Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

New to me, ASV, Initial Questions
#21
RE: New to me, ASV, Initial Questions
The scales are pretty crazy in that last chart. You can manually set the Y-axis by right-clicking near the title and setting the Y-axis range.  In ASV mode EPAP stays static, and the PS moves in the allowed range to try to maintain minute vent somewhat steady.  I think your charts are easier to understand with mask pressure than the pressure chart.

Your understanding of pressure support is correct.  EPAP + PS = IPAP.  The IPAP pressure peak may only be present very briefly.  We use EPAP pressure to hold the airway patent against obstructive collapse. The pressure support in ASV is to augment a spontaneous breath or to cause a machine triggered breath, and the machine logic provides as much pressure as is needed, when it is needed to keep the respiration rate and volume steady.  I'd like to do something totally radical and just have you use the default ASVauto settings.  It seems to me, your events may not be mainly obstructive, and without the pressure support needed to correct that, you have a lot of events.  In your last chart with EPAP min of 11.0 you should not have had a lot of obstructive events. You could demonstrate that by just using CPAP mode.  If you don't see decreasing events with increasing pressure, the problems are not obstructive but central.  Anyway, we may eventually go to CPAP and try a level titration.  If you want to try ASV, set EPAP min 5.0, EPAP max 15.0, PS min 3.0, PS max 15.0.   We can go back to your novel settings or try CPAP titration if this doesn't work out.

[Image: attachment.php?aid=4210]
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.
Post Reply Post Reply






Donate to Apnea Board  
#22
RE: New to me, ASV, Initial Questions
SDave,
You and SleepRider really complement each other's words to present a much clearer image of understanding for me on all this,
and I'm now looking forward to getting my 2 new Full Face masks to increase the Pressure Support Maximum so we can see where this is going.


SleepRider, 
Thanks for providing the ASV titration protocol flow charts. This combined with your help describing the way it all works together has me more confident
I can give the wider protocol some trials with a better fitting mask which I should have soon.

EPAP min 5.0, EPAP max 15.0, PS min 3.0, PS max 15.0.  Will be the way I go.

Though the last graph in ASV mode had more events,  8 AHI with increased Hypopneas, I seem to feel I had a better sleep than the previous one, Is the term Hypopnea a subset of "Centrals", or completely different animal? 

Not quite sure what you mean by "Y axis manual setting near the title". Can you explain further?

Jim
Post Reply Post Reply
#23
RE: New to me, ASV, Initial Questions
If I've got it accurately, OSCAR titles are the chart segment names like Events where the flags are, Pressure, Flow Limit, such like. Point at a title, right click and a menu pops up. Go to Y axis and edit that. It'll increase or decrease the range of data up/down that segment portrays.

Let us know when you get the F&P Vitera, we can go over fit and adjusting. I've got this mask. You will want a rather loose fit.
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.
Post Reply Post Reply
#24
RE: New to me, ASV, Initial Questions
The cool thing about letting the Resmed ASVauto titration protocol work, is that one way or another, we get the answers we need. If events are central, they will be treated. If events are obstructive, EPAP pressure will rise. Most of the time, it works, and that is when we can optimize and narrow things down a bit.
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.
Post Reply Post Reply






Donate to Apnea Board  
#25
RE: New to me, ASV, Initial Questions
Dave,

You bet, I'll let you know on the F&P Vitera!

I'm really looking forward to what comes of that titration and the findings you fine folks might learn to help guide me forward
towards sleep at last,,

Enjoy your weekend,,

Jim
Post Reply Post Reply
#26
RE: New to me, ASV, Initial Questions
Copy that, try to get some rest.
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.
Post Reply Post Reply
#27
RE: New to me, ASV, Initial Questions
I managed to set up my DreamWear FF in a manner I (though temporary) hoped would tolerate the titration in ASVAuto last night, and it seemed to.    Settings  MIN EPAP 5   MAX EPAP 15   MIN PS 3   MAX PS 15   I don't yet get reading the charts but the Sidebar statistics seem improved some with 2.5 minutes in Apnea, my lowest during these ASV trials.  5.97 AHI  Fewer UA's but Hypopneas are there.
95% pressure" at 19.74    95% EPAP 8.74   IPAP shows 8 to 30, but not sure how possible if machine max is 25?  I'm interested to know if I am understanding "95%" correctly, as meaning "average or most of the time" for the night?

I didn't appear to have any leaks, but I had the mask top straps down even tighter than usual using mask fit to confirm its ability to withstand higher pressures than I have ever run without leaks that would wake me up normally. I also installed a brand new squeaky clean face mask, as well as used Cover Roll Stretch tape over my mouth rather than the 3M I usually use. It seemed to hold well and be a bit thinner and more comfortable. My concern that I wouldn't be able to handle the higher pressures and swings were mostly unfounded and I felt "heavier" sleep than usual. My sleep watch data showed a decent night with 3 short wake ups at 3am 430am and 530am which is typical.

   
Post Reply Post Reply






Donate to Apnea Board  
#28
RE: New to me, ASV, Initial Questions
Not terrible but it'll get better I'm sure. Let's see, 95% stat if I got it right is where the measured x, in this case the pressure, is equal or less 95% of the time.

When I'm dialing in my ResMed, I typically prefer Median over 95% stats. On Respironics I reverse this and focus on the 95% over Median.

OK here's my suggestion on one pressure edit. EPAP Min up one step to 6, all others remain the same. Attempting to combat Hypopnoea BTW which should lower overall AHI score. If you try it and don't like it, revert back to this pressure set.

Keep updates on OSCAR stats and how you're feeling during and after therapy.
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.
Post Reply Post Reply
#29
RE: New to me, ASV, Initial Questions
PS correct this ResMed ASV can reach only IPAP max 25 but those settings allow the algorithm to juggle EPAP or PS as it wants. Sometimes PS needs to jump up and other times it'll move EPAP. It only bumps things as required.
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.
Post Reply Post Reply
#30
RE: New to me, ASV, Initial Questions
Got it, Bump the EPAP MIN to 6, keep notes in Stats, "Median" is preferred for Resmed level targeting.

Any benefit in my  Uploading an old 2018 Sleepyhead chart with autoset at 13 to 17 to see what I had been looking at with that machine regarding events compared to this machine now? Latest years were lost, but if it may give further understand I'm good to provide it.

Jim
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [split] Resmed AirSense 11 Initial FCC Filings pholynyk 9 2,106 04-29-2021, 12:27 AM
Last Post: cathyf
  Initial Data from CPAP usage MiddleAgeGeek 2 166 04-08-2021, 08:27 PM
Last Post: Sleeprider
  mystery continues: initial burst of AHIs first hour of sleep renoir 17 969 01-01-2020, 03:52 AM
Last Post: renoir
  New member needing initial assessment Salcorn 9 614 11-28-2019, 11:09 AM
Last Post: Salcorn
  [Pressure] New AirSense 10 Auto User-Need Help w/initial Pressure Min/Max Settings Orionsnet 49 6,568 10-19-2019, 08:17 PM
Last Post: jmsnyc
  Generally, how many mask replacements do you get during your initial 30 day window? vroomvroom 10 900 03-10-2019, 12:58 AM
Last Post: vroomvroom
  Follow-up (with charts) from initial post by my wife Domino 7 874 01-22-2019, 09:49 AM
Last Post: Gideon


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.