hear that some of you have adapted well to the ASV machines. The doctor mentioned that the only down side as compared to the Bipap was that some people don't seem to want to adjust to them and quit the their treatment. Evidently adjusting easily to the Bipap doesn't assure you'll easily adapt to ASV. That's why I was curious. Of course I was also curious as to whether or not going from mild apnea to even less I can expect anywhere near the quality of life improvement I experienced going from severe apnea to mild. I guess I'll find out shortly.

SeekSleep wrote:I'm glad to hear that some of you have adapted well to the ASV machines. The doctor mentioned that the only down side as compared to the Bipap was that some people don't seem to want to adjust to them and quit the their treatment. Evidently adjusting easily to the Bipap doesn't assure you'll easily adapt to ASV. That's why I was curious. Of course I was also curious as to whether or not going from mild apnea to even less I can expect anywhere near the quality of life improvement I experienced going from severe apnea to mild. I guess I'll find out shortly.

One of the techniques that helped me adapt at the beginning was to take several deep long breaths for a minute or two at the beginning of my bedtime, right after I would lie down with the machine running and my mask on. It gave me the feeling that I was controlling the machine, rather than the machine controlling me. Then I could relax and just breathe normally as I cared to, and I would soon fall asleep.

Best wishes, Nate

I have just started ASV, after fighting with the CPAP for over a year.

I have the respironics.

I am doing good adjusting to it, with one caveat.. I had to start Ambien to be able to sleep with CPAP.

I am going to wait till this 2 week vacation is over and I will start to move off of the Ambien.

I have been sleeping 6 to 7 hours each night.. And have even put it back on after a bathroom break.. That's a huge step for me..

I only feel it, when I am starting to fall asleep and I feel a pulse..

I just wish that I had software to view my data..

I had my third Titration study last night using an ASV machine in the sleep lab. It woke me up a few times when the pressure ramped up enough to make my mask leak. It will be a week or so before I know the results though. The lab tech said there were several pressures where I looked pretty good, but it would be up to the Sleep doctor to score, and decide if the improvement was significant enough to warrant moving away from the Bipap. I'll attempt to load some of the Bipap data for opinions:

First, here is the overview data until last night which was spent in the sleep lab.


Here are the results from the last night:


Details:

I'll also include a couple snapshots zoomed in to give a better idea of what's going on.

First, an example of the CA clusters from last night:



Now a section of OA clusters from the night before last:



I ended up shrinking the screen captures down a little bit, which has made them a bit blurry, but hopefully they are clear enough for those with a little experience interpreting these things to provide some input as to how things look so far.

From what I see in those graphs, it appears as if ASV therapy would be a good match for you.

The leaking can be helped with a properly fitting mask and a mask liner. The mask liner both helps reduce leaks and when it does leak it decreases the noise that the mask makes (it's a loud hiss instead of the old face fart sounds). You can find information about them at:

http://www.remzzzs.com/
http://padacheek.com/PAC_Maskliners.html
http://quietusliners.com/

I personally have used both the REMzzzs and the Pad-A-Cheek mask liners. I make the REMzzzzs more economical by changing them once a week or so, instead of daily.

Also, you will find that the mask cushion dies a LOT faster with ASV therapy due to the constant flexing with the change in pressure. I personally use a Resmed Quattro FX full face mask. I find I have to change the mask cushion on a monthly basis. When I had CPAP and BiPAP therapy the mask cushions would often last three to six months. Not with ASV therapy.

As an aside about the sleep study, the lab actually does the scoring and makes recommendations about the therapy. (They run it through diagnostic software that helps identify problems and makes initial recommendations that the sleep techs at the lab then refine into specific recommendations for your doctor). But if they saw several pressures, it's a good sign for you. You should ask them for a full copy of the sleep study (not just a couple page summary). You might need to know those alternative pressures in the future and those would be revealed in the full study.

Hope that helps.

JohnBFisher wrote:Also, you will find that the mask cushion dies a LOT faster with ASV therapy due to the constant flexing with the change in pressure. I personally use a Resmed Quattro FX full face mask. I find I have to change the mask cushion on a monthly basis.

How do you know when a cushion is dying and needs to be replaced (especially with mask liners)?

sawinglogz wrote:

JohnBFisher wrote:Also, you will find that the mask cushion dies a LOT faster with ASV therapy due to the constant flexing with the change in pressure. I personally use a Resmed Quattro FX full face mask. I find I have to change the mask cushion on a monthly basis.

How do you know when a cushion is dying and needs to be replaced (especially with mask liners)?

It starts to leak more .. When that means it awakens me more than I like, I switch to a new mask cushion. Remember, the flexing will occur even if the mask liner reduces the contact of skin oils. And with ASV therapy (at least for me) it's the flexing of the mask cushion that seems to stiffen it more than it is the skin oils.

JohnBFisher wrote:

sawinglogz wrote:How do you know when a cushion is dying and needs to be replaced (especially with mask liners)?

It starts to leak more .. When that means it awakens me more than I like, I switch to a new mask cushion.

How do you tell the difference between that and the headgear stretching out and needing to be tightened?