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New to ASV-Need help getting more symptom relief
#21
RE: New to ASV-Need help getting more symptom relief
Not the best night of sleep last night.  I made it to 4 hours, or just under.  My settings were pressure max-25, EPAP max-20, EPAP min-8, PS Max-12, PS Min-4.  

   
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#22
RE: New to ASV-Need help getting more symptom relief
(03-21-2019, 09:56 PM)Sleeprider Wrote: We created support for the advanced Philips BiPAP machines in Sleepyhead 1.1.0 but the ability to transcribe settings is clearly not perfect. Hacking machine data is a difficult task, and the version of Sleepyhead you are using contains the best interpretation of the hexadecimal data from the SD card that exists.  What we really need is manufacturer cooperation to provide an interpretation of the data.  Working on it.

What you did create is awesome!  Not perfect, but has done more for my success then my doctor.  When i got the new machine, i found the 1.1.0 version easily and downloading it was even easier.  Thank you to everyone that works on this product.
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#23
RE: New to ASV-Need help getting more symptom relief
Thanks

Why do you think you had a bad night?
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#24
RE: New to ASV-Need help getting more symptom relief
I didn't sleep many hours. I don't remember taking the machine off at 5am. I am very tired today.
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#25
RE: New to ASV-Need help getting more symptom relief
The ASV can take some getting used to giving puffs of air when you think you don’t need it. Hopefully you will get used to it and sleep better
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#26
RE: New to ASV-Need help getting more symptom relief
What about the settings and the data? Should i keep them all as is? Or do you think i should change anything? What is the goal for Timed Breaths? Thanks.
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#27
RE: New to ASV-Need help getting more symptom relief
As is for another night
Timed breaths goal. Ignore. That is the ASV stopping central events.
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#28
RE: New to ASV-Need help getting more symptom relief
On the chart, it says epap min 4 and not min 8. Was that a typo?
If it was my chart, you can have min 8 if that was your intent, that is the 95% and set by your doctor, but 7 may be enough to put as a floor and let the machine adjust for the last bit.
The max settings are well clear of the chart max. I wouldn't change them for now

You haven't changed the I-time?
If the chart is accurate. You have a 3 sec inhale. Is this a norm for you and the doctor is aware?
I don't have the manual but min setting should be around 0.3 sec for a normal lung function. Generally the max is 2
Do you have the rise time set to min? That will help with a quicker inhale. As will more min PS.
I assume the forum has told you about chin tucking and how that can constrict the breath. I foam cervical collar for $10 is often used to see if it is an issue.

You have the breath rate on auto?

page 11 has an overview on titrating the philips
https://www.sleepapnea.com/downloads/100...fGuide.pdf
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#29
RE: New to ASV-Need help getting more symptom relief
It's been a busy week.  I turned 41 and was off the machine for a few days.  Below are the days is did use it.  I am still not getting any symptom relief.  I'll check the Rise Time when i get home.  My settings were pressure max-25, EPAP max-20, EPAP min-8, PS Max-12, PS Min-4.  Ignore what is in the SleepyHead info for settings since it is wrong.  Thanks.  

   
   
   
   
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#30
RE: New to ASV-Need help getting more symptom relief
(03-20-2019, 09:03 AM)jteetie Wrote: ... For the first 6 weeks, the settings were 12 to 25 and i couldn't do more then 1 to 2 hours a night.  The doctor lowered it to 8 to 20 and now i'm having success keeping it on.  Many nights i am able to wear it for 6 to 8 hours and my AHI is typically between 3 and 7 down from 55 without the ASV.  Since the change i have 14 days with AHI below 7, most of those days being 3 or 4.  However, i'm not having much of a change in symptoms.  I do feel marginally better on some days, but often, I am still falling asleep at red lights or at my desk by the afternoon. ...

Hi jteetie,

I’ve read your more recent posts but am replying to the first one in order to highlight your doctor originally prescribed a minimum pressure of 12.  I suppose your titration study likely indicated you needed an EPAP of 12 to avoid obstructive events such as hypopnea. Hypopnea appears to be your most frequent major event at this time.

If you haven’t already received a copy of your full titration study, not just a summary and bottom line conclusions but also graphical or tabular data, I suggest you request it. (You have a right to full copies for your personal records).

I suggest working toward gradually increasing Min EPAP (perhaps by 1 cmH2O per week or per month) until you reach 12, or until the obstructive hypopneas are reduced to an acceptable frequency, or until you’re sure you can’t gradually learn to sleep with higher Min EPAP. It is not uncommon that users need to reach a compromise between suboptimal treatment efficacy versus avoiding the discomfort of aerophagia or some other problem. Good luck with this. 

If you are not finding the Min PS of 4 annoying then I suggest retaining it. But if you find a Min PS of 4 annoying then I suggest lowering it to 2 or 3.  (I prefer Min PS of 5, myself.)  PS does for us a portion of the work of breathing and tends to make sleep more restful.  During Central events when my airway is open and PS is doing for me 100% of the work of breathing it rises to around 10 or 11.

In your case it looks like you’ve never come close to your Max PS setting of 12, so I recommend keeping Max PS at 12 or lower.  An unnecessarily high Max PS setting can be highly annoying, especially when we are awake and the machine at times appears to have a mind of its own.

Take care,
—Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  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.
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