Post Reply 
Newbe , ASV and min EPAP.
Author Message
HermannTheGerman Offline

Preferred Members

Posts: 36
Joined: Feb 2016

Machine: Resmed S9 Autoset-CS
Mask Type: Hybrid
Mask Make & Model: Resmed Liberty
Humidifier: i5
CPAP Pressure: 6-24
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #11
RE: Newbe , ASV and min EPAP.
Hello Mongo,

is it Uelzen or Uelsen?
The first one is near Hamburg, the other one is near the Dutch border.
People mix them up very often. Have you been there?

Yes, my results are very good. Thats one advantage of the ASV machines. They work like a swiss cronometer and it is very comfortable to use them.
On the other side I have done a lot to get my body in a good shape.
I do a lot of sports, at least one hour a day, startet to cook my meals with fresh produkts(no more junk food), don´t drink, don´t smoke and got married to a wonderful ukrainian girl.

Greatings from Germany
Hermann
02-05-2016 08:31 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
justMongo Offline

Monitors

Posts: 3,847
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #12
RE: Newbe , ASV and min EPAP.
It's Uelzen. Located in Niedersachsen. It's a north-south and east-west rail hub.
The district includes towns like Rosche. And, they have a Nordzucker plant.

My friend is retired from the railroad. He helped me research the shootdown of a B17 bomber that came down in Wittingen, 18 March 1945.
He is one of the authors of the book: Uelzen und die Eisenbahn.

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.
02-05-2016 10:02 AM
Find all posts by this user Post Reply Quote this message in a reply
Sleeprider Offline
Wiki Editor
Advisory Members

Posts: 3,340
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #13
RE: Newbe , ASV and min EPAP.
Hermann, I read your original post and the symptoms you have been suffering. ASV Auto is a wonderful technology, and it can be a bit intimidating. I know of some people that obtained zero AHI, yet remain uncomfortable. You can make some adjustments to the therapy pressures and observe the results and comfort level and this trial and error approach can improve your results, and your comfort. The best part is, you can conduct these experiments safely, and if the results are not in the right direction, you can revert to the last settings that worked.

So, looking at your graphs and pressure results, a few things stand out to me. While there are no "events", your machine is quite active, which means it is frequently providing higher pressure to prevent centrals. You also have considerable flow limitation. Neither of these are hurting the efficacy of your treatment, and are more than an acceptable trade-off for the increase in comfort that your lower EPAP has allowed.

I think it's great when patients can make small changes, and observe the results. In your case the results are certainly for the better...stick with it. I'm sure the doctor would agree.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
02-05-2016 10:08 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
HermannTheGerman Offline

Preferred Members

Posts: 36
Joined: Feb 2016

Machine: Resmed S9 Autoset-CS
Mask Type: Hybrid
Mask Make & Model: Resmed Liberty
Humidifier: i5
CPAP Pressure: 6-24
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #14
RE: Newbe , ASV and min EPAP.
(02-05-2016 10:08 AM)Sleeprider Wrote:  So, looking at your graphs and pressure results, a few things stand out to me. While there are no "events", your machine is quite active, which means it is frequently providing higher pressure to prevent centrals. You also have considerable flow limitation.
Thank you Sleeprider for your reply.

Of course my machine is quite active. I believe that is the reason why I need it and why my insurance is paying for this very expensive piece of high tech.

I swiched the machine to straight CPAP 2 month ago. Just out of interest what would happen. Since the first sleep study there has been a lot of changes to me and my body. I was courious if I still need the ASV.
During this test I had a lot of obstructiv apnoes with pressure below 11 and above that it changed more and more to centrals.
The total numbers of apnoes stayed nearly unchanged.

The reason for that is unknown. My heart is ok and I don´t suffer from any other desease.
So I think the machine is doing what it is supposed to do and as long as I have 0 events and I am feeling ok.
I will slowly adjust the pressure to get the best comfortlevel that is possible.
Do you agree with that?

greetings
Hermann
02-05-2016 10:49 AM
Find all posts by this user Post Reply Quote this message in a reply
Sleeprider Offline
Wiki Editor
Advisory Members

Posts: 3,340
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #15
RE: Newbe , ASV and min EPAP.
(02-05-2016 10:49 AM)HermannTheGerman Wrote:  I will slowly adjust the pressure to get the best comfortlevel that is possible.
Do you agree with that?

greetings
Hermann

I'm pretty sure that's what I said. Thinking-about

Good work, nice to have you on the forum. Perhaps you can help others with questions about their ASV. Your personal experience will be valued by those with little of their own.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
02-05-2016 11:57 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
vsheline Online

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #16
RE: Newbe , ASV and min EPAP.
(02-05-2016 10:49 AM)HermannTheGerman Wrote:  I swiched the machine to straight CPAP 2 month ago. Just out of interest what would happen. Since the first sleep study there has been a lot of changes to me and my body. I was courious if I still need the ASV.
During this test I had a lot of obstructiv apnoes with pressure below 11 and above that it changed more and more to centrals.
The total numbers of apnoes stayed nearly unchanged.

A few suggestions/guesses for you to consider.

Not sure what your Min PS setting is, but you could try increasing it to see if that might help avoid the sweating.

