(05-24-2016, 03:14 AM)Jeffo1 Wrote: Hi tmoody!
Yes, I've been following in your footsteps and I remember earlier on that with your PR Bipap ASV Advanced you had wanted to change your pressures, as well.
As someone here at the AF recently said , Complex Sleep Apnea is challenging to treat. I get that - and an occasional 10 AHI is a lot better than 78!
How are you doing these days??
I'm doing pretty well, thanks for asking. As I described on the other forum (and here), I'm more systematic in my approach than I was when I started out. I'm trying to maintain the discipline of changing one variable at a time and leaving it alone for at least a week before trying anything else. At the moment, my AHI is running around 2.8, usually with no centrals (but I had 3 of them last night!), and that's fine with me.
I also turned off Flex and went to Rise Time=1, which I seem to prefer. At some point I'll try other Rise Time settings, but again, I'm just doing one thing at a time. Even though Rise Time is a "comfort" setting, it's still a variable.
There's something else we need to keep in mind, however--especially those of us with complex apnea. The ASV really is a different kind of beast, compared to other PAP machines. It takes a while to get used to it, at any settings
, I believe. Just like moving to a new location, with different ambient night noises, it takes a while for the brain to adapt to the machine's behavior. It could hardly be otherwise.
Since I've only been on ASV since March 22, I suspect I'm only now getting to the point of being adapted to it. Many improvements in AHI that I attribute to my tweaking of settings might have occurred anyway, just in the course of adaptation. I'll never know. On the other hand, some changes seemed to cause immediate and dramatic worsening of AHI, and I believe those were real effects.
But in your case, the OAs are the more immediate problem, and the first line of defense (or offense, if you like) should be to increase EPAPmin.
Since PS is essentially the "delta" of EPAP and IPAP, as you raise EPAPmin and leave PSmin alone, your IPAPmin will also increase. So you need to see what happens then. If your OAs go down and your CAs stay about the same, it's all good. If your OAs go down but your CAs go up, you might consider keeping EPAPmin at its new value but dropping PSmin.
There are many differences of opinion on this and other boards about how to set PSmin. I don't have any expertise, by a long shot. I only have some trial-and-error result of self-experimentation. In the long run, you'll need to do the same.