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New to ASV (Last night 1st Night) Need Help
#21
(10-20-2013, 03:15 PM)LOVEDOG Wrote: Vaughn........I am so new to ASV that I don't understand what your point is, or what you are trying to say to me. Is there something on my sleepyhead report that is concerning? I had another night of zero events last night. My way of thinking (and I could be wrong) is that once you reach the golden numbers of 00 you should not mess with anything. The numbers I am using are: Epap=6 PS min =4 PS Max=12.6. If there is something else that I need to do or look at please let me know.
...
For all I know the machine is malfunctioning because 00 two nights in a row is suspect to me, but I have never had experience with AVS, so many questions........
...
Vaughn....By the way I also have chronic bradycardia. Thanks for helping me, and if you could clairify what it is you want me to know I would appreciated it.

Hi LOVEDOG,

The point I had in mind to make, which I now see I neglected to actually state (silly me), was that it looked like the Pressure Support can stay where it is, that there appeared to be no hurry (indeed, there appeared to be no reason) to walk the Pressure Support up to 15, because no times were visible when it was higher than about 8. (EPAP + PS = IPAP, 6 + 8 = 14). And if the statistics were valid and IPAP really was shooting up occasionally close to 19 (even though we do not see it doing that on the IPAP time plot), perhaps this was only during occasional swallowing.

But actually, on second thought, I think we would need to be looking at the "High Rate Pressure" plot to see more complete detail.

There is no reason to suspect the 36007 machine is not working correctly. Unless my Leak numbers get very high (above 40 L/m) my nightly AHI is pretty much always zero. If the machine is adjusted well and Leak stays low, I think zero AHI nights are not uncommon for the average ASV user.

By the way, I use a wrist-mounted Pulse Oximeter nightly, and my chronic bradycardia improved when I raised my minimum Pressure Support to 5 or 6. I was using 6 as my PSmin for a long time, but I've backed it off lately to 5, because my Oxygen Saturation had often spent long periods maxed out at 98 or 99, which might be unhealthful. Too much O2 in the blood can create problems -- more oxidation, more free radicals, things like that. At many hospitals they are careful not to give too much O2 to patients nowadays, because of the problems too much O2 was causing years ago.

Take care,
--- Vaughn


Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#22
Vaughn I had no idea too much o2 98%+ was a bad thing.

What is the ideal target? I also have a CMS 50i wrist SPO2 meter, but I don't use it every night.
Should I be using it every night?
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#23
I also have the CMS 50 wrist 02 oximeter......I will give it a check one of these nights on the ASV. Thanks for the clarification B. I didn't know how common 00 events were on ASV...nice to know, and happy to be there! Smile I would get too upset using it while on my S9 Autoset, as it would go down into the seventies quite often.......I am just plain lucky that I have not had a stroke or worse.

LOVEDOG
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#24
(10-20-2013, 07:57 PM)bwexler Wrote: Vaughn I had no idea too much o2 98%+ was a bad thing.

What is the ideal target? I also have a CMS 50i wrist SPO2 meter, but I don't use it every night.
Should I be using it every night?

Hi bwexler,

Recommended to wear intermittently (not every night) for a few nights or weeks when we are changing medications, or feeling worse than normal.

No, of course there is no need to use Pulse-Oximeter every night. (I only wear one every night because I am probably over-curious as to what is happening O2-wise.)

Regarding what would be a good target range for SpO2, perhaps 94% to 96%, according to the article linked below, but when we are asleep, I would think it would be okay to go down to 90% or so. 88%, even if asleep, is widely considered too low.

The following is is a quote from the article linked below.

"Protocols need to be aligned to reflect the 2010 ECC guidelines: administer oxygen to keep saturations between 94 and 96 percent. No patient needs oxygen saturations above 97 percent and in truth, there is little to no evidence suggesting any clinical benefit of oxygen saturations above 90 percent in any patient."

http://www.ems1.com/columnists/mike-mcev...ygen-hurt/

About the author: Mike McEvoy, PhD, REMT-P, RN, CCRN is the EMS Coordinator for Saratoga County, New York, a paramedic for Clifton Park-Halfmoon Ambulance, and Chief Medical Officer for West Crescent Fire Department. He is a clinical specialist in cardiac surgery and teaches critical care medicine at Albany Medical College. Mike is the EMS editor for Fire Engineering magazine, a popular speaker at EMS, fire, and medical conferences, and lead editor of the Jones & Bartlett textbook, "Critical Care Transport".
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#25
Hmm - sounds like I would be smart to get and use one of these - ordered one just now.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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