11-19-2017, 10:23 AM
Reset asv
I was referred to a shyster sleep lab that falsely diagnosed be with severe complex sleep apnea. I have since seen a qualified MD that said I don't have central sleep apnea and set me up to do another sleep lab to titrate me for osa. My machine is a Dreamstation asv set at: Max pressure 30, Max EPAP 15. min EPAP 4, min ps 4, max ps 15, breath rate auto. At these settings my AHI averages 21. How's that for mal practice? My question; it's going to be few days until I have my sleep study and get set up correctly so in the mean time I would like to set up my asv to operate like and auto bipap and see if I can find a pressure that gives me a good AHI. Any suggestions?
RE: Reset asv
No problem, but I'd like to see some charts to see what is needed. Auto SV works in a way that it only provides pressure support when it detects your breathing is insufficient. I suspect your EPAP is set too low, and the machine is responding to obstructive events with pressure. As I said, it would really help to see your charts, and even better, the results of the sleep study.
Your machine can be setup in CPAP mode for fixed pressure, or in a bilevel mode with more limited pressure support. In Auto SV mode, your machine can be set for minimum EPAP, Maximum EPAP, Maximum Pressure, and minimum and maximum PS. For obstructive apnea, we need to make a reasonable guess at what pressure your obstructive events are controlled. Your SV machine is at default settings now, so whoever set it up didn't have a clue what you really needed. Please record all settings before you make changes. I especially want to know what your current BPM is set for.
For CPAP pressure, just set the mode to CPAP and set pressure to 10. If you have obstructive apena, we increase pressure. If no