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[Equipment] UARS diagnosis - Which machine should I get?
#81
RE: UARS diagnosis - Which machine should I get?
The high trigger sensitivity setting was a long shot that works for the odd person. Recommendations for ASV come quick when centrals are present because it is the main treatment for centrals.

Do you have an ASV now or on the way? Will want to start with modest settings EPAP = 4, PS min = 3 and give it a while for body to adapt, your body will slowly adapt over weeks/months.
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#82
RE: UARS diagnosis - Which machine should I get?
If you get your hands on the ASV then, base ResMed Titration would likely be a good bet.
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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#83
RE: UARS diagnosis - Which machine should I get?
(06-19-2021, 11:03 PM)SarcasticDave94 Wrote: If you get your hands on the ASV then, base ResMed Titration would likely be a good bet.

What do you mean?
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#84
RE: UARS diagnosis - Which machine should I get?
Pretty much the same thing I said. If you google resmed titration protocol you can find their recommended procedure for titrating ASV.

Starts with settings of Min EPAP 4 cm, Max EPAP 15 cm, Min PS 3 cm, Max PS 15 cm.
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#85
RE: UARS diagnosis - Which machine should I get?
Yes Geer1 has it.

See the Titration Chart from ResMed. On ASV Auto mode, starting EPAP 4-15, PS 3-15. The IPAP is Auto filled via the ASV algorithm, would be IPAP 7-30.

I'm referring to ASV Auto as the mode. This is on the right of this chart.

   
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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#86
RE: UARS diagnosis - Which machine should I get?
(06-08-2021, 06:49 PM)Sleeprider Wrote: You have reduced PS to zero to reduce CA events and still have no apparent obstructive events, with mostly CA, UA and H.  If you have found a good deal on ASV then you will immediately cut AHI to less than 2 with settings of EPAP min 6.0, EPAP max 8.0, PS min 3.0, PS max 12. Leaks need to be controlled. I can't promise you will feel better or more rested, but you won't have apnea, and the PS min 3.0 is going to be pretty comfortable.  I don't diagnose or prescribe. This is simply based on experience with similar problems presented by many other members.

If you get a good price on a used machine, your risk is pretty minimal. You can re-sell if you can't get it to work for you, and it will save trying to go through sleep studies that cost much more.  In the end, you get to choose what works best and gives you restful sleep.  Let's be clear; a sleep study is nothing more than a trial and error, and the ASV auto does not need a sleep study to demonstrate efficacy. It will just happen if it's appropriate, or drive you crazy if it's not.  Sleep medicine is not rocket science, it is trial and error with a high fee paid to doctors, and sleep clinics.  I don't begrudge those professionals their right to make a living, but this stuff is dead-simple.

I had my first night with the AirCurve 10 ASV, reset to default, with settings of EPAP min 6.0, EPAP max 8.0, PS min 3.0, PS max 12, as suggested by Sleeprider on 06/08/2021. I used a new AirFit P10 system, medium size nose pillows.

Compared to my experience with the Vauto, the pressure was aggressive enough to keep me from falling asleep. I went to bed around midnight and took off the mask for the night at 3am.

I tried the blowback technique, but it didn't help (unless I wasn't doing it correctly). I tried knocking the EPAP min to 4 but that didn't help either. The pressure was so high at certain points air seemed to be leaking where the nose pillows meet the rest of the mask, so I tried going back to the F20 face mask, but the pressure was still so high that the mask was sticking up from my face. It's a huge change compared to the Vauto, where at certain points I wasn't even sure if it was on & I had far less trouble falling asleep.


Should I try lower settings?
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#87
RE: UARS diagnosis - Which machine should I get?
Post an OSCAR screen so we can help interpret. If the results look good we could try limiting pressures a bit but that handcuffs the machine and keeps it from doing its job so if your data looks questionable wouldn't be recommended.

ASV is a different beast and will take some acclimatization. It varies pressure and has backup rate to try and force you to breath even if you don't want to. Take a small breath it tries to pump you up like a balloon on the next one. That is what makes it work for centrals and even some obstructive issues but it also makes it tougher to adapt to.
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#88
RE: UARS diagnosis - Which machine should I get?
Some have reported that their breath rate is high when masking up, as in Sleep and ASV related anxiety. There's a necessity to relax when masking up that's noted.

Maybe it applied to you, but I'm not certain.

Yes do post an OSCAR shot. Standard view first.
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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#89
RE: UARS diagnosis - Which machine should I get?
Would Oscar data be useful even if I don't fall asleep?

   
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#90
RE: UARS diagnosis - Which machine should I get?
I'd likely steer you to consider the ResMed default starting titration settings, or a slightly modified on min EPAP.

Blowback isn't hard to do. When the ASV blows and you're trying to fall asleep, blow back through your mask. Kinda like a snort where you're blowing snot out your nose.

I found good results by keeping PS at or near 3-15. You're in the right mode, ASV Auto, so it's mainly getting used to it
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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