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Love My AHI Going Down But What About Time in Apnea and sleep quality?
#11
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Just a question, are you sure that this issue isn't that the ResMed ASV treats your Apnea and gets it to the reported 1 AHI versus the Respironics SV Auto that can only get your AHI to 7. Possible conclusion is the ResMed algorithm you dislike works better because it does actually follow breathing better.

If the issue you portray is rather that the ResMed ASV reported AHI of 1 is fake or not helping, it's likely due to your setup.

This appears a bit confusing, AHI 7 is better than ResMed's AHI 1 because Respironics SV Auto operates differently? You'll accept and actively choose higher untreated AHI over well treated numbers.

Side note, yes the failure to give timing adjustments on the ResMed is a big oversight/problem for some, myself certainly included due to the very high complex issue of respiratory disease and CA that I deal with. Your situation may be complicated but in no way like mine. You've always stated intolerance to high pressures, which means ASV can't work nearly well enough, but the ResMed still got you to 1 AHI.

Anyway possibly disregard all I've said here, which I don't really care if you do. But all your actions go against common sense, such as higher untreated AHI is better than treated because the ResMed is your supposed enemy.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#12
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Resmed omission of some key parameters in their ASV therapy setup is what makes me suspect their results. Ie. just because the machine reports a low AHI, does not necessarily mean that it is true. Indeed an algoritm can be designed around a pre defined outcome (helps sales) rather than reporting on the actual results.

We just need some time to prove that, now that we have facility and data to do so.
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#13
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Just for full disclosure and educating any that read, my Central count on a '17 diagnostic was 124 CA to 24 OA. At that time the ResMed ASV was well able to treat, I was under 3 AHI reported typically. The only thing that broke the ASV therapy was my respiratory disease. It not only reported doing well, but I felt better until the extra issue and then a bout of pneumonia and bronchitis, one after the other in '19. Then the only flaw I found on ResMed's ASV was missing time controls.

My conclusion about my own therapy, ResMed's ASV was excellent at treating Centrals as designed. Throw in respiratory disease, and it's no longer the right tool.

Anyway, certainly do what's best for yourself. And a sincere best to success.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#14
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Resmed ASV is known to be significantly more responsive and capable in treating central apnea. It wouldn't surprise me that your AHI is higher on DS.

I still think your biggest issue is too high of PSmin or something not related to central apnea.
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#15
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
I've said for a long time that my treatment doesn't work and I don't feel better.  I've been compliant for about 35 years.

Greatest change has followed a suggestion from a wonderful member here that I use a soft cervical collar.  I have a Dr Dakota collar all worn out. I tried it. I hadn't used it in years.

Using this collar with my ResMed N20 mask eliminated mouth breathing.

Point is I think I needed to investigate and improve sleep quality. I've had low AHI for years. That wasn't enough.

So my goal is to sleep long enough each day, and use a soft cervical collar to prevent mouth breathing.

edit;
http://www.apneaboard.com/wiki/index.php...cal_Collar
DaveL
compliant for 35 years



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#16
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Interesting.
I always thought soft/hard cervical collars were used to treat neck pain/injuries. Who know it also helps stop mouth breathing?
I don't have much issue with mouth breathing though and since I went back to my Dreamstation ASV machine, I tend to sleep much better even though my AHI numbers have gone from averaging 0.5 to about 5 or 6:-)
Even more interesting is that my "total time spent in apnea" has dropped to zero and stayed there.
So I sleep better and spend no tim e in apnea, so higher AHI numbers don't bother me. In fact I like to see how many events of this type I experience while asleep and how the machine takes care of each event for me, instead of just being told that my AHI is low, like my Resmed ASV does, and only because it simply doesn't monitor as many inputs as the Philips Dreamstation does.
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#17
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Congrats on 0 "time in apnea". What about time in hypopnea? Did you know hypopneas also cause desaturations (your main concern in OP) and that during in clinic sleep studies they are defined as requiring a 3 or 4% desaturation depending on definition?

Have you used your oximeter to verify that you are having fewer desaturations and maintain higher average oxygen saturation with the PR machine? I would like to see some data supporting this as it is counter intuitive to the results being stated/posted and without data backing up this claim I can't help but consider these claim potentially harmful to other members that may follow your opinions/recommendations.
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#18
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
S. Manz I've recently seen a video on youtube (lanky lefty) showing how mask fit changes in REM sleep. Jaw drops down and back....and he says the mask doesn't fit. Leakage starts.

I bought 2 Knightsbridge Dual Band caps. second is a spare. Initially they were perfect. Then things went wrong. Perhaps I bought the wrong size...This is a chinstrap intended to prevent the jaw from moving down and back. Most chinstraps actually pull the jaw back and that's not good.

Last night I used my old Dr Dakota wedge and taped my lips. I didn't sleep well, but this combination solved the leak problem I've had lately.

I ordered a new soft cervical collar from amazon in Canada. The Dr Dakota wedge strap is in rough shape.

Many people use full face masks. I've tried a lot of them. I've never found one that passed the first night test; and I'm claustrophobic.
DaveL
compliant for 35 years



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#19
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
(12-08-2021, 03:50 PM)Geer1 Wrote: Congrats on 0 "time in apnea". What about time in hypopnea? Did you know hypopneas also cause desaturations (your main concern in OP) and that during in clinic sleep studies they are defined as requiring a 3 or 4% desaturation depending on definition?

Have you used your oximeter to verify that you are having fewer desaturations and maintain higher average oxygen saturation with the PR machine? I would like to see some data supporting this as it is counter intuitive to the results being stated/posted and without data backing up this claim I can't help but consider these claim potentially harmful to other members that may follow your opinions/recommendations.

Yes, so I use an oximeter every night.
My saturation median is a steady 95% night after night (I dobn't trust the accuracy of these chinese made products so I'm saving for a real one, like an American or a Japanese made unit).
Anyway I am not able to find a clear correlation between mu=y saturation levels and Hypopnea events, not yet anyway.
My O-Ring samples ever second but records data every 4 seconds which is plenty of data to find a correlation, if one indeed exists.
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#20
RE: Love My AHI Going Down But What About Time in Apnea and sleep quality?
Yes, full face masks are not for everyone.
I personally can't tolerate frontal tubing masts anyway, so I can only use masks that deliver air via a "frame" that sits atop my head and gets strapped with soft straps around the back.
You can use both a nasal mask or a full face masks with this type of frame, however I also find nasal masks a difficult exercise as I must keep my mouth shut through the night.Like most people this must be done consciously, which takes away from a deep sleep which means that I will then have to use mouth tapes Big Grin
So now with a moth tape and all that head gear, it is simply too much for me to get used to, As a result I just use a full face (I don't even know why they are called full face because mine only covers my moth and sits snugly under my nostrils). I find it very cofortable with the indirect air supply through my head frame.
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