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ASV machines
#11
Oh, one more thing for the experts.  I am going to switch to the ResMed Airfit P10 mask and see if it is more comfortable.  The current mask is starting to really bug me after this long.  By the way, I am not a mouth breather so I figure it is worth a try.  What do you think?  Also, what would be your top 6 graphs, besides events, to display in Sleepyhead?
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#12
(07-10-2017, 11:56 AM)Lost53 Wrote: . . .  what would be your top 6 graphs, besides events, to display in Sleepyhead?

Please review my link to Posting SleepyHead Charts in 5 Easy Steps for this information.
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Useful Links -or- When All Else Fails:
Posting SleepyHead Charts in 5 Easy Steps
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#13
    Hey Sleeprider  and Deep breathing.  Here is my latest screenshot with new settings and AirFit P10.  Tell me what you think.
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#14
If it was my chart, as per the titration manual page 41 https://www.resmed.com/us/dam/documents/...lo_eng.pdf
I'd lift the min epap to 8 for the couple of OA/H you are getting, as an initial setting. The UA is probably an OA, your minimum tidal and minute vent is 0.0 which may indicate an obstructive issue. Resmed have said they get all the CA.

I wouldn't, but if you want to restrict the max settings. You would need to scroll through the chart and see where you are getting any low tidal volume/minute ventilation, to fully resolve issues. To see if you have enough max EPAP and PS. The ASV adjusts to 90% of the minute ventilation as a target. You need to make sure there is enough max pressure support to fully ventilate during a CA, Using the zoom on the flow chart, tidal volume and minute vent to compare.
I know that with me on the ST, a PS of 6 will vent my lung to about 14l/m which is half a breath. With my current settings, my min tidal volume is 300 and the min minute vent is 4. You should be able to do much better on the ASV than this.
new user http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or sleepyhead, set the min CPAP 1cm below median pressure. Or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#15
Lost53, I have to ask you how you are feeling. Have the new settings resolved the discomfort you were feeling with the higher pressure? Are you sleeping better?

Your results are excellent, and I'll have to disagree with ajack that chasing a few obstructive events is a worthy endeavor with this very low event rate. The machine is working pretty hard to counter centrals and hypopnea with significant pressure support through the night, but your median pressures are only 8.98/6.42 which is pretty reasonable, and your 95% at 15.8/8.9 is also pretty good. So as long as you are feeling this is good progress, I'm not seeing a compelling reason to recommend any changes.
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#16
   
Thanks for the reply Sleeprider.  I don't feel any different in the morning but I do sense less pressure during the night.  I have been using the AirFit P10 for 3 nights now and I like the way it fits. I got a big surprise this morning though.  I ended up with a 1.1 AHI and I haven't had one that bad in over a year.  Here is a screenshot.
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#17
You need to take a holistic approach to sleep quality.  CPAP/ASV is a big part, but don't rule out non-CPAP just because you have had a complete physical.  Did they test for Vitamin D levels?  You want the 25(OH)D blood test, not the 1-25 version that is often ordered.  Taking supplements has improved my sleep quality.  I am on T replacement as well, but is it too early to say on that.  It has not hurt.  

Sleep-well
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#18
You had more flow limitations. I don't feel at all alarmed about an AHI of 1.1. There is considerable flow limitation and the minimum EPAP is responding to that. My original recommendation had your EPAP minimum at 6 rather than 5, and there is merit to ajack's suggestion. I would consider raising minimum EPAP slowly, and see where it feels best. You might need to keep a journal to recall the relative difference with these subtle changes since we are mostly after comfort and sleep quality; the AHI is not a problem.
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#19
8 may be a bit aggressive, conservative would be to have min epap:7 and min ps:3, which will give a floor of Ipap:10
I would lift the max epap and PS back to the recommended default 15. I have no valid reason to restrict the algorithm.

The average tidal volume, minute vent and insp/exp times all look good to me

It would be good to see a zoom on 00:20 area with the UA/H and see what is happening. That is the area that needs a tweak. It's possible that is where the max epap/PS:11 is choking and 15 would be better
new user http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or sleepyhead, set the min CPAP 1cm below median pressure. Or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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