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New to me, ASV, Initial Questions
#41
RE: New to me, ASV, Initial Questions
Thank you Dave and Opal, for your feedback on sizing out a soft collar to help prevent Chin tucking and potentially reduce positional obstructions, a subject I knew little about. I've always wondered about those folks with low AHI and it sounds like they do it by considering sleep apnea to have multiple contributing factors.

I did just order the Caldera Releaf Neck rest - Large - Black (REL200) | Fits 15 1/4" to 17 1/4" neck size, from Amazon seeing some folks finding it to be effective and comfortable. If this consistently lowers my numbers even a little I'll be thankful for the information alone as another variable to know about.
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#42
RE: New to me, ASV, Initial Questions
OK good, update when you try it.
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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#43
RE: New to me, ASV, Initial Questions
Thank you all for this thread. I am learning a great deal from it.

I, too, am new to ASV. I have complex sleep apnea (both obstructive of long standing and central in he last few years).  CPAP at 11.5 took care of OA, but left CA untouched. My average of very inconsistent AHI ran about 9, mostly CA. A short fling with BiPAP more than doubled CA. Changing sleep docs I finally got treated for CA.

I had an overnight study for titration. My initial prescription is IPAP: Auto, EPAP Max 15cm, EPAP Min 5cm, PS Max 15cm, PS Min 3 cm, Auto Backup. It has reduced my AHI to well below 1. I am very comfortable with these settings.

I have been using a ResMed F20 mask for some time. It was adequate at constant 11.5 CPAP pressure, However, the higher ASV pressures have caused noisy leaks at the sides.I have a narrow face.The noise and vibration interrupt my sleep. A chin strap helped somewhat. A mask stabilizer from supplier 31 helped much more - until early this morning. A search on mask fitting led me to this thread.

I have just looked at Fisher and Paykel's Vitera web page. I will follow up and give it a try. Just the size of the cushion looks promising. Thanks for that recommendation.

Whitenoise, I hope you get a satisfactory solution to your apneas. After almost 2 weeks on ASV I have significantly climbed out of sleep deprivation. It is a great relief. I am grateful you started this discussion.
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#44
RE: New to me, ASV, Initial Questions
CLGlover,  (sorry for the late post)

Yes, the folks and information on this board are life saving, and I aspire to follow them and one day contribute with some wind behind me!

Appreciate your feedback on 2 weeks of ASV and your huge AHI drop beyond the magic 1. and making progress on reducing your sleep debt.
I know when I am paying it back as I feel sleepy as I get out of bed, but the day has more energy and stamina embedded which increases over time.

I'll follow this post with an Oscar Upload after trying out the SCC (Soft Servical Collar) for several nights.

Always helps when another who struggles has started an upward path, Thanks,,

Let us know how the F&S Vitera FF works for you,

Jim
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#45
RE: New to me, ASV, Initial Questions
After several nights on ASVAuto mode on the Aircurve ASV, titration settings wearing the large sized  "Caldera Neck Rest"  Collar there has been a consistent downward AHI shift below 5 each night. I am a size 17" neck diameter and near 4" neck to sternum, and I favored wearing it looser rather than tighter. More comfortable than the standard collar I had worn and tossed in the past due to not fully understanding or maybe believing it did anything but numbers don't lie. I have also felt some deeper nights and sleep debt payback for the first time in quite a while.

Collar addition was also matched with an EPAP MIN change up from 6 to 7, and wonder if I might go to 8 as that seems like the number that "Median" hovers near.

I did also reach a conclusion from last night (not representative of the other nights) that I do get out of the blue mask leaks that are nasal congestion related as I woke up leaking at 4am, adjusted the mask, went back but had a repeat after 2 hours. This time I shot some Afrin decongestant up into the nostrils, and refilled the bone dry water chamber, and tried again. After 5 minutes or so of syncing with ASVauto, there was a very noticeable smoothing of my breathing in and out which is comforting in itself and no leaks. Note: I mouth tape with  4 inch "Cover Roll Stretch" tape which stops mouth breathing and provides some chin support.  I use the FF mask as a way to cover the taped area with some pressure as I mouth leak very easily due to my oral/facial anatomy, so essentially I am using a FF mask as a nasal (without the comfort ) to avoid mouth puffing/air swirling and resulting extreme dry mouth. I will eventually be trying the F&S Vitera I have but want to keep everything the same for now. I figure if I can target pressure settings and lower AHI first, the always dreaded mask fitting might go a bit easier with an optimized foundation (and less sleep deprivation) beneath me.

I'll post a representative chart for feedback and continued support.

Jim

   
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#46
RE: New to me, ASV, Initial Questions
So how would you score comfort and rest currently? Overall the data says under 5 at 3.38 with Hypopnoea being worst on this chart. Leak chart is a bit high but still acceptable unless it increases. So really the ball's in your court to grade it by feel. If you're happy with it, so am I.
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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#47
RE: New to me, ASV, Initial Questions
I can handle the ASV breathing me ok and with some time may feel the improvement better.

I feel the best with the lowest apnea duration which fluctuate between .5 min on a short night and 2.5 min on a long one.

I do wonder why the machine can't bring the hypopneas down even wide open as it is.

If you could give me a direction on further tuning on my own with respect to setting changes vs further reduction that would be appreciated.

Any reason to ever try ASV mode vs this one based on what I have learned from Auto mode?

Jim
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#48
RE: New to me, ASV, Initial Questions
I've got the same ASV here. Here's what I know on ASV vs ASV Auto modes: ASV mode gives EPAP as static 1 pressure, ASV Auto makes EPAP a range of Min and Max. Myself liked EPAP range in ASV Auto.

If you feel the need to attack Hypopnoea, if me I'd leave it in ASV Auto and edit your EPAP Min pressure about a half to a whole step. You're at 7 on EPAP min now, so go between 7.6-8.0 EPAP Min. See what that does.
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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#49
RE: New to me, ASV, Initial Questions
I’ll give that a try Dave,

Your time, Attention, and experience in this realm are greatly appreciated.

Jim
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#50
RE: New to me, ASV, Initial Questions
You're welcome. Let us know how that edit helps out.
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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