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AirCurve 10 in ASV mode
#11
RE: AirCurve 10 in ASV mode
Not to be contrary, but with ASV treatment, flow limits more or less were ignored by me with my ASV, which is identical to your ASV model here. What I mean is, I didn't factor FL in titration decisions. Feel and basic results of AHI, leaks, and pressure were about all I looked at. However it turned out, when I dialed in my ASV via my own Titration, flow limits were oddly low. Just a bonus I'm guessing.

When you're ready to go up to bat again with ASV Auto, let me know and we'll walk through it. Myself, I tackled EPAP first then PS. I didn't read ResMed titration directions until afterwards. Oh well, I still had good therapy with it, scoring some 0.0 AHI nights.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#12
RE: AirCurve 10 in ASV mode
This chart does not show any positional apnea problems or patterns of flow limitation that would be related to chin-tucking.  Usually with ASV, we see flow limitation that is related to the user relying on pressure support to provide a breath. These are the isolated spikes of FL we see in your chart.  From 22:40 to 23:20 we see a period of fairly low pressure support indicating spontaneous breathing, but relatively high flow limitation.  This is real obstructive flow limitation and is associated with increasing EPAP pressure.  Based on this, I recommend increasing EPAP min to 5.0.  Everything else looks great.

[Image: attachment.php?aid=33990]
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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.
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#13
RE: AirCurve 10 in ASV mode
With the last 2 posts you have the best and brightest helping you with ASV. Listen to them.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#14
RE: AirCurve 10 in ASV mode
Thanks again for all your observations and suggestions. I'll pause this thread and start working on the things you all have advised. I'll do my best to document changes and conditions for each step and do them one at a time. I'll hope to report back with improvements. This is a great community! I have also made my brother aware of you. He is working without a doctor and can benefit from you a lot. I gifted him an O2 ring to aid him in understanding his progress.
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#15
RE: AirCurve 10 in ASV mode
I have a question since I am trying to learn.  In the plot of ASV Auto mode, waitedwaytoolong's SpO2 levels were much lower than in the plot provided at the top of the post.


Are these lower levels likely from the positional issues?

Also, does anyone have hints on a camera setup for detecting these things?  I am thinking of some sort of camera that films my father overnight, perhaps with a clock moved next to his bed, so I can later correlate any obvious positional issues with OSCAR apnea results.  Or is this overthinking?  Is the better approach to try a collar and see if things improve?
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#16
RE: AirCurve 10 in ASV mode
I don't see any issues with SpO2, however, in the first post the EPAP was set at 10.0 cm and in the most recent, EPAP ranged from 4.0 to 8.0. It is a basic principle of PAP and mechanical ventilation that higher EPAP results in better oxygenation, while higher PS results in higher ventilation and lower CO2. I would suggest that the original settngs were too high for comfort and resulted in much higher tidal volume and a slightly more suppressed respiration rate. The over-ventilation suppressed respiratory drive and made the user more reliant on the ASV pressure support to correct the hypocapnea induced centrals. In the end, we would rely on subjective "how did you feel" to evaluate the results. I can tell from the much smoother respiration flow rate graph, this was closer to the mark than the original settings.
Sleeprider
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____________________________________________
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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.
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#17
RE: AirCurve 10 in ASV mode
Thank you fir sharing your knowledge.  You’ve given me some things to chew on.  

My father’s sleep study got delayed from last week till tomorrow; hoping to learn something from that. 

Thank you again.
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