BiPAP ST to ASV - Optimizing

[fikus56]

Just took a few nasal pulls with the new settings and it feels great !!

[SarcasticDave94]

The EPAP Min edit should immediately feel like a bit more air to you. The ASV will probably move up from that often enough to combat events, but when it does drop back it won't feel like air got cut off.

[fikus56]

last night was interesting.  Worse score and woke up at about 3am for an hour with a ton of anxiety.  Also have a lot of good but stressful things happening in my life.  Also, my sinuses were pretty stuffy and was having some trouble breathing at times.  Also , there were some leaks later on in the night.  Nonetheless I basically felt great and full of energy with one cup of coffee.  Levels are starting to fade now but looking forward to trying again tonight. 

Last nights report is attached.  Thanks for your support.

[fikus56]

wrong attachment - attached is last nights

[SarcasticDave94]

You could likely go again as is tonight. You want to see if the events at 0440-0545 are absent next go. That bit was either leak causing the Hypopnea or events and pressure increase gave the leaks. Either way, this will be your trouble spot for the night. If it's a non-repeatable thing OK just move on. The trouble comes if it's a repeatable thing.

It could be the mask is somewhat easily knocked about to setup becoming leak prone. Just something to watch.

[fikus56]

it seemed like a slept ok last night, I didn't wake up with that magical feeling though that seems to be associated with the super low AHI.

AHI was 7.53.  Chart looks really crazy as well.   I know a lot of is probably mask leak but also seems the high pressures may be contributing to them.  Although I suppose to high pressures could also be the machine attempting to resolve apneas. 

At this point it seems like the default settings were working better?

Let me know what y'all think and appreciate the support.

[Sleeprider]

There is some clustering of events that may be from positional chin-tucking. Obstructive events are present so normally we would increase minimum EPAP by one, however a return to default settings would be an interesting test to see if AHI drops back.

[fikus56]

Thanks Dave - that’s what my wife and I were thinking as well regarding default settings. 

… I already own the cervical collar in case the chin tucking becomes an issue

[SarcasticDave94]

I'm thinking chin tuck could be a cause as well. I'd try the collar to see what happens.

[fikus56]

I’ll go back to the default settings, if there are clusters there then I’ll try the collar