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Just tried ASV and I hate it. Help?
#31
RE: Just tried ASV and I hate it. Help?
(05-28-2019, 06:15 PM)sheepless Wrote: yes, I'm quite sure my asv has whipped me into shape such that it I don't have this problem anymore.  we frequently talk about wrestling or fighting the machine when it increases pressure.  therein lies the problem.  and the answer.  the whole point of the increase in pressure support is to get us to breathe when we're not. who doesn't want to breathe?  but I do remember disliking this aspect of asv treatment intensely the first couple days to a week, thinking no, I don't want to breathe just now, don't wake me up, leave me alone.  the obvious solution is to breathe, stop fighting, relax, do what it 'wants'.  breathe at the first sign of pressure nudging you to do so before it gets unbearably high.  when you do, it'll quickly ease back the pressure.  

if your asv doesn't respond to the blow back method and it doesn't ease up when you breathe with it, maybe it should be checked out.

As another ASV user, I agree sheepless. That’s a good point on machine malfunction as well. Good eve.

Coffee
Dave

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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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#32
RE: Just tried ASV and I hate it. Help?
Managed to rest around 2:00pm only because I was really tired. Please make sense of this for me.

Thoughts:

1. You're probably gonna tell me to raise the max PS.
2. Raising the max PS might let me get to sleep at all, but I will try.
3. I need to start being more specific about what is happening.

4. When I say that I can't breathe with the machine anymore upon waking up with it, the problem is that I feel like I can't take more than very shallow breaths. If exhaling completely was -100 and a deep breath was +100, I feel like I'm breathing between -20 and +20. I feel like I need to take the mask off and breath in and out fully several times to stretch my lungs out and regain my range of breathing.

5. Maybe its because I didn't use the machine correctly. But if I continue to feel this way even after using ASV correctly, I feel that I might as well go back to trying CPAP. The whole point of making the change was so I could last an entire night on the machine.

Again, its still early, but I'm not happy with any of this.


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#33
RE: Just tried ASV and I hate it. Help?
Being really tired is a good aid to getting use to pap.
You will feel better with a PS min of 4
You really need to keep the mask on all night.
Look at your tidal volume, you are getting plenty of air. It is just you getting use to the feeling of pressure.

Looking at your other charts, you were a new user and had a lot in the beginning and went down to CA 3 per hour. Even on cpap, it was only a couple of hours at a time. TBH I don't know why the doctor and lab put you on an ASV. Your thought of going back to cpap, for a month or so and see if the CA clear, isn't a silly one. It will get you use to pressure. It will tell you if they are all pressure emergent CA and are settling completely. You can set the ASV up with the same pressure, but you will have backup breath working.
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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#34
RE: Just tried ASV and I hate it. Help?
It doesn't really matter at this point since I plan to see a doctor in a few days, BUT. 

Under SLEEP REPORT, there is no info other than "Hours Used" and the 2 smiley faces.

To view the rest of the data, including AHI, I have to be in the Clinician Mode. 

This doesn't seem right, does it? 

If this isn't normal, I wonder what other things might also not be right with this machine.
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#35
RE: Just tried ASV and I hate it. Help?
You can increase the information in the on-screen sleep report by going into the clinical menu and changing the setting of Essentials to Plus. When Essentials is set to ON the machine shows less information than when it is set to PLUS.
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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#36
RE: Just tried ASV and I hate it. Help?
(06-02-2019, 08:08 AM)Sleeprider Wrote: You can increase the information in the on-screen sleep report by going into the clinical menu and changing the setting of Essentials to Plus.  When Essentials is set to ON the machine shows less information than when it is set to PLUS.

Ah. Thankyou.
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#37
RE: Just tried ASV and I hate it. Help?
Well I finally have some good news for once.

I got so upset with this machine that I put it away and shelved it for a while. Then I decided to try it again. I set it to my own settings and found that the backup rate wasn't so bad with the ramp. It goes no higher than the MIN PS in ramp mode, which is not bad at all. The pressure can be ignored and doesn't hurt and feel like air being forcefully pushed into my lungs when I am not ready. 

I kept waking up every few minutes with the machine and went to the doctor. He told me that my settings were good and that I need to just continue with the machine until my body gets used to it.

I told him that I thought he would scold me for the high minimum pressure support (6) I chose and he said no. He said I have central apnea and I NEED pressure support. I said "I thought it causes MORE problems" and he said no. After a certain point it does. But 5 or 6 is where I should be. 

I went to bed with it again after seeing him (ramp ON, as always). I woke up a few times. Sometimes with the mask on my face. Sometimes with the mask on my head. I felt like Mr. Potato head with the mask. But the point is, I was able to put it back on and go back to bed.

Got about 5 hours with the machine (which was WAY more than I could last on CPAP). 

The next day, I got another 5 hours with the machine, then decided to try for 2 more without the machine. I couldn't sleep at all because I was struggling to breathe laying down after waking up. This disturbs me that this is STILL a problem despite using the machine and having an AHI of 1. 

Today I was able to get another 5 hours with the machine plus another few hours again with the machine for a total of 8 hours. I think I may have still woken up in struggling-to-breathe-laying-down mode, but I think the machine was forcing the air in me. High sudden pressures that would normally hurt me were now feeling good.

I'm also trying to adhere to a new bed regimen. In bed no later than 12. Out of bed no later than 9. This should help me get to sleep faster. 


