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Chart Envy
RE: Chart Envy
Give the increase in max PS a few days to settle, the TV has risen from 560 to 720 and will settle down. I'd also look at the I:E then. I think it was a good move to raise the max PS

Just on this chart for an overview, if it was the norm and I'd wait to find out.
Going low epap may introduce some UA and H and flow restrictions, it's a balance. The med is 11.6 and 95% 12.3. 12 still looks like what I would try
The min tidal volume and minute vent overall looks good, with minor dips. You could zoom in on those to see what is going on.
The med PS appears to be 5.6, I think min ps 5.6 or ps 6 is worth trying later as a floor. The machine will self adjust from PS4 though.
A higher floor/min PS may decrease the I time, that and along with higher min epap. You only have pressure adjustment on an asv, to try and have a quicker inhale. To get closer to 1:2 or 1:3
You can see any effect on the insp time chart during the night. That is assuming the machine is reading your I:E right and not picking up a blip, giving a false reading. If at the end of the day, if you don't improve the I:E time a lot. It's not that big of a deal and could be talked over with your doctor at your next appointment.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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RE: Chart Envy
Don't worry about the flow limitations graph it is not an issue to look into further for now the lines are very spaced out and look very similar to my flow limitation graphs when on asv
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RE: Chart Envy
Flow limitations on the ASV can be an artifact of the machine using pressure support to trigger a breath. These are often machine triggered breaths, and without your spontaneous effort, the flow rate can look flow-limited, however it is not a restrictive flow limit, but the fact that as your lungs fill the flow rate slows as backpressure increases against the machine's pressure support. I don't know if that explanation makes sense, but if you have questions we can talk about it. This is a pretty common issue on ASV and it does not affect therapy in the same way as flow limitation from upper airway resistance.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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RE: Chart Envy
Thanks for all the advice and encouragement folks - sounds like I should leave well alone for a few nights and maybe up the pressure support after a few nights home - last night was near perfect in AHI terms and again a glorious 11.5 hrs of sleep.

We're doing the all inclusive thing for the first time in Mexico in an Eco Resort - I have to say I'm enjoying the margueritas and vibe a whole lot better feeling awake, alert and relaxed - its amazing the impact good or bad sleep has on your wellbeing.

Rob
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RE: Chart Envy
(03-27-2019, 07:13 PM)Technopauper Wrote: Thanks for all the advice and encouragement folks - sounds like I should leave well alone for a few nights and maybe up the pressure support after a few nights home - last night was near perfect in AHI terms and again a glorious 11.5 hrs of sleep.

We're doing the all inclusive thing for the first time in Mexico in an Eco Resort - I have to say I'm enjoying the margueritas and vibe a whole lot better feeling awake, alert and relaxed - its amazing the impact good or bad sleep has on your wellbeing.

Rob

What's an Eco Resort? No straw in your Margarita?  Sounds like a warm nice place, and you should sleep well.

(Without pictures it never happened.)
Sleeprider
Apnea Board Moderator
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: Chart Envy
(03-27-2019, 08:16 PM)Sleeprider Wrote:
(03-27-2019, 07:13 PM)Technopauper Wrote: Thanks for all the advice and encouragement folks - sounds like I should leave well alone for a few nights and maybe up the pressure support after a few nights home - last night was near perfect in AHI terms and again a glorious 11.5 hrs of sleep.

We're doing the all inclusive thing for the first time in Mexico in an Eco Resort - I have to say I'm enjoying the margueritas and vibe a whole lot better feeling awake, alert and relaxed - its amazing the impact good or bad sleep has on your wellbeing.

Rob

What's an Eco Resort? No straw in your Margarita?  Sounds like a warm nice place, and you should sleep well.

(Without pictures it never happened.)

No straws to be seen, reusable cups and even a Vegan restaurant (without lines to get in) funnily enough ! Its built through a mangrove, you can snorkel through the clearer bits of it and theres lots of wildlife lives here / lots of vegetation that paths run through so doesn't look or feel like a huge resort (which it is). I think I spend way too many hotel nights for its simple shortcomings though, but thoroughly enjoying the beach and reading again for the first time in years - feeling great thanks to all your help :-)

Wonder if better concentration is a factor here ?

Rob
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RE: Chart Envy
Loving the ASV and also being on holiday I think, maybe freedom 55 is a great plan - 3 yrs and counting ........

In the last week I've averaged 10 hrs sleep per night, resort is noisy so a little broken but think this will improve when home tomorrow. My AHI has averaged >0.2 over 7 nights and my resp rate has settled back to pre ASV days and my tidal volume is dropping back to normal too (as Ajack said it would) - any thoughts or concerns on the trends ?

All feels great from my perspective, lets see what the altitude bump does tomorrow - from sea level plus about 8 feet to 2800 feet in Calgary - wonder how the ASV will do on 'just back' altitude change - will monitor and report !

Home tomorrow to hand back all three loner machines and break ties (I think) with the private sleep doc, will book appointment with hospital doc to try to get an ASV prescription so I have the option of a new machine should I need one.

I have also posted my long term trend so any casual readers of this thread can see whats possible - it may seem an impossible mountain to climb but look how far I've been able to come in 9 months..............Unless you're a really simple case then yes it takes time I'm afraid but I can assure you the results are worth it. I am full of energy, alert and even have my sense of humor back. If you are struggling in the early stages of your own personal apnea hell then take solace in what is possible if you just stick at it, keep a positive attitude and treat it as a series of challenges to be overcome - if you do then you will succeed ! This is an amazing forum that will give you the tools you need to be successful, you just have to play your part and take control of your treatment and wellbeing and follow guidance a little less stubbornly than me.

Rob
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RE: Chart Envy
congrats on your great results! for some of us it's a long frustrating slog but your results are proof improvement is possible with perseverance. how wonderful it is to start feeling better. my long term chart looks similar to yours: 1.5 years of relatively crummy results on apap with huge improvement, visually striking in the graphs, now with 10 mths asv.
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RE: Chart Envy
The ASV results are almost always the most satisfying to see, as people move from AHI of 20 -50 down to near-zero. That is your story and of course several of us on the forum have advocated this course since nearly the beginning. There is nothing in your settings I would change at this point based on your comfort with the therapy and the excellent results. Congrats!
Sleeprider
Apnea Board Moderator
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: Chart Envy
I think raising your max ps had the most effect. You can see how the pressure chart doesn't have a the flat tops now and there are spikes. Tidal volume and minute vent looks good. Enjoy your holiday and see what it's like when you get home for a week. It might need a bit of fine tuning then.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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