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ASV questions
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robysue Offline
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #11
RE: ASV questions
(05-05-2016 10:07 PM)PoolQ Wrote:  Payton,

I have tried to figure out what wakes me up and have failed to narrow it down to anything.
I wake up with the goal of taking the mask off, I sit up, stand up and walk around for less than 5 minutes and then remask up and go right to sleep. No noise or light. Very consistent every night, just different number of times.
Are these wakes roughly 90 minutes apart? If so, they may be normal post REM wakes that once you realize you're awake, you decide you need a brief break from the mask.

It's very normal to briefly wake up after a REM cycle. The thing is, most of the time a person wakes up just enough to realize that everything is ok and they go right back to sleep. The total wake is maybe a minute or two long and the person doesn't remember it in the morning.

But what may be happening now is that when you wake up post-REM, you're still noticing the mask as an alien on your nose instead of "normal". So you wake fully up and decide that you need to get the alien off your nose. But you're also conscious enough of the need to not go back to sleep without the mask on your nose. So you take the mask off, but sit up and walk around just a bit in order to prevent yourself from falling back asleep without the mask.


Quote:I never did this before CPAP. with the adjustments I made in the first post, I mostly now only get up 2-3 times a night.
Prior to starting CPAP, you most likely reacted to normal post-REM wakes in a normal fashion: You quickly established that nothing was wrong and you fell right back asleep and didn't remember the wakes in the morning.


Quote:I sleep 10-11 hours at a time and my getting up usually stops between 4 & 6 am, giving me 3-4 hours of uninterrupted sleep at the end.
My guess is that if you have any post-REM wakes after 4-6AM, you're body and brain are now reacting in a normal fashion: The brain is no longer concerned about the alien on your face, and so you go right back asleep after the post-REM wake.


Quote:Making those changes made a big difference so I thought that there might me more changes that would help on a different machine. It "seems" that I wake because I am fatigued from using the CPAP and just need to get vertical and take a break.
I disagree. I don't think you are waking because you are some how "fatigued" from using the CPAP.

I think your wakes are most likely normal post-REM wakes that you are reacting to in a fashion that prolongs the wake so that you remember them. And because you remember them, they have become disruptive to your sleep.

As for what to do about them. I think you need to train yourself to react normally to these wakes so that they last 1-2 minutes long and so that you don't have to get out of bed before going back to sleep.

I've had some experience with having to retrain myself to not over react to post-REM wakes during my first year or so of PAPing. So maybe my story may help you figure out how to deal with these wakes in a way that minimizes how disruptive they are to your sleep.

During the first year of PAPing, I had such horrible problems with aerophagia that every time I found myself awake in the middle of the night, I badly wanted to "escape" the pressure. The aerophagia problems not only caused a lot arousals and wakes, it also meant that every time I had a normal post-REM wake, I still would wake up and start worrying about the aerophagia and that made it much harder for me to get back to sleep. (Which in turn increased the aerophagia and would cause additional wakes.)

After being switched to a PR System One Auto BiPAP in with an EPAP range of 4-6 and an IPAP range of 6-8, I decided that rather than take the mask off, I'd just turn the machine off and then back on. That way I knew the pressures were back down at EPAP = 4 and IPAP =6 and I wouldn't get aerophagia while getting back to sleep.

This simple habit of turning the machine OFF and back ON when I find myself awake in the middle of the night and some CBT for insomnia allowed me to conquer the worst of the aerophagia-related wakes. But I still have post-REM wakes most nights. However, turning the machine OFF and back ON every time I find myself awake in the middle of the night usually lets me immediately fall back asleep and the only reason I know the post-REM wakes happened are that the OFF/ON cycles show up in my SleepyHead data. In other words, I am now reacting to these post-REM wakes in a normal fashion: I wake up, realize there's nothing serious causing the wake, turn the machine OFF and back ON so that I don't have to worry about my stomach, go back to sleep, and I don't remember the wake in the morning. And because the wakes are now down to 3-4 a night and I don't remember them, they no longer disrupt my sleep too much.

Questions about SleepyHead?
See my Guide to SleepyHead
05-05-2016 11:24 PM
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PoolQ Offline

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Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
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CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

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Sex: Male
Location: Sillicon Valley

Post: #12
RE: ASV questions
Robysue, thanks for the input.

