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First night results aircurve 10 ASV
#21
RE: First night results aircurve 10 ASV
(07-26-2017, 02:42 PM)mike.winslow Wrote: What seriously sucks is that I cant post a picture until I have four posts - really?  It's 2017, not 1997..

Hi Mike, welcome to the forum.  Our software prevents brand new members from posting links (in order to avoid spammers). Without that feature, we'd be spammed into oblivion.

That feature requires new members to have 4 posts and been a member for a few hours before you can post links or images.  There is a second alternative that allows you to post an image right away, and that is to post your SleepyHead images as attachments (which you don't need to do now that you have 10 posts and have been a member for a day or so).

I would encourage you continue concentrating on getting help here in your thread and if you have further issues or questions concerning the forum software, please send me a Private Message (PM) or post your issues in the Member Account Help Forum.

Thanks.

Coffee
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#22
RE: First night results aircurve 10 ASV
(07-27-2017, 12:45 PM)mike.winslow Wrote: 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..

Is your mouth is opening and air is gushing out under the FFM mask? A chin band or collar can resolve this. 

If the mask is still sealed, it doesn't matter if your mouth is open or not. I would go back for an early review with as you say, "You see in my profile a machine which transmits data where I and the professionals treating me, can review the data" for a look at tweaking of your minimum epap pressure. If you feel your physical position therapy is concluded, the epap is normally raised to counter these obstructive events. 



Quote:What seriously sucks is that I cant post a picture until I have four posts - really?  It's 2017, not 1997..

It's pretty obvious that you are angry and upset about things and a vent is good for all of us. The forum is normally initially tolerant. Being diagnosed and starting treatment can throw us all out of our comfort zone.
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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#23
RE: First night results aircurve 10 ASV
"Is your mouth is opening and air is gushing out under the FFM mask? A chin band or collar can resolve this. 

If the mask is still sealed, it doesn't matter if your mouth is open or not. "

Maybe  you dont experience this on an S9, IDK.

Pretty much anytime that I open my mouth, the machine reacts with a push..

I noted this at the lab on a different aircurve ASV, and on my own.

No - no leaks at all..

Recognize that mouth volume is  lets say 200 ml. I open my mouth and  it fills with air, machine sees a  pressure drop and assumes im inhaling and pushes.. You with me on that? my mouth closed has no air..  Maybe i should let my mouth equalize pressure sometimes before opening.. The tongue usually is inhibiting air from nose into mouth..  maybe that's our difference.. Maybe I need to learn to stop that.

Also please keep in mind we're talking two nights here, and last night was pretty close to the labs 2.8 AHI..

(The frustration with the image posting was transitory, but as far as making my own prescription changes before I have a baseline and on advice from someone on the web - not gonna happen, and I'm not shy about pushing back on making changes without consult and agreement from my sleep lab..  you know - board certified and all.  This is under the VA if that helps to discourage others from going there again.  They havent failed me, and we ( the VA and I) have a professional patient and caregiver relationship.)
My comment on the open mouth thing was that I was getting a sleep disturbing reaction from the machine from opening my mouth.

What's valuable to me in your response is that your experienced with ASV and that you didnt recognize what I was talking about.  The reason more likely due to differences in our breathing mechanics rather than a machine setting.  The same thing has happened on two machines.

At this point - I'm thrilled with the results  and am sharing my experience.. Maybe I need to keep repeating that.. Sharing "do you get this when ... "  experiences with other users  help me to troubleshoot my own experience..

So - right now, if you can humor me - lets go back to the mouth pressure equalization thing.. Maybe when you do it, your mouth is already at the same pressure as your nasal cavity, and opening your mouth indeed doesnt cause a reaction from the machine. That would make sense to me.  
<edit>  Also it dawns on me  too:  The wider the mouth opening - the larger the volume.  Also - as you pointed out - opening too wide is going to tempt a leak..  
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#24
RE: First night results aircurve 10 ASV
I understand what you mean now, yes it will sense that as starting to breath and apply ipap pressure. The s9 does the same, there is no Ti on the resmed ASV to adjust this.
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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#25
RE: First night results aircurve 10 ASV
I need to study the soft palate and how it's supposed to work i think..  i'm pretty sure that the mouth opening with no air - causing the distracting push from the machine - can be avoided if i let the pressure into my cheeks with my mouth closed.. eg both airways open, but mouth closed initially..  I'm fairly certain that my arousal on this was associated with the cluster of UA's last night - which I'm beginning to convince myself that these were obstructive.

This whole thought process makes me think tongue depressor, and not cervical collar FWIW..  

Thanks for the insight..

I was talking with my 83yt/o mom about this today -  " make a 'k' sound with your mouth - note where your tongue is   - now without making the sound - can you shut off your airways, both mouth and nose with the tongue" , she understood - that's where most of the apneas come from for me.

I look at those minute intervals - where there is little airflow, and I can see the machine trying to push breaths in the pressure,  but the airways are clearly obstructed  and the machine is pushing pretty hard, right?- yet, the machine is logging UA's because it's detecting a leak at the end of the event, but that's probably my mouth opening  because part of me knows i need to breath and cant because probably my big fat tongue or something is pushing the nasal airway closed..  when it's closed like that, it would take a painfully high pressure to force air past that tongue lock..

Maybe i can train my subconscious  to keep both airways open with my mouth closed.. 

I never thought in a thousand years that i'd be describing airway closures on the internet..  lol

Just the opposite of what some do to keep their mouth from opening by suction cupping their tongue against the hard palate to keep the mouth closed..  I'll give this a try in a couple hours or so..  test the theory..

[Image: Gray994.png]
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#26
RE: First night results aircurve 10 ASV
you will find that they will increase the min epap for you. This air splint will keep the airway open, providing other factors aren't in play, like bringing your chin to your chest.

I block on exhale going to sleep on my back, this also needs more epap. I snored on the inhale and exhale.  also I found after a while, I didn't block as much and can reduce the epap a bit. I put this down to inflammation/swelling of the membrane from snoring, settling down.
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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#27
RE: First night results aircurve 10 ASV
Quote: yet, the machine is logging UA's because it's detecting a leak at the end of the event, but that's probably my mouth opening

I don't think that's exactly the case. The machine is logging an apnea because there was no airflow. It is normal to see the flag at the end of the event, and not an indication that a leak is being logged.

I just tried to replicate your experience with my S9 ASV and I think I can understand what's going on, and it does feel quite disconcerting. When inhaling, if the mouth opens slightly (but the tongue is sealing the back of the mouth) the air will rush into the mouth and inflate the cheeks. It seems to start the inflation at the back and move forward, and feels quite strange. However the machine isn't doing anything unusual, it's purely a feeling inside your mouth. You might be able to overcome this by manipulating your tongue as you suggested.
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