Looking for Tech Manual for Dreamstation ASV

[racprops]

OK I found the more complete simple version of ASV titration instructions here:

-----Commercial link to DME removed by moderator. Search bipapautosv-advanced-bilevel-machine-protocol.pdf at Supplier #18

AND  OMG Here is the HOLY GRAIL:  http://www.isetonline.org/yahoo_site_adm...190318.pdf

THIS IS the ASV titration instructions, deep readings with the real testing gear...


I wonder if I am using the setting correctly??

I use them to control the inhale and exhale pressures, giving me control on how easy it is for me to breath.

I have my settings at:

Max 30

EPAP max @17.5

EPAP min @ 13.5

PS max @ 11.5

PS min @ 6

Rate @ auto

By Flex @ 3

During operation I "see"3.5 exhale and 19.5 inhale, system can and has raised these settings I believe as needed.

These current setting seem to give me good treatment both on my old System Ones 95./960 ASVs and most of the time now on the Dreamstation ASV.

Corrections??

Rich

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[Sleeprider]

Something is wrong with those settings, EPAP max is listed twice, and I assume your EPAP min is 13.5. If so, your machine setting range is 19.5-25.0/13.5 to 23.5-30.0/17.5. That is very high pressure for SV.

Have you tried other BiFlex settings. I have no experience with the Auto SV, but on my old 760, I found the BiFlex disruptive and out of sync above a setting of 2.

I think this rare Philips article may contain much more information that is useful for understanding how your machine works, identifies abnormal breathing and responds. http://www.isetonline.org/yahoo_site_adm...190318.pdf

Here is a good article, you might find useful for treatment emergent CSA and other applications of ASV, as well as an explanation of how the Philips and Resmed machines work differently. http://www.masm.wildapricot.org/resource...Morgan.pdf

[racprops]

Something is wrong with those settings, EPAP max is listed twice, and I assume your EPAP min is 13.5.  If so, your machine setting range is 19.5-25.0/13.5 to 23.5-30.0/17.5.  That is very high pressure for SV.

yes my typo.

Have you tried other BiFlex settings.  I have no experience with the Auto SV, but on my old 760, I found the BiFlex disruptive and out of sync above a setting of 2.

I think I do not understand that setting.

I think this rare Philips article may contain much more information that is useful for understanding how your machine works, identifies abnormal breathing and responds.  http://www.isetonline.org/yahoo_site_adm...190318.pdf

I think it will be a great help.

Here is a good article, you might find useful for treatment emergent CSA and other applications of ASV, as well as an explanation of how the Philips and Resmed machines work differently.  http://www.masm.wildapricot.org/resource...Morgan.pdf

Your find is also looking like a great article and should also be a great help.

As for: "If so, your machine setting range is 19.5-25.0/13.5 to 23.5-30.0/17.5.  That is very high pressure for SV."

I followed the Titration instructions to raise EPAP slowly (over a couple of nights) to treat obstructive events and shoring, that seemed to what was needed to do so.

I have had fair to good response with Pressure Support in treating Centrals and fair response with Hypopneas.

I am beginning to think I need to redo my titration specially with this newer Dreamstation ASV.

Rich

[Sleeprider]

I use the EPAP min to treat OA, but not snoring. Once we get the airway patent during expiration, any inspiratory snoring is usually extinguished by the pressure support. Try some lower BiFlex settings. What you end up with is up to your comfort perception, but my experience with BiFlex 3 was not good.

As far as titration, I coach users to start with the EPAP min to eliminate OA first. We usually start at PS min 3.0 and move up for hypopnea or snoring, and PS max needs to resolve any CA or UA that arises. Your pressures are at the high end of ASV users, and individuals using such high EPAP and PS have usually come from BiPAP with unresolved hypopnea and flow limitation. Is that your experience?

[racprops]

WOW I have read though both articles and OMG there is so much to be considered.

I now REALLY feel I may have gotten very poor titrations in almost all my sleep studies.

I now really feel I might really need a GOOD sleep doctor whom will follow the guild lines of a sleep study and READING and working on improving my sleep beyond JUST getting my AHIs under 5 per night and then saying : "OK your cured now go away and stop bothering me."

I have not found such a doctor.

My first doctor may have been such a doctor if he had not been such a power freak and had been willing to work with me, but his word was LAW...he precriped my treatment and offered to sell me a machine, and when I bought my own machine from Secondwind CPAP, he then claimed ONLY his people could do the settings NOT my DMS (BS) and then at my next visit to his office demanded I being the whole package as he did not want to even hint at the use of the records on a SD Card, which I was all ready reading with Sleephead in my first month on the machine in 2013.

This behavior made me leave him.

My current doctor is the kind to say: "OK your cured now go away and stop bothering me."

I now wonder why my first study reported I have complex sleep apnea, and why my three to four years later studies did NOT show that and I was told I only needed simple CPAP??

SO I have had to do it by myself.

Here is why I am on a ASV machine:

At this point I was on Medicare and access so I asked my PCP to replace my bad ASV machine…but they demanded a new sleep study, and the would only provide a APAP machine.

I was showing low AHI numbers so figured THEY were right but I was still crashing nearly every day with only about a couple of hours of being alert….this was very depressing so I looked for help:


I then spent the next two/three years seeing every Doctor I could.


The findings were all the same. They could not find any cause of my crashes. I joking said the Dr.s all said, “ I will live to 125 IF I don’t mind doing it so very tired getting there.”


Then two things turned up. The first was my wife received a Fitbit HR for Christmas.

This device seems to be able to monitor sleep cycles. Not just how long one sleeps but the sleep cycles like Light, REM, and Deep.

A important report of the Fitbit, it CANNOT report any sleep cycle of less than three hours. As I was waken more often that that I was a little hard to get full night’s sleep reports.

I found there are a number of systems to monitor you sleep cycles, I use a system by Resmed called Sleep Score Max, a good system which can give a fairly accurate of all your sleep cycles.


REM and Deep sleep cycles are very important. With low of no REM and Deep sleep cycles you cannot function.


I got a Fitbit HR (For Heart Rate) first and found my replacement simple CPAP Machine was badly reacting and stopping most of my REM and Deep sleep cycles. I matched their time stamps and saw every time I entered REM or Deep sleep the APAP would over react after each event and raise pressure to the point I was aroused and pushed out of either cycle, IT was short changing these sleep cycles.


I dug out my older ASV machine (a much better sleep machine, Adaptive Servo-Ventilation Machines) and did a complete set up. I soon found I have was having a major improvement in my days; my sleep cycles are much better giving me much better days.

So with a ASV Machine I enjoy much better days 80+ of the time.

To see my full report check out http://www.apneaboard.com/forums/Thread-...-treatment

Rich

[Sleeprider]

Rich, I hope we were able to help. I learned a few things and found some useful articles as a result of your questions.

[racprops]

Oh you have.

Now to see if we can fine tune my use.

I will start the help request thread soon.

Rich