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Optimizing UARS Therapy From ASV to Vauto
#1
Optimizing UARS Therapy From ASV to Vauto
Hi all,

After failing CPAP, APAP, and not being satisfied with Resmed BiPAP to treat my UARS, I bought a Phillips AutoSV.

Attached are:

- Total overview of last night.
- Periodic breathing portion.
- OA cluster portion.

The reason why my min. EPAP is so high is because when I go lower, I tend to get a lot of OA clusters like the one I posted. If you'll notice, these are expiratory in nature. I believe that I breathe in and then my palate prolapses, which prevents me from breathing out. People have told me that they notice me breathing like this in my sleep. Keeping EPAP high seems to keep that phenomenon to a minimum.

I currently use a double chin strap, as well as a P30i mask + lanolin. 

Today I felt like crap and I would like to improve my therapy. Any tips? I'm going to mouth tape tonight to keep the leaks lower.

Thank you!


Attached Files Thumbnail(s)
           
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#2
RE: First night with Phillips AutoSV - Where to go from here?
It's not bad, but you need to increase the max PS to 10 and especially max IPAP to 25 to get the full capability of the machine. During the periodic breathing period, you completely ran out of pressure support and the machine was unable to treat the flow variations. Treating the obstructive clusters, aka positional apnea would be the best way to avoid running out of room, and the need for such persistently high EPAP. I'm sure we have discussed the soft cervical collar and positional apnea issues?
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.
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#3
RE: First night with Phillips AutoSV - Where to go from here?
Sleeprider, thank you. Yes the soft collar was discussed before; however I switched to a double band chin strap which I thought would serve me just as well.

I'll be making all of those adjustments tonight.
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#4
RE: First night with Phillips AutoSV - Where to go from here?
Last night with mouth tape, cervical collar, lansinoh.

For one, I'm thinking I gotta shave so the mouth tape sticks better.


Seems crazy that PS ran up to 15...!

Any ideas?


Attached Files Thumbnail(s)
   
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#5
RE: First night with Phillips AutoSV - Where to go from here?
It looks like there's some leaks, and I know they're charted different on Respironics. Regardless, I think this SV Auto is getting overwhelmed by your therapy needs, so noted because your IPAP hits 29.75 but you have untreated CA of 7.12 and AHI at 9.83. I suspect the ResMed AirCurve 10 ASV would do better. It is faster to respond instead of watching events go past and doing nothing about them. This therapy being untreated is something I would not accept, and would be calling doc's office to complain. This is not just slightly untreated, it is barely contained with this machine.
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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#6
RE: First night with Phillips AutoSV - Where to go from here?
I share Dave's frustration looking at this. We just don't see crap results like this from members using the Resmed ASV. The one thing any ASV should be able to accomplish is to resolve central apnea, not just flag them.
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.
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#7
RE: First night with Phillips AutoSV - Where to go from here?
Thanks, guys.

I’m not sure if it makes a difference, but these are treatment-emergent CA’s - never had them with CPAP APAP or BiPAP.
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#8
RE: First night with Phillips AutoSV - Where to go from here?
So, we're treating obstructive apnea, hypopnea and UARS? What device gave you the best results in the past, and why did you move to the SV?
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.
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#9
RE: First night with Phillips AutoSV - Where to go from here?
I don't understand some of the terms used, but I have had the same problem with exhaling. That's why I use C-FLEX pressure relief during exhaling. The Dream Station I just switched to does a good job, very good. It's almost as if there is no cpap machine. What helped me before was truyng to keep my mouth slightly open so if I can't exhale through my nose, it can out my mouth.
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#10
RE: First night with Phillips AutoSV - Where to go from here?
(01-27-2021, 08:39 AM)Sleeprider Wrote: So, we're treating obstructive apnea, hypopnea and UARS?  What device gave you the best results in the past, and why did you move to the SV?

I was using a ResMed AirCurve 10 VAuto, and it worked well - however I would wake up most nights with it off.

Last night I went into the data (stupid of me...should've done it sooner), and I realized that leaks were making me take the mask off.

So I went back to it last night with a cervical collar + mouth tape, and woke up an hour into sleep with the worst dry mouth ever. I took off the collar and changed out to my double chin strap and went back to sleep. These were my results for last night:

   

Certainly looks more therapeutic than the Phillips; however the leaks are uncontrolled. Part of the issue may be that I have an MSE (maxillary skeletal expander) on the roof of my mouth and it's difficult keeping my tongue up there, and therefore my mouth shut.
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