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Need help adjusting ASV
#1
Need help adjusting ASV
Well, I tried the blow-back trick (I had to do it a few times throughout the night), and I managed to get to sleep.  Moreover, I finally got an AHI under 2, for the first time ever. (!)  Now, I know numbers aren't everything ... I still feel a bit tired because it still took me a while to fall asleep. And then the dreaded "male-pattern-bladder" had me up a few times during the night ... but all in all, it went pretty well.

   

I did wake up at about 5:15 with a splitting headache, which is unusual for me. I almost never get headaches. Not sure if this was connected to the use of the machine or not.  Also, my mouth was as dry as the Sahara ... I know my jaw often drops open at night, and with the full face mask, my mouth can get pretty dry.  I should try taping again.  

So I'll keep going at the current settings for a while.  Any thoughts on what I should be looking for in Oscar to tweak my settings?
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#2
[split] Need help adjusting ASV
like Congrats on the positive direction. For myself before I switched from full face, I had to have humidity added to keep from drying out.

On edits...unless you need EPAP Min that low, I'd bump it up off of 4.0, maybe try 6.0. Myself would need more air than 4 provides. It may also address the hypopnea. The median shows 12.19 in the above chart. Let's see what others think too.
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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#3
[split] Need help adjusting ASV
I agree your min epap of 4 looks too low it takes a while to go up but it does go as high as 11

I suggest a starting point of 6 for now
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#4
[split] Need help adjusting ASV
(08-25-2019, 01:02 AM)jaswilliams Wrote: I agree your min epap of 4 looks too low it takes a while to go up but it does go as high as 11

I'm still a little fuzzy on what I should be tweaking based on my numbers.  Here's last night for instance:
   

I increased my Min EPAP to 6 last night, which seemed to offer some improvement.  But I'm not sure how to interpret numbers like my Median/95%/Max pressure, and what tweaks those numbers would suggest I make.  

Also, I read on the ASV Auto Protocol that Sleeprider shared with me last year (http://www.apneaboard.com/forums/Thread-...tor?page=3, 5th post on page), that - apart from tweaking min EPAP for comfort - you shouldn't need to touch Max EPAP to resolve UAOs unless the EPAP reaches the Max EPAP setting.  In my case, my actual Max EPAP comes nowhere near the machine's Max EPAP setting ... so why aren't my hypopnea being automatically resolved by the machine?  Is there something I should be changing here?
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#5
RE: Frustrated with recommendations by doctor
your chart looks pretty good! hypopnea are minor but some appear clustered so you might still have a positional thing to work out. they may dissipate now you've bumped min epap (give it a few nights) and/or you can also try nudging up your min ps.
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#6
RE: [split] Need help adjusting ASV
I’d try this as is for at least another day. Wanting to see trends or patterns. Looks good though right now. How do you feel when you’re using it? Any comfort issues?
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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#7
RE: [split] Need help adjusting ASV
(08-25-2019, 12:40 PM)SarcasticDave94 Wrote: How do you feel when you’re using it? Any comfort issues?

It's not too bad. I think that I do end up swallowing a lot of air, esp. when the pressure ramps up. But I'm going to try it for a few more nights to see how it goes.
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#8
RE: [split] Need help adjusting ASV
(08-25-2019, 11:12 AM)allanri Wrote:
(08-25-2019, 01:02 AM)jaswilliams Wrote: I agree your min epap of 4 looks too low it takes a while to go up but it does go as high as 11

In my case, my actual Max EPAP comes nowhere near the machine's Max EPAP setting ... so why aren't my hypopnea being automatically resolved by the machine?  Is there something I should be changing here?

I think in reality the max pressure the machine can give to try and resolve a hypopnoea is 25 although the max ipap seems to be set at 30

I would not worry about the few hypopnoea you are seeing
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#9
RE: [split] Need help adjusting ASV
OK great. Let's see what it's like in a few days. When I first started ASV I had to deal with the air swallowing as well. Mine diminished over time.
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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#10
RE: [split] Need help adjusting ASV
Just a quick tip you may find helpful...

Some nights I have trouble falling asleep, and my ASV tends to bump the 20 cmH2O ceiling (my max), which again keeps me from falling asleep. My stomach starts to bloat with air. All adding up to make for the perfect storm for staying uncomfortably awake. When this happens, I just shut-er-down and quickly fall asleep. Then the first time I wake, I am pretty relaxed and drowsy and can mask-up and fall asleep fairly quickly again.

I found my max pressure seems to be 20 cmH2O. Anything over that and mask leaks seem to be guaranteed. And that quickly wakes me and the wife with a loud serenade of faux facial flatulent formations.    Dielaughing

Also, for me, whenever I make a slight change in settings, I like to run those settings for about two weeks to see if I have an improvement (or not) in my AHI, sleep comfort and how well I feel during the day.

Sleep-well
RayBee

  
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