Before I made those changes, on a good night I would wake every hour +/- maybe 10 minutes all night (I would look at the clock and go yep one hour, on a bad night it would be every 30 minutes. I "may" be going into rem that often, but I would be surprised if I was.

When I wake I have tried just staying still and relaxing, breathing slowly and my anxiety increases until I sit up. Not fast and not all that much, but it's there. It decreases as soon as I sit up and goes completely away as soon as I take the mask off. This is not even close to panic. Just a low level uncomfortable.

If I take a nap during the day I can sleep any where from 1 - 2 hours and lay awake in bed thinking how nice it is to breathe with the mask on, it really is my friend at this point. I was not sleeping at all before PAP.

If I can't "fix" this that will be okay, but if it can be fixed my life would be better. I don't want to get 5 years down the road and have someone ask why I didn't try xyz because that was the cause of my discomfort.

Just checking if there is anything else I can try.
05-05-2016 11:57 PM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Perth, Western Australia

Post: #13
RE: ASV questions
Interestingly, Resmed do not use the name VPAP in any of the Aircurve series. However they do use it for the Lumis series of ventilators which appear to be based on the AirCurve platform. The Lumis series comprises the Lumis 100 VPAP S, Lumis 100 VPAP ST and Lumis 150 VPAP ST noninvasive ventilators that support a variety of therapy modes, built-in wireless connectivity, integrated humidification and intuitive simplicity that are the hallmarks of the series. Further the ResMed AirCurve 10 ASV is now called the AirCurve 10 CS PaceWave in Australia and other markets.

I always thought the Philips / Respironics nomenclature was a mess, but Resmed seem to be getting equally silly.

At one time we looked at setting up a database of machines to make it easier for members to identify their particular model, but gave the idea up as too hard - at that time there were 56 different model numbers for the S9 series alone. It's even worse now.

DeepBreathing
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
05-06-2016 12:29 AM
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palerider Offline

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Machine: s9 vpap auto
Mask Type: Nasal pillows
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CPAP Software: SleepyHead

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Sex: Male
Location: Dallas(ish)

Post: #14
RE: ASV questions
(05-06-2016 12:29 AM)DeepBreathing Wrote:  At one time we looked at setting up a database of machines to make it easier for members to identify their particular model, but gave the idea up as too hard - at that time there were 56 different model numbers for the S9 series alone. It's even worse now.

oh? things like 36025 were never found on the back of the machines, or were you thinking about things like the Autoset CS-A?

besides, it's been done. https://sleep.tnet.com/cmd
(This post was last modified: 05-06-2016 12:40 AM by palerider.)
05-06-2016 12:37 AM
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PoolQ Offline

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Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

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Sex: Male
Location: Sillicon Valley

Post: #15
RE: ASV questions
(05-06-2016 12:29 AM)DeepBreathing Wrote:  Interestingly, Resmed do not use the name VPAP in any of the Aircurve series. However they do use it for the Lumis series of ventilators which appear to be based on the AirCurve platform. The Lumis series comprises the Lumis 100 VPAP S, Lumis 100 VPAP ST and Lumis 150 VPAP ST noninvasive ventilators that support a variety of therapy modes, built-in wireless connectivity, integrated humidification and intuitive simplicity that are the hallmarks of the series. Further the ResMed AirCurve 10 ASV is now called the AirCurve 10 CS PaceWave in Australia and other markets.

I always thought the Philips / Respironics nomenclature was a mess, but Resmed seem to be getting equally silly.

At one time we looked at setting up a database of machines to make it easier for members to identify their particular model, but gave the idea up as too hard - at that time there were 56 different model numbers for the S9 series alone. It's even worse now.

Perhaps it is different over here, the Resmed site on their devices page clearly lists all the Aircurve machines under the header VPAP, I could be wrong but it sure looks that way to me. see the link in my earlier post
05-06-2016 01:24 AM
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DeepBreathing Offline
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Posts: 2,296
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Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #16
RE: ASV questions
Quote:Perhaps it is different over here, the Resmed site on their devices page clearly lists all the Aircurve machines under the header VPAP, I could be wrong but it sure looks that way to me. see the link in my earlier post

Yes, you're quite right. My point is that they don't use the VPAP in the model names any more, so saying you've got an Aircurve VPAP is just confusing. But of course they do use it in the Lumis models so that's even more confusing. Oh-jeez

DeepBreathing
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
05-06-2016 01:53 AM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #17
RE: ASV questions
heh well right you are, so far I have not been impressed with the sleep therapy business, from start to finish.
05-06-2016 02:00 AM
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robysue Offline
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Posts: 1,245
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #18
RE: ASV questions
(05-05-2016 11:57 PM)PoolQ Wrote:  Robysue, thanks for the input.

