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First night results aircurve 10 ASV
#11
RE: First night results aircurve 10 ASV
If the apneas in your screenshot are central, then the solution is increasing maximum pressure support. The events looked obstructive to my untrained eye, although they taper in a manner typical of CA; but either way, there is a solution. If you were using ASV auto mode, you could be starting from a lower EPAP pressure with more amplitude for PS. It would appear 10 PS is not getting any traction in this case. You might want to open up PS maximum to 15 cm.
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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#12
RE: First night results aircurve 10 ASV
"'Id like to learn more about your settings so we can be sure you have sufficient pressure support to overcome central apnea when it occurs, but we need to deal with the unresponsive obstructive apnea that this appears to be."

epap 12 ps 3-10


You also suggested the cervical collar..

I had previously done some tests during a sitting nap using the oximeter but without any forced air..  I'll have to try that again seated to see what happens..

I'm pretty sure to rule that out, as it might have shown up in the Lab study when they titrated me.. then again, in the lab, the AHI was down to 2.8 for 300 some odd minutes.. I'm going to keep an open mind on that.

seated or supine with the oximeter untreated looked just as bad.  but that's no basis for conclusion

This is as good as an excuse as any for an afternoon nap tomorrow, as if I need permission.. lol..

Putting me right on ASV was a decision by a board certified sleep Dr MD.  FWIW..  I have severe obstructive but mixed apnea..  My tongue - something which has gotten me in trouble before (in a different way- haha)..  can easily block air going in or coming out..  I'm glad that you made me think of that..
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#13
RE: First night results aircurve 10 ASV
I would do the cervical collar, they do look like an obstructed cluttered event. the rest of the night is clean, with a bit of rubbish at the beginning and end of your sleep.

I think sleeprider has it, I would also switch to auto mode and open the max setting up, You will find there are periods where the machine may want more than the 22 and the 3cm can make a difference. Not in this case, as the pressure isn't making a dent in the obstruction. I think it is being fixed from you arousing from sleep and getting muscle control back and then repeating this till the events stop, probably from a body position change.
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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#14
RE: First night results aircurve 10 ASV
Hi mike.winslow,
WELCOME! to the forum.!
Good luck with CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#15
RE: First night results aircurve 10 ASV
(07-26-2017, 08:56 PM)ajack Wrote: I would do the cervical collar, they do look like an obstructed cluttered event. the rest of the night is clean, with a bit of rubbish at the beginning and end of your sleep.

Dude...  I'm not sure where you dreamed up "the rest of the night" ..  I posted a very small segment of 8+ hours of sleep.. a mere 10 minutes.

and one night's experience doesnt warrant making any changes unless it's a supervised study.. 

At this point - I'm still somewhat in shock that I can exhale and not breathe for a minute.. repeatedly as in the 8 or so minutes which I showed..I dont think that I would be able to do what the machine says that I did last night while awake.. It would be extremely uncomfortable, and I slept through it.

A recording oximeter before air therapy showed that this was a near constant thing which started almost immediately at sleep..  Now after only a single night plus 3 hours in two naps - I can see most of the events have disappeared, but with definite increase in duration later through the night of the type shown 

I'll look into the cervical collar.. I keep an open mind, but not always my airway..

When it comes to making changes - You see in my profile a machine which transmits data where I and the professionals treating me, can review the data.  I'll confer with them on changes, but only after sufficient sessions to see the nature of remaining problems and patterns.

As a new user - just about anything may happen.. It's a little early to make changes, but I'll sleep on it for a while..
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#16
RE: First night results aircurve 10 ASV
You are right, the zoomed in section just showed one little bit clearly. The top event flags chart shows the time you slept and the events you had during that time. you had 3 clusters of multiple events during your sleep period. This is what I was referring to and it is what I would still say.

I hear your frustration, It is scarey seeing the chart results at first. I think the forum can help you with those events.

Your results are far from the worst on an ASV ...have a look at this guys chart and the effect of a collar
http://www.apneaboard.com/forums/Thread-AHIs?page=3
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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#17
RE: First night results aircurve 10 ASV
Night 2 - AHAH!

It's when I open my mouth.

I realized it on arousal..  I see it in the stats.

If my mouth opens, it's easy for my tongue (or whatever) to move in a way to seal off the airway..  
[Image: VcEKU]
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#18
RE: First night results aircurve 10 ASV
I'm not sure if that worked..
http://imgur.com/a/VcEKU
[Image: VcEKU]
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#19
RE: First night results aircurve 10 ASV
(07-27-2017, 07:51 AM)mike.winslow Wrote: Night 2 - AHAH!

It's when I open my mouth.

I realized it on arousal..  I see it in the stats.

If my mouth opens, it's easy for my tongue (or whatever) to move in a way to seal off the airway..  

[Image: zwv3oAp.jpg]


This looks much more promising.  Your description of the problem the night before confirms the clusters were indeed obstructive.  If you can resolve them without the soft collar, that's great.  The pattern of a relatively good night with clusters of OA is pretty easy to recognize when we have seen so many charts.  Whether that is positional, or your mouth dropping open is kind of a technicality as the collar addresses both issues.   I'm really glad to see this is under control and things are working better for you.
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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#20
RE: First night results aircurve 10 ASV
If RESMED was clever, it would recognise an open mouth in a FFM based on a table level drop in air pressure that stabilized..  I'm sure the  incredibly talented programmers must have considered this at some point..  Just an "in general"  response from seeing how the machine reacts from me just opening my mouth, but not breathing at that moment.  I think it sees the sudden drop as the start of an inhale..  That's distracting  for me if my mouth drops open just falling asleep between breaths.. My behavior is easier to control on this than the machines in the short term..
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