Conceptually, if obstructive apneas are occurring below 11 when in standard CPAP therapy mode, I would think EPAP should be 11 or higher when in ASV (non-Auto) therapy mode, and should be allowed to raise itself to at least 11 when in ASVAuto therapy mode.

Might be interesting to gradually increase Min PS near to your median PS, and then try gradually increasing the Min EPAP and Max EPAP.

But, on the other hand, after gradually raising the Min PS at least to 2, perhaps it would be best to leave EPAP alone and, instead, make sure you will not roll onto your back while asleep.

Obstructive Sleep Apnea is usually strongly positional, and sleeping flat on our back "supine" usually requires higher pressures to treat, which can aggravate complex/central sleep apnea.

If we take measures to prevent the possibility of rolling onto our back while asleep, this will usually lower our pressure needs, which often lowers the number of CA events we get, too.

Some 'PAP users have found marvelous improvement by making sure we won't roll onto our back while asleep. Some sleep wearing a light knapsack on our back with something light but bulky in it. Others sew a sock or pockets onto a teeshirt with a couple tennis balls inside, between the shoulder blades along the spine. Others use long body pillows under the sheet to help remain on their side. Others sleep in comfortable recliner chair so the head and neck are elevated but stay aligned. Whatever it takes.

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.
(This post was last modified: 02-06-2016 06:23 PM by vsheline.)
02-06-2016 05:57 PM
Find all posts by this user Post Reply Quote this message in a reply
HermannTheGerman Offline

Preferred Members

Posts: 36
Joined: Feb 2016

Machine: Resmed S9 Autoset-CS
Mask Type: Hybrid
Mask Make & Model: Resmed Liberty
Humidifier: i5
CPAP Pressure: 6-24
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #17
RE: Newbe , ASV and min EPAP.
(02-06-2016 05:57 PM)vsheline Wrote:  Not sure what your Min PS setting is, but you could try increasing it to see if that might help avoid the sweating.

min PS is 2 and max PS is 15.

(02-06-2016 05:57 PM)vsheline Wrote:  Conceptually, if obstructive apneas are occurring below 11 when in standard CPAP therapy mode, I would think EPAP should be 11 or higher when in ASV (non-Auto) therapy mode, and should be allowed to raise itself to at least 11 when in ASVAuto therapy mode.
I want to raise the max EPAP in smal steps to 11 or above.
Went to 10 last night in autoASV.
The EPAP Pressure stayed around 6.6 med and 7,8 95%.
I will contiue to raise the pressure, but if the machine doesn´t use the possible higher pressure, I don´t believe that there will be any change.

Hermann
02-07-2016 11:36 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaytonA Offline
Wiki Editor
Monitors

Posts: 3,007
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #18
RE: Newbe , ASV and min EPAP.
Welcome to the forum, Hermann. Your story is absolutely amazing. I felt like I was out of breath when I finished reading it.

Best Regards,

PaytonA
02-07-2016 12:43 PM
Find all posts by this user Post Reply Quote this message in a reply
HermannTheGerman Offline

Preferred Members

Posts: 36
Joined: Feb 2016

Machine: Resmed S9 Autoset-CS
Mask Type: Hybrid
Mask Make & Model: Resmed Liberty
Humidifier: i5
CPAP Pressure: 6-24
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #19
RE: Newbe , ASV and min EPAP.
Here is a screenshot of my last night.
I kept the min EPAP at 6, because most of the time I am laying on the side and pressure is enough at 6.

Max EPAP is at 10 at the moment, but I believe that this is still not enough.
When I lay on my back there is lots of snore and flow limits.
The EPAP increases to 10 and stayed there for nearly 30 minutes because of the snore and flow limits.

I am going to increase max. EPAP and find a way not to lay on my back.

Screenshot

Hermann
(This post was last modified: 02-20-2016 08:09 PM by HermannTheGerman.)
02-20-2016 07:48 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaytonA Offline
Wiki Editor
Monitors

Posts: 3,007
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #20
RE: Newbe , ASV and min EPAP.
Looks to me like you are on the right track but I am not an ASV user.

Best Regards,

PaytonA
02-20-2016 09:09 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  [CPAP] Interpreting Sleephead Stats EPAP GaryMann 4 415 08-28-2016 11:18 PM
Last Post: GaryMann
  EPAP Vs CPAP bib03 7 565 06-20-2016 01:09 AM
Last Post: vsheline
  What should I do about my EPAP settings on my ASV machine? Jeffo1 2 402 05-30-2016 11:45 PM
Last Post: robertbuckley
Question EPAPmin and minimum EPAP tmoody 26 1,429 04-22-2016 07:00 PM
Last Post: robysue
  Happy New Year from a Newbe Apneaman1 9 925 01-02-2016 02:33 PM
Last Post: cate1898
  More EPAP, IPAP or Pressure Support? Cookie 14 2,204 11-29-2015 02:30 PM
Last Post: Sleepster
  Newbe with Complex Apnea - Best ASV to get? racprops 156 43,581 10-17-2015 12:50 AM
Last Post: My3rd3y3

Forum Jump:

Who's Online (Complete List)