Before I made those changes, on a good night I would wake every hour +/- maybe 10 minutes all night (I would look at the clock and go yep one hour, on a bad night it would be every 30 minutes. I "may" be going into rem that often, but I would be surprised if I was.

I am talking about what's going on NOW, not what was going on before you made the adjustments. In an earlier post you've stated that:
Quote:with the adjustments I made in the first post, I mostly now only get up 2-3 times a night.
and
Quote:I wake up with the goal of taking the mask off, I sit up, stand up and walk around for less than 5 minutes and then remask up and go right to sleep. No noise or light. Very consistent every night, just different number of times.
So it sounds to me like you're waking up enough to know that you are awake only 2-3 times a night right now.

If that's wrong, please clarify: How many times a night are you currently waking up and how far apart are the wakes?


Quote:When I wake I have tried just staying still and relaxing, breathing slowly and my anxiety increases until I sit up. Not fast and not all that much, but it's there. It decreases as soon as I sit up and goes completely away as soon as I take the mask off. This is not even close to panic. Just a low level uncomfortable.
Since the anxiety goes away completely when you take the mask off and you describe it as a low level of uncomfortable, it sounds to me like you are still noticing all the sensory stuff coming from the PAP when you wake up in the middled of the night. And as soon as you notice all the sensory stuff, the low level of uncomfortableness kicks in and that leads to the anxiety ....

Also, although it's counterintuitive, your attempt to stay still and focus on relaxing, slow breathing may be adding to the problem. Concentrating on one's breathing while using a PAP can make things (a lot) worse for me if I'm even slightly uncomfortable from the mask, the pressure, or the exhaust flow blowing on me.

So why not just turn the machine off and back on while you're lying in bed to see if that takes the edge off the anxiety? In other words, rather than lie there trying to stay still and focusing on your breathing until it gets to the point where you decide you have to sit up and take the mask off, why don't you try this first:
    As soon as you wake up, turn over (if necessary) and turn the machine off and pull the mask cushion away from the nose to get a couple of normal breaths. Then reset the cushion and turn the machine back on and allow yourself to wiggle around and get comfortable enough to go back to sleep.

If you're still awake after 5 minutes or so and you are beginning to get uncomfortable, you can always still sit up and take the mask off like you're currently doing. But the simple act of turning the machine off and back on may be enough to relieve the low level of discomfort to the point where you can quickly get back to sleep.

Quote:Just checking if there is anything else I can try.
As I said before, I'd try the simple trick of turning the machine off and back on as soon as you wake up. And I'd try to not concentrate on the breathing in the middle of the night.

Questions about SleepyHead?
See my Guide to SleepyHead
05-06-2016 09:16 AM
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robysue Offline
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Posts: 1,245
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #19
RE: ASV questions
Yes, it does look like the Resmed naming scheme has become just as bad as the PR one. From the Resmed web pages, it does look like the AirCurves are all listed as "Bilevels", and the names of the machines are indeed given as:

AirCurve 10 ASV
AirCurve 10 VAuto (This one is particularly confusing)
AirCurve 10 S
AirCurve 10 ST

So it seems that Resmed's naming convention has changed significantly from the previous S-series, where the CPAP/APAPs were called S* CPAPs and S* AutoSets and the bilevels were called S* VPAPs.

So "AirSense" = Resmed CPAP/APAP and "AirCurve" = Resmed VPAP.

At least PR's naming scheme is finally getting better rather than worse: The DreamStations finally have deleted REMStar from the main part of the name.

Questions about SleepyHead?
See my Guide to SleepyHead
05-06-2016 09:24 AM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #20
RE: ASV questions
to add even more confusion, when I looked at sleepyhead last night it show my machine as Aircurve VPAP, go figure
05-06-2016 04:13 PM
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