Conclusion:

I am starting to adapt to this machine at a very fast pace and my experience with it is snowballing.

But I'm still upset that I don't have enough options to do what I want. If I wake up with difficulty breathing laying down, then resetting the ramp might not give me the pressure I want. (PS is maxed out at 6cm in ramp mode. I would have to increase the EPAP I guess. But if I should ever need a higher PS in ramp mode, I am screwed because I am maxed out.) And keeping the ramp off means I would have to contend with the backup rate pressure. I want a button that will disable it for 10 minutes. The blowback trick should be able to disable it for at least 5 minutes, but it does not. So I am still very upset with how this machine was designed. It shouldn't be this way.
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#38
RE: Just tried ASV and I hate it. Help? [Update]
An update on how I'm doing now.

Once again, I won't make a new post for fear of being scolded, so hopefully this won't get burred here (it will).

I'm still NOT doing good. BUT I've gotten to the point where I'm about 100% comfortable with the machine. There are still many problems though.

1. To this day, I can NOT not use the ramp with my settings. The machine will hit me with a high pressure difference when I don't conform to its chosen breathing rate. And it hurts. If I were to hold my breath, it will hit me harder and harder with air and it will hurt.

NOW heres the interesting thing. When I wake up after a certain amount of time, this is no longer a problem. I can hold my breath and the machine will forcefully blow air at me and it won't hurt me at all. I went back to the machine once, after 3 hours of being awake and moving around. I sat there and held my breath while waiting for the backup rate to kick in at full force. It didn't bother me at all. Its almost as if I'm physically different for a few hours after waking up? I'll never understand.

2. The doctor changed (lowered) my settings recently (which I eventually changed back). During that time, I was, like everyone else, able to skip the ramp. Because the pressure settings were so much softer, it didn't hurt one bit to be hit with the air when not ready to inhale.

3. I wake up, consistently, after about 5 and a half hours. After that time, I am no longer tired enough to continue to sleep with the machine. My choice is to either get up, or try to resume sleep with no machine. When I sleep without the machine I wake up after 1-2 hours due to, I assume, sleep maintenance insomnia, caused my sleep apnea. I get a feeling in my chest that I was struggling to breath every single time I rest without a machine.

4. Despite using a machine, I'll sometimes wake up struggling to breathe. Sometimes I'll feel myself struggling in my dream. This is rare with the machine though. Usually I just wake up struggling.

5. At this point, I will take off the mask and breathe SO much better. Its often possible to keep the mask on, but my breathing will be more labored and uncomfortable than without the mask. Sometimes I can breathe almost perfect once taking off the mask. Other times I'll continue to have a hard time breathing, but have a much easier time without the mask on.

6. With CPAP, I would wake up after 90 minutes struggling with very very shallow breathing. The doctors reduced settings with less pressure support started to bring me back to the CPAP days when I woke up sometimes.

7. Doctor had me do another (home) sleep study. This time I used the WatchPAT. I was told I have moderate obstructive apnea. Not mixed. AHI 16. All the centrals from my CPAP were likely caused BY the CPAP.

8. Its official. I'm getting an oral appliance. Had impressions done the other day and the gentleman (with years of experience) said I was the perfect person for a mouthpiece. I am disturbed though that even he didn't seem to have ever heard of anyone experiencing what I am experiencing. I hope this thing makes a difference. If it doesn't, I'm not sure what to do. In the mean time, I need to wait a few weeks for the thing to get made.

9. I changed the doctors stupid settings 2 days ago. This time I cranked up the the EPAP. I'm not 100% sure what I'm feeling as soon as I wake up as my brain is all confused at the time, but I'm still only getting 5.5 hours out of the machine before waking up. Again, even if I don't happen to have a problem breathing, I simply can't sleep anymore with the mask on. The AHI and everything looks very good though.

10. Yet, still I remain a low-energy scuzzball. A year ago I hoped that CPAP would change my life. That I would be like everyone else and that, after a brief hazing period, my problem would be fixed, I would have more energy, more ambition, and increased sexual vigor (lol).

I don't know what else to say.
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#39
RE: Just tried ASV and I hate it. Help?
Your therapy has always been a challenge, but you have come to understand much better what does and doesn't work and control the outcome. Ramp is not recommended for ASV. I can't explain why your settings "hurt" when your machine applies full pressure on initial startup, but it doesn't seem to bother you as much after a wakeup. What are your current settings?

Good luck with the mouthpiece, ya "low-energy scuzzball". Smile
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Attaching Files
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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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#40
RE: Just tried ASV and I hate it. Help?
regarding your #10: when I started apap I felt somewhat better but nowhere good enough. when I started asv I felt still better but still nowhere good enough. now more than a year into asv I'm finally starting to notice a difference. with asv I'm able to control my apnea but it turned out I have more than apnea to deal with. in my case, periodic limb movement arousals were leaving me still somewhere north of tired. I finally got an Rx for that which is helping enormously. even though I still see some some respiratory response to plm in my flow rate, I'm finally starting to think of myself as feeling almost 'normal' again.

all this to say that: 1) for some of us it's a long frustrating slog to get everything dialed in; and 2) there may be other things besides apnea holding you back.

p.s. we know central apnea appears inconsistently. you might have had a night without. but if you truly don't have ca, the asv probably isn't the best machine for you.
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