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[CPAP] Beyond ASV with Overlap Syndrome!
#91
RE: Beyond ASV with Overlap Syndrome!
Oximeter could show you if you are getting insufficient ventilation and not evacuating CO2 well enough as your oxygen levels should be dropping in that situation. I have an equivalent of the CMS50F and it works well enough.

Rise time adjusts inspiration time and doesn't kick in until inspiration is started so has no influence on exhalation time. The only change that is possibly going to extend exhalation period I can think of is to set low trigger sensitivity and high cycle sensitivity so machine kicks into EPAP mode sooner and IPAP mode later, even then backup rate is likely to be your main enemy and if you have backup rate too low may have more CSA issues.

Does ASV allow you to modify backup rate and if so have you tried?
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#92
RE: Beyond ASV with Overlap Syndrome!
OK copy on the CMS 50F, thanks.

No timing adjustments available on this ASV including Rise Time. On ASVAuto, I have EPAP Min/Max and PS Min/Max. ASV mode makes EPAP single pressure. ASV mode did not work well for me.
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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#93
RE: Beyond ASV with Overlap Syndrome!
Yeah I know they don't have ticontrol, sensitivity etc. I have a hard time believing those settings are going to make a signifcant difference though as it seems your issue is far more severe than just a slight discomfort/minor tweak of settings. If you were able to get mediocre sleep most of the night I would say those settings are more important but since you barely can even use it I feel there has to be something bigger that is being missed.
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#94
RE: Beyond ASV with Overlap Syndrome!
Sparky,
A thought just crossed my mind.  You didn't mention this problem until after you had the spinal electrical stimulation.  Have you looked into the possibility of the electrical impulses are interfering with your breathing responses?
Crimson Nape
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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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#95
RE: Beyond ASV with Overlap Syndrome!
Hadn't thought of it beyond a fleeting moment. It's easy enough to rule out. I'll mask up with sparky off and see what happens. I''ll report back tomorrow how it went. Thanks for thinking of it. It's worth a shot.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#96
RE: Beyond ASV with Overlap Syndrome!
OK, here's the update after I saw pulmonary doc this afternoon as the follow-up on recent PSG. I'll scan the detailed, 4 page redacted version soon. I have it now, but devil printer doesn't recognize the PC to upload scan files right now.

I addressed doing what doc wanted, taking ASV to RT at DME, as a done did thing. I mentioned the RT saw inverted I:E ratio and I may be suffering from air trapping because of this, according to the same RT. Doc asked what settings the RT changed to help the inverted I:E; I explained my AirCurve ASV doesn't have time controls. Bingo, he got it! He was beforehand not aware my model ASV doesn't provide time settings. He and I discussed what options the RT gave, which is to move to an NIV, specifically the Respironics Trilogy. He said he can see making the case for this. He also suggests I edit my PS range from 4-13 to a 4-7 and let him know if it helps until May. We may have a greater chance to get Medicare to change to an NIV with my medical necessities than my current Medicaid based health insurance.

I wasn't able to try the ASV as mentioned to try what Crimson Nape suggested. I've not been sleeping well since this disturbance in the force. I don't have the flu or tumors or such, but I've just been in insomnia mode. Must be the blue lights and Sumatra coffee at midnight...Smile

Doc doesn't think there's great odds that my SCS implant is hindering therapy. I'll edit my PS and see what happens tonight and do an OSCAR tomorrow (with the PSG if possible). I didn't see much on that report IMO. It did indicate some arousals and "fragmented" sleep, no PLM. I didn't see apnea events though.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#97
RE: Beyond ASV with Overlap Syndrome!
The Ti controls are a godsend for COPD to conserve expiration time. Statistically and in most closeups, you seem to have sufficient time for expiration, but we now with COPD, it's not always being able to get the air in, it's getting the air out (right piggies?). I don't personally see respiratory stacking, but unlike Geer1, I'm not such a pro. What ST-A can do that your ASV cannot, is maintain your ventilation rate with a curtailed time of inspiration. So if we cut your TiMax to 1.8, it is pressure support that will ensure enough respiratory volume to at the same respiration rate, to allow for a 2.6 second expiration time vs the chart posted above with 2.12:2.02 median I:E (1 to 0.95 I:E ratio).
Sleeprider
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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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#98
RE: Beyond ASV with Overlap Syndrome!
The RT is basing inverted I:E on what she observed overall with the machine and my own breathing in a mask on, and it was an awake status. But again it's her observation of machine and patient interaction and not the display on the ASV only. None of her observations are OSCAR based.

The most recent OSCAR is out there, I'm in an I can't use the ASV status. It wakes me up within 2 hours of falling asleep.

My opinion is that a machine that can extend exhale time before triggering an inhale is the desired remedy.

Thanks for recent thoughts Geer1 and Sleeprider.

My self initiated actions are reducing the PS range as the Doc suggests. I will show professional respect and try it. I'll know very quickly if it helps or not. If it helps, I run with it, and if it doesn't positively affect my therapy, I reset to current and basically wait until I get another machine. Doc wants me to try it and give feedback assumed via a call. I also have my yearly COPD required PFT spirometry test in April with a doc follow-up a week later and can give feedback then as well.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#99
RE: Beyond ASV with Overlap Syndrome!
At the request of SarcasticDave94, this thread has been cleaned-up and restored for posting. Please stay on-topic, which means Dave is basically directing the conversation here.
Sleeprider
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www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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RE: Beyond ASV with Overlap Syndrome!
FWIW I plan on adding latest PSG 4 page probably tomorrow
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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