RE: AHI is getting worse. Having more centrals
(05-18-2017, 07:09 PM)Amdx64 Wrote: Well it's been awhile. Though I would just give an update on how things were going. Had my appointment with my new sleep doctor and it went great. She listen to everything I had to say, looked at the data I had brought from sleepyhead and agreed with me that an asv was the proper machine for my ca's. So now I am scheduled for a ekg and asv titration.
Glad to hear you got a new competent doctor and are on your way to effective treatment. The ASV journey is often long and winding.
RE: AHI is getting worse. Having more centrals
I am late the party and have all but given up trying to get AHI down, but interested in the ASV, as I meet with sleep doc June 1st.. However I found an article by ResMed and unsure if I understand it ie using ASV may be detrimental to your health if you don't have heart problems, OR this a a good all around machine especially for central apnea (assuming doc thinks this is problem of my high AHIs), light years removed from my Respirionics Aflex machine.
http://www.resmed.com/us/en/news-and-inf...comes.html
I assume my machine technology and ASV are apples and oranges.
05-24-2017, 06:25 PM
(This post was last modified: 05-24-2017, 08:04 PM by richb.)
RE: AHI is getting worse. Having more centrals
ASV therapy is not recommended for people suffering from Congestive Heart Failure ans who have an ejection fraction under 45%. An echo cardiogram is usually given to those who are going to get an ASV machine to confirm a high enough ejection fraction.
Rich
RE: AHI is getting worse. Having more centrals
(05-24-2017, 03:52 PM)CPAPreturnee Wrote: I am late the party and have all but given up trying to get AHI down, but interested in the ASV, as I meet with sleep doc June 1st.. However I found an article by ResMed and unsure if I understand it ie using ASV may be detrimental to your health if you don't have heart problems, OR this a a good all around machine especially for central apnea (assuming doc thinks this is problem of my high AHIs), light years removed from my Respirionics Aflex machine.
http://www.resmed.com/us/en/news-and-inf...comes.html
I assume my machine technology and ASV are apples and oranges.
Risks pertaining to ASV apply to a relatively small cohort of individuals suffering from congestive heart failure with left ventricular ejection fraction less than 45%, based on the possibility of sudden cardiac death. This unexpected study finding has essentially translated into all ASV candidates being screened for CHF and low LVEF. ASV was previously the favored technology to address the central apnea and Cheyne-Stokes Respiration problems common in CHF. More study is pending on that.
For the rest of the world, there is an important role for ASV in treating complex and central sleep apnea. About 3-15% of OSA patients will develop central apnea when treated with positive pressure (CPAP). Many of those patients eventually adapt to CPAP and are well treated. Others are unable to tolerate CPAP pressure and must treat ASV using either bilevel with a backup rate, or the far superior ASV approach. ASV today includes automatically adjusting EPAP (exhale pressure) to target OSA, and uses pressure support to increase inhale pressure (IPAP) to cause a breath to be taken in the event of a central or increase the breath rate during hypopnea. No CPAP machine can do that. The ASV works on a breath by breath basis and regulates the breathing rate and volume to prevent nearly all periodic breathing, hypopnea and apnea in treated persons.
RE: AHI is getting worse. Having more centrals
it's been awhile but I thought I'd post an update while I'm sitting here waiting for the DME to bring me my new Resmed ASV. I am super excited. It's been quite the long nights waiting for this day to come.
09-01-2017, 02:36 PM
(This post was last modified: 09-01-2017, 02:38 PM by Sleeprider.)
RE: AHI is getting worse. Having more centrals
(09-01-2017, 02:32 PM)Amdx64 Wrote: it's been awhile but I thought I'd post an update while I'm sitting here waiting for the DME to bring me my new Resmed ASV. I am super excited. It's been quite the long nights waiting for this day to come.
Congratulations! We have not seen an update on this since May, so I think that shows the kind of time that often passes before the medical community gets its act together. We called it on the forum by the second post in this thread in February. Keep in touch as you begin the next phase.
RE: AHI is getting worse. Having more centrals
Good to hear that you are getting your ASV machine. Let us know how you do with it.
Rich
RE: AHI is getting worse. Having more centrals
Well here is how my first night went with the new machine. It said I had a bad mask seal but i never woke up with air leaking in to my eyes or on my face. Around 4:30 or so I got up and went to the bathroom then I switched to my P10 and it didn't show any leaks. When I had my titration I used the nuance pro and the tech said it fit great with no leaks. However the machine they were using was a Philips Respironics. Could the amount of air coming from the middle vent on the nuance be messing up the leak rate in the machine? The pressure was a little higher than I am accustom to and I felt like I laid awake all night even though I didn't. So far I happy with the ASV and think once I get adapted to it I will love it.
Min EPAP 10
Max EPAP 13
Min PS 3
Max PS 10
RE: AHI is getting worse. Having more centrals
Your treatment results are very good, and resolving the leaks is your next task. The P10 worked much better.
Minor tweaks to try once you are comfortable with it may be to lower min EPAP to 9 and see if event rate remains low. I think it's likely the auto will increase EPAP to 10 anyway, but may be interesting.
RE: AHI is getting worse. Having more centrals
Night number 2 with the p10 till about 4:30 then put the nuance back on. Stupid leaks!!
My wife said she heard it leak all night she woke me a couple of times. I think my mouth could be being blown open from the pressure. I'm going to try my full face tonight.
Min EPAP 10
Max EPAP 13
Min PS 3
Max PS 10