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Question about Oximetry on ASV
#1
Question about Oximetry on ASV
Does anyone know if the pressure algorithm in Resmed Aircurve 10 ASV uses oximetry data to set pressure, if the oximetry module is connected? I have searched for an answer both on Google and on these forums, but cannot find any mention of it. I am guessing the data is not used in this way since it is not mentioned anywhere, but confirmation on this would be great if anyone knows?

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Here is my background in case it is relevant to the question (or in case anyone happens to read this and has any suggestions to offer): I was diagnosed with sleep apnea in late 2016, AHI was 27, mostly hypopneas but with some elements of central apneas. I do not have any medical conditions that should cause central events, and doctors considered them irrelevant/incidental.  I was on CPAP for a year, my AHI ranged from 8-15 as recorded by the machine, with essentially all remaining events interpreted by the machine as central apneas. 

After a year on CPAP I started waking up almost immediately after falling asleep in full panic, ripping off the mask and going back to sleep without pressure support.  My doctors continued to interpret the central events as irrelevant, but I was desperate to try anything and bought a second hand Resmed Aircurve 10 ASV just to test if it made any difference. I discussed this with the doctors, and the nurses at the sleep clinic helped me get the settings right. The problems with waking up early in the night and ripping off the mask persisted on ASV. I became obsessed with finding out whether the nightly wakening events and panic attacks were caused by desaturations.  Yesterday, I was able to convince my doctors to lend me an oximetry module for three days. I tried it for the first night yesterday, but surprisingly, for the first time in 3 months, I was able to sleep through the night with the mask attached. This may have been random, but I want to know whether the machine was able to use the oximetry data to optimize the treatment.  According to OSCAR, my saturation dropped to a low of 89% almost immediately after falling asleep, pretty much at exactly the time I would normally wake up in panic. For the rest of the night, my oximetry looks good. 

Another thing to note is that my doctors interpret my apnea to be primarily caused by nasal obstruction. I had very clear findings for obstructed nasal air flow; and I was also part of a research study where I had polysomnographies three nights in a row at a hospital, where they assigned one of the nights at random to give me nasal spray (otrivine). Apparently my polysomnography was much better on the night I got otrivine. They proceeded to operate on my nose. Subjectively, this made no difference, but the objective findings of nasal obstructed air flow were resolved. I had a polysomnography with my ASV machine afterwards, which was apparently much improved for earlier polysomnographies. However, this was one of the very few nights I was able to wear my mask through the night (possibly because it was underneath a net and therefore harder to rip off).

(I am a non-practicing medical doctor without any background in sleep medicine, this allowed me to get the machine without prescription)
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#2
RE: Question about Oximetry on ASV
As far as I know, the answer is no. Unless I have it wrong, no xPAP available sets any of the settings with oximetry data.

PS if you would, get the OSCAR report tool and post SD card data from typical sleep sessions. There’s a few chart gurus here on AB that’ll give feedback on these charts which in turn may give insight into making therapy better for you.
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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#3
RE: Question about Oximetry on ASV
I'm not aware of any feedback from the oximetry lead to the Resmed ASV algorithm, and to the best of my awareness, none is mentioned in the technical literature. Your experience with your doctors disregarding your sleep onset central events is unfortunately common, and we see it frequently among members here with complex and central apnea. Many, like yourself, end up buying a machine out of pocket and self-titrating pressures.

Can your tell us what settings your machine is currently using? Also, if you want to attach an image of your OSCAR graphs, we might be able to spot an issue.
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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#4
RE: Question about Oximetry on ASV
Thank you so much guys! I've attached screenshots from OSCAR from last night. Obviously, this was quite a good night, but I am curious about whether it offers any clues as to why I rip off the mask in a state of panic shortly after falling asleep almost every other night. The machine is set to ASVAuto mode, Min EPAP 4cm H2O, Max EPAP 14cm H2O, PS Min 3CM H20, PS Max 15cm H2O.  The max settings were reduced last week on advise of the nurse at the sleep clinic.   Thank you again for the help!

               
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#5
RE: Question about Oximetry on ASV
Yes! You need to turn off ramp. Note that nearly all events are near the beginning of therapy just as you probably are falling asleep, but the ASV capabilities of your machine are disabled due to ramp. Resmed does not recommend the use of ramp unless you absolutely don't tolerate the pressure support, and then to make it as short as possible Everytime you start your machine, you get EPAP 4.0 and IPAP 7.0, with no response for centrals or other events. As soon as ramp ends, the machine becomes responsive and your events are terminated.
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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#6
RE: Question about Oximetry on ASV
Thank you so much!! This makes total sense
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#7
RE: Question about Oximetry on ASV
Of course Sleeprider has it nailed. ASV and Ramp seem to not play well together for most patients. As mentioned, it delays the ASV portion of your needed therapy.

Coffee
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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