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Newbee intro an need thoughts on settings
#1
Just a little about my road to here. Six months in, two trips to sleep lab an two DME's later. I'm five nights into sleeping better. An now I have Questions.
Where this started 15 months ago diagnosed with diabetes type two, after seven months was still rundown feeling. Doctor asked about sleeping habits, said I sleep like a rock but, snore like a freight train. Suggested a sleep study, untreated AHI of 84. Failed CPAP couldn't stand pressure an Tech could not get me under something like twenty five anyway. Can't remember why I failed BiPAP. Second trip for ASV titration we found something that worked. Then came the fight with DME's to get ASV type machine even though that's what was prescribed that was in November of last year. Doctor's appointment in December we're still working to get you something. Then out of the blue two weeks ago get a call saying the DME will be calling to set an appointment we finally got you set up.

Now to the back ground for my questions. Got machine setup at home, first two night very uncomfortable pressure way high. So after some searching I found this place an started reading. Found how to get into settings an found ASVauto mode. An thought this thing is supposed to be able to adjust  itself what the heck.  Last three nights have been much better.
But need thought on how to adjust. Will download SLEEPYHEAD when I get off my twelve hour daylight shifts in a couple of days. below is what settings look like now, an my ASV titration. Can't post pics doing this from work.

ASV titration:  EPAPmin 12-- EPAPmax 13-- PS min 3
ASV mode: EPAP 13--PSmin 3--PS max 12      pressures way to high can't get mask to seal an uncomfortable
ASVauto mode: EPAP min 4-- EPAPmax 15-- PSmin 3- PS max 15     these may be default settings

Any thought would be appreciated cause I'm pretty much flying blind here. Thanks Torrey
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#2
You sure ended up with a great machine! I have some ideas that may help, but first, do what you can to get 4 posts under your belt so you can post the Sleepyhead data images. So first things first, you need to download SleepyHead. It's free and will give some of the best feedback possible for your ASV. Use the links in my signature to learn how to format charts and post them through Imgur so we can review what is in the data. I will recommend increasing EPAP min to your average or median EPAP as shown after 3-nights at the default settings. We may drop PSmin to 2 and keep PS max at 15.

Amazingly, few doctors and clinicians work with enough of these machines to have a clue, and you are fortunate to have been dispensed the one you have.

Be sure to get copies of your sleep studies and prescriptions for your personal permanent records. You would be amazed how these records seem to disappear in time, and they are very important to you being able to continue therapy and avoid future expensive tests. Now post back and say hi! If you have the AHI breakdown from your diagnostic test and any other subsequent tests that would be helpful to know. Mainly looking for the breakdown of OA, CA and H on those tests before treatment, during CPAP and your current Sleepyhead data should help.
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#3
Hey thanks for the info Sleeprider. Already have copies of sleep studies an will get a call in to doc for script. It will be a couple days before i'll have time to get sleepyhead downloaded. Twelve hour shifts an a forty minute commute each way so not much time for anything but work eat an sleep for the next couple days.

I knew I was getting a high end machine. Just didn't know it was this good till I researched it.
An your right Doc or clinican are going to be much help. Clinician told me she had to call resmed to set it up because she had never even seen one of these. Comforting thought. :/

Will get those other numbers an post back later tonight or in the morning.
Torrey
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#4
Hi TPeters,
WELCOME! to the forum.!
I wish you good luck with your CPAP therapy, it’s great that you came here for guidance.
trish6hundred
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#5
A few more numbers for you guys to check out. these are at 3% criteria.

Pre treatment: CA-- 0.4, OA-- 80.9, HA--177
Post treatment: CA --0, OA--28.2, H-- 114

treatment on split night thought this might be useful.
CPAP started at 4cm increased to 15 cm could not resolve issues
BIPAP started at 16/12cm increased to 23/19cm, think this is where I was at 28 and could stand the pressure

ASV titration: CA--0, OA--12, H--82

got Sleepyhead downloaded to laptop last night will get Data post asap.
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#6
Looks like you got your 4 posts in, so links will work in the future. I'll be interested to see where your EPAP range ends up in ASVauto mode. I suspect you may need to start higher than 4 cm based on your history, but let's see what the charts show.
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#7
With all those obstructive apneas and hypopneas, it may be helpful to test the following ideas to see if they might work for you, if you are not already doing them.

1) Sleeping on your side, rather than sleeping on your back. For those with obstructive events, this can reduce them considerably. (Mine dropped as low as 1/8 the number as lying on my back).

2) Prevent your chin from bending towards your chest, as that puts a kink in the airway. Some folks find that a small pillow under the chin, or a cervical collar may help with that.

Of course, everyone is different, so your mileage may vary with these ideas.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#8
Beej, thanks for the input.  I'm well aware of the side sleeping helping, I probably haven't slept on my back for any time at all in the last twenty years.
Unless I fall asleep in my recliner. LOL
The pillow under the chin maybe something to experiment with though. My wife does that cause she says it helps her sleep better. Though it was just a quirk, may be something too it.
Don't tell her I said that though. Smile
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#9
[Image: RGjwfrdl.png][Image: SpjIoQbl.png][Image: 4RmDtH5l.png]

Sleepy head data from the last three days. Any Thoughts?
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#10
I wish everyone with a need for ASV could have your experience. The autoASV mode on the Resmed is amazing.
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