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Mostly Centrals
#51
RE: Mostly Centrals
(09-04-2018, 06:01 PM)zzzzk Wrote:
(09-04-2018, 05:48 PM)Sleeprider Wrote: I can't begin to guess why you break your sleep into five or more sessions followed by breaks of 10 minutes to 2+ hours.  That is a sleep hygiene issue, not therapy.  I think it would be helpful for you to focus on the problem as being the issue, rather than trying to tie it to PAP/ASV therapy.

Thank you, however, with the change in machine, I have the change in continuous sleep.  I may be wrong, but it seems to me there is a cause and effect.  While my old machines did not correct the central apnea, I did not have such an extreme cut in continuous sleep.  I also wake up usually only after an hour.  This has been the same for about 2 weeks, so it is definitely a pattern.  

I have a partial theory.  Now that my centrals are corrected, I wake up less exhausted, so I don't back to sleep as quickly.  

Also, what do you mean a "sleep hygiene issue"?  

Thank you for your help.
Hello, thank you for the info.  Insomnia before?  I don't think so, although I haven't slept for more than 2-3 hours at a time for a long time.  It's gotten worse since the new machine.  I've never had trouble getting back to sleep (that much) before the new machine.  Since the new machine, I have a lot of trouble getting back to sleep. 

I know it sounds crazy, but I do think that the corrected apnea is something my body is not used to, yet, so I hope the broken sleep improves.  Finally having enough oxygen is keeping me awake?  Possible?  

I am on blood pressure meds and I take benedryl at night to help me sleep.  

I'll look into what you said, too. 

Thank you for your help.
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#52
RE: Mostly Centrals
You might want to update your profile to your current machine and settings. I think there are two major possibilities for your arousals. The first one you note as better rest resulting in less desire or need to fall back to sleep. The other may be disruptions caused by the ASV changes of pressure. Without the data we can't speculate on the latter, but it's worth being aware that may happen.
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#53
RE: Mostly Centrals
(09-08-2018, 08:49 AM)Sleeprider Wrote: You might want to update your profile to your current machine and settings.  I think there are two major possibilities for your arousals. The first one you note as better rest resulting in less desire or need to fall back to sleep. The other may be disruptions caused by the ASV changes of pressure.  Without the data we can't speculate on the latter, but it's worth being aware that may happen.

Ok, thank you.  I'll change my profile.  Is there any way to change the asv bursts in pressure to more gradually happen?  I'm pretty sure that is one think that is waking me up.  Or another solution?  On another note, is there a recommended sleeping pill I could use which might help?  

** I can't find where to change my profile.  Do you have a link?

Thank you   Smile Smile
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#54
RE: Mostly Centrals
The link to your user control panel (User CP) is in the upper right corner of this page http://www.apneaboard.com/forums/usercp.php You will find all of the links needed to change your user profile, password and signature there.

I'm not aware of a setting on the Aircurve 10 ASV to change the response rate for pressure support (rise time). This is an excellent question and might be a good feature for Resmed to consider. The maximum pressure support can increased or decreased, but that does not affect the rate at which pressure can rise, just the amount. Rise Time can be adjusted on the Philips Auto SV, but not Resmed. See this article and search "rise time" http://www.masm.wildapricot.org/resource...Morgan.pdf
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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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#55
RE: Mostly Centrals
zzzzk, am I correct in understanding that you've been using your ResMed ASV for about 2 weeks or so?

If so, it has been my experience that these machines tend to be aggressive early on. Often this rapid pressure rise seems to happen right at sleep transitions (but at other times as well). It was my experience and is what many other ResMed ASV users report as well.

I remain uncertain if the machines have an algorithm that "learns" from us or if we simply get trained into breathing patterns that don't trigger the machine, but it does seem like most of us have this issue with aggressive pressure increases initially, but they resolve.

If you do have such an episode then employ the "blowback" technique, which is to exhale forcefully several times into the mask. This will settle the machine in the short run.

In the near term, I expect you will fall into sync with the machine and the feelings of overly aggressive pressure rises will pass. This seems like a typical pattern for new users of ResMed ASVs.

Bill
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#56
RE: Mostly Centrals
(09-04-2018, 05:48 PM)Sleeprider Wrote: I can't begin to guess why you break your sleep into five or more sessions followed by breaks of 10 minutes to 2+ hours.  That is a sleep hygiene issue, not therapy.  I think it would be helpful for you to focus on the problem as being the issue, rather than trying to tie it to PAP/ASV therapy.

Hello Sleeprider,

I have a possible MAJOR discovery for people who have centrals.  Maybe you already know, I don't know.  However, I am taking diuretic for high blood pressure which lowers potassium.  I found an article from USC which discusses low potassium and centrals.  I did an experiment last night, using the pure cpap setting and taking potassium supplements, NO centrals!  I still have obstructive, though, due to sinus issues.  I am beginning to believe that centrals are a nutrition / effect of medication issue for many.  

Now a question.  I have the aircurve 10 asv.  I would like to change my setting for a pure auto bipap, (not asv), is that possible?  You wrote this before in a different thread, but it is not complete:  

"In CPAP mode the machine provides fixed CPAP. For your question, we need to go back to AutoASV mode. To simulate APAP, we set the EPAP min and EPAP max to the range desired for APAP to prevent obstructive apnea. We can then set pressure support to zero for true Auto CPAP, or set the minimum and maximum pressure support to a value that gives an auto bilevel effect or APAP with EPR. It gets complicated, and if you find yourself in this position, just ask, and we can guide you"

Could you please tell me the settings to make it simulate the non-asv machine I used before to see if it now corrects my obstructive, but NOT centrals now that that seems to be corrected with potassium?  Here were my airfit 10 (no asv) settings:  

asvauto:
Min epap: 6
Max epap: 9
Min ipap: 8
Max ipap: 25
ps Min 2
ps max 16

How can I have the equivalent on my airfit 10 asv?  What settings?  Or do you recommend different?  

Thank you for your help!
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#57
RE: Mostly Centrals
ZZZZk, interesting information about a possible nutrition connection to centrals, but I would caution you to make a broader assumption about the people this discovery might apply to, or certainly that potassium is a major reason centrals occur. I think there are many more reasons that are possible, and potassium may or may not be applicable to any individual. Worth looking at for sure, but more common causes are CNS issues, hypoxemia and individual factors we don't fully understand. One of the more recent discoveries that came to my attention as a possible cure is Enhanced Expiratory Rebreathing Space EERS http://www.apneaboard.com/wiki/index.php...ace_(EERS)

I have also been guilty of being overly broad or inaccurate with my assumptions at times. My information regarding ASV from that thread was incomplete, and experience since then has shown that the ASV has a CPAP setting, but cannot act as a Vauto due to the the fact it will continue to trigger variable IPAP based on the previous breathing rate and volume. So while the response can be limited, it is a different feel and effect than vAuto, and the difference grows with the PS max. I think it was member JesseLee that obtained an ASV and tried to simulate Vauto using limited settings and found it was very different. This was his post following the first trial on that machine, and you can read the rest of the thread if you're interested http://www.apneaboard.com/forums/Thread-...#pid249297

His first attempt used a PS range of 3 to 10 which made it operate like ASV. He later cut that to 3 to 8 and still found the machine very uncomfortable, although the AHI was low (post #36), his final conclusions are here http://www.apneaboard.com/forums/Thread-...#pid249489 Anyway, as a result of this thread, I had to eat my words, and learned that what I thought I know about ASV being able to work as Vauto was probably wrong.
Sleeprider
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____________________________________________
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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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#58
RE: Mostly Centrals
(11-06-2018, 04:09 PM)Sleeprider Wrote: ZZZZk, interesting information about a possible nutrition connection to centrals, but I would caution you to make a broader assumption about the people this discovery might apply to, or certainly that potassium is a major reason centrals occur.  I think there are many more reasons that are possible, and potassium may or may not be applicable to any individual.  Worth looking at for sure, but more common causes are CNS issues, hypoxemia and individual factors we don't fully understand.   One of the more recent discoveries that came to my attention as a possible cure is Enhanced Expiratory Rebreathing Space EERS http://www.apneaboard.com/wiki/index.php...ace_(EERS)

I have also been guilty of being overly broad or inaccurate with my assumptions at times. My information regarding ASV from that thread was incomplete, and experience since then has shown that the ASV has a CPAP setting, but cannot act as a Vauto due to the the fact it will continue to trigger variable IPAP based on the previous breathing rate and volume.  So while the response can be limited, it is a different feel and effect than vAuto, and the difference grows with the PS max.  I think it was member JesseLee that obtained an ASV and tried to simulate Vauto using limited settings and found it was very different.  This was his post following the first trial on that machine, and you can read the rest of the thread if you're interested http://www.apneaboard.com/forums/Thread-...#pid249297

His first attempt used a PS range of 3 to 10 which made it operate like ASV.  He later cut that to 3 to 8 and still found the machine very uncomfortable, although the AHI was low (post #36), his final conclusions are here http://www.apneaboard.com/forums/Thread-...#pid249489   Anyway, as a result of this thread, I had to eat my words, and learned that what I thought I know about ASV being able to work as Vauto was probably wrong.
Ok, thank you.  Is it then safe to assume the pure cpap setting does NOT act as an asv?  What is the difference between the autoasv and the asv, also?

I read the JesseLee post and can identify.  I could not get used to the aircurve 10 asv despite it correcting my ahi.  I also never slept for more than an hour at a time.  Is that a common occurrence?  

I mostly got used to the non-asv version, but it did not fix my centrals, before.  Now that potassium seems to be my problem, the non-asv machine may be my answer.  Any suggestions?  Thank you.
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#59
RE: Mostly Centrals
The CPAP mode will deliver a single fixed pressure with up to 3 cm EPR if you set it up. If you want IPAP 9.0 and EPAP 6.0 set pressure to 9.0 and EPR at 3. Adjust up for obstruction, or down for no events or CA, but this should put you in the neighborhood. ASV is fixed EPAP but otherwise works the same as autoasv.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#60
RE: Mostly Centrals
(11-06-2018, 05:49 PM)Sleeprider Wrote: The CPAP mode will deliver a single fixed pressure with up to 3 cm EPR if you set it up.  If you want IPAP 9.0 and EPAP 6.0 set pressure to 9.0 and EPR at 3.  Adjust up for obstruction, or down for no events or CA, but this should put you in the neighborhood.  ASV is fixed EPAP but otherwise works the same as autoasv.

On the machine, when I enter clinical mode, I only see an adjustment, for CPAP of one pressure setting.  Am I missing something?  I only changed the pressure to 11 last night for straight cpap.  I do see any other settings for cpap.  Thank you.
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