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#1
My original sleep study results: AHI 38, CAHI 27.6  Oximetry  10%  <88% O2 Sat. or 56 minutes. My previous Dreamstation ASV settings at: Pmax 15, EPAPmax 11, EPAPmin 9, PSmax 4 PSmin0 BPM Auto gave various results from AHI of 8.1 to 4.1. Last night I set the ASV at 16,11,9,6,0, Auto. This gave me a best ever AHI of 3.7.  I think I can improve on this. Tonight I'm going to try 17, 10.5, 8,6,0, Auto. I also changed masks from F20 Airtouch to F20 Airfit. The Airtouch starts to tear at the bridge of the nose area within a few days of being new. The Airfit is actually more comfortable because it does not need to be as tight as the Airtouch to prevent leaks. Best of all feeling better all the time. See attachment.
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#2
Congrats on the progress. You have come a long way on leaks and events, best of all you are feeling better.
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#3
Thanks this Board has been a big help. BTW I tried your suggestion of PS max of 10 but that caused huge leaks  so I dropped it to 6 with the results I described. Thanks again for your help.
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#4
Hi RLSdss,
CONNGRATULATIONS'! on your progress, keep up the good work.
trish6hundred
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#5
I was using F20 Air fit with a large cushion and standard head gear and it was better then anything else but sometimes it  made my nose sore. The air touch cushion tears within a week. Now I have a large nose and head so I have a large cushion but I was supplied a standard head gear. That seemed dumb so I bought the large head gear and what a difference. Last night I a four hour stretch of solid sleep which is the longest I've had in years.
Also the current settings I have posted have always given me the fewest CAs and OAs but there was always a period during the middle of the night that OA and Hs would go way up. The  H index is always high and my oximeter  hardly ever agrees. Most nights my O2 sat is above 90% 75 to 80% of the time even with this hour in the middle of the night that is crazy. I fiddled with all the settings but never solved this problem. But now I think I know what is going on. I mostly sleep on my right side because of arthritis in my left shoulder. When I wake up around the time of these high readings my left leg is often sore for some reason. I think I roll over on my back when this happens to relieve the pain and so my OAs a Hs go up. I get up and take an aspirin go back to be Sleep on my side and and AHI goes back to below 3. See Encore Pro data attachments.
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#6
Your hypopnea is high because you decapitate the pressure support at 6-cm.

We have discussed this, and you keep putting the settings back to an ineffective range. Your choice .
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#7
(01-19-2018, 05:32 PM)Sleeprider Wrote: Your hypopnea is high because you decapitate the pressure support at 6-cm.

We have discussed this, and you keep putting the settings back to an ineffective range.  Your choice .


I know very little about ASV and this is probably a stupid question to ask, but is it possible that increasing the Min EPAP could also help with those middle of the night OAs and Hs?
-Amin
Nothing I say on the forum should be taken as medical advice.
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#8
The OA is only 1.1/hour in that chart. My specific recommendations (that worked when implemented) were to increase PS min to 3.0 and PS max to 12 and Pmax to 20. That resolved hypopnea and centrals, and gave all the room necessary for the auto EPAP mode to move higher. We have been through this at least 3-4 times. This is self-inflicted.
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#9
You are playing and I think tripping yourself up, as sleeprider is saying. It's not that hard to set up an auto ASV. You have min epap at your median epap pressure. the min PS is whether you have any lung issues, if not PS:3 is a good choice. the max settings are set to the max available or 15, whatever your choice. This should get your AHI down very well, if you are still having events, raise your min epap.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 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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#10
Again, I am just asking to learn here. Is what the OP describes as unsolvable full face mask leaking when using a high PS Max a valid concern / reason for not going using the necessary PS Max?

I ask this because on the rare occasions that I use a full face mask, I too have a lot of leak issues and basically have to adjust the straps for the highest pressures I will see, which is unpleasant. As a result, I tend to switch from auto BPAP to CPAP on those nights, so I can just set the strap tightness to prevent leaks at a single pressure. I can imagine that using ASV and trying to get a full face mask not to leak even when the algorithm chooses a PS of up to 15 could be a leakmare.

I suppose his results on the current settings are already pretty good, and I guess what you're saying is that if he wants a lower AHI, he's got to find a way to raise the PS Max and address the leaks. Is that right?
-Amin
Nothing I say on the forum should be taken as medical advice.
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