Please review my Sleepyhead results and settings

[Chris12]

I've had two previous machines, but my doctor said they weren't working and has stepped me up to their most severe level, level 3.

I currently have a resmed s9 adapt (vpap adapt?), with a resmed humidifier and resmed oximetry adapter. I am using a F&P Eson nose mask.

My prescribed settings are:

Asvauto
Min Epap - 5
Max epap - 15
Min ps - 3
Max ps - 15
Start epap - 5.0

Sleepyhead:

Last 4 days average (all I've had it)

6:43 hours/night
9.70 ahi
0.00 obstructive apnea
6.98 hypopnea index
5.06 average leak
16.80 90% leak
2.37% % time above
7.09 average epap
4.08 min epap
20.42 max epap
20.18 90% ipap
5.00 min ipap
25.00 max ipap


Do you recommend I change anything? I've been compliant, but I'm going to need sleep some time. I've called my doctor once, they told me to stick with it until our next visit in 10 days.

[Sleepster]

Do you recommend I change anything? I've been compliant, but I'm going to need sleep some time. I've called my doctor once, they told me to stick with it until our next visit in 10 days.

I highly recommend that you do NOT change anything. Ten more days of data will give the doctor a good idea of how you're responding to the therapy. If you change the settings it will interfere with the doctor's ability to do that.

You need several days of constant settings to allow your body to adjust to the therapy. Then the doctor will be able to determine what, if any, changes are needed. Adjusting your particular type of machine is very difficult and requires someone trained and experienced to do so.

[zonk]

Do you recommend I change anything? I've been compliant, but I'm going to need sleep some time. I've called my doctor once, they told me to stick with it until our next visit in 10 days.

I recommend to do what the doc said and keep up with the scheduled appointment
Not many understand ASV machines, best left to the professionals

[trish6hundred]

Hi Chris12,
WELCOME! to the forum.!
I'm sorry you are having such a rough time getting used to the new machine but just stick with it.
Hang in there for more suggestions and don't give up.

[Chris12]

Thank you all, I didn't realize that it was an asv machine, I'll need to read up.

[zonk]

Thank you all, I didn't realize that it was an asv machine, I'll need to read up.

That is what been said in the first post
[My prescribed settings are: Asvauto]

[Sleepster]

Thank you all, I didn't realize that it was an asv machine, I'll need to read up.

Hi Chris. Yes, what you described in your first post as being moved up to a level 3 machine is the same thing we're talking about here.

At first, depending on the results of your sleep study, most people start out on a plain CPAP machine or an auto-CPAP. These machines deliver a constant pressure, although the auto-CPAP will adjust the level of that constant pressure slowly.

When this type of machine doesn't work for a variety of reasons, the next level up machine prescribed is a bi-level machine that delivers a higher pressure when it senses you're inhaling, and lower level when it senses you're exhaling.

Sometimes, and it appears in your case, the third level of machine is the ASV. These machines are much harder to adjust so you have to be patient with them. At the risk of oversimplifying, what these machines do is raise the pressure to force you to inhale, and then lower the pressure to force you to exhale. They are trying to get you to breathe because for whatever reason your brain is not telling your body it needs to breathe. This condition is called central apnea as it's the central nervous system malfunctioning. This is in contrast to the much more common obstructive apnea in which the breathing stops because the airway is blocked or obstructed.

You likely have both central and obstructive apnea, a condition called complex sleep apnea or mixed sleep apnea.

As in all cases of CPAP therapy, it often takes our bodies and minds time to adapt. We just have to be patient and celebrate what successes we do have. The rewards are worth the effort.

[diamaunt]

I currently have a resmed s9 adapt (vpap adapt?), with a resmed humidifier and resmed oximetry adapter. I am using a F&P Eson nose mask.

I'd suggest you change your equipment listing to "s9 VPAP Adapt 36037" just to make it clear.

ASV machines aren't very complicated to set, there's only the four settings, easier than some of the less capable machines

yours is set to the default settings, which actually works out well for a lot of people, the ASV machines are pretty smart, think of it like a little buddy watching over you, breath by breath and helping you out when you need it.

there's a lot of info on the resmed pages, as well as in the clinicians manual you can get here.

we've got one in the house here, so I've got a experience working with it.

[justMongo]

Chris, Right now there's nothing to adjust. The machine is running nearly wide open. With time, perhaps the window of pressures can be narrowed. But, that will take time and data to determine. Based on 4 days of summary, looks like you're doing OK. Of course "the devil is in the details." You must have some sort of sleep disorder breathing where you are not initiating the cycle. The ASV is one step down from an invasive ventilator. (An ASV is a non invasive ventilator that cycles pressures at a timed backup rate to inflate and then drops pressure to permit exhalation.) Your oximetery data will be important to the doctor.

Get detailed copies of your sleep reports. They help one understand the what and perhaps the why of things that are going one.
Keep a copy with you -- if you ever end up in a hospital, their RTs can use it to know you need to be on a machine; and get an idea what settings they need.

[diamaunt]

mongo, actually the asv is two steps down, the ST-A with ivaps is another step, but it's *way* more complicated to set up, and addresses subtly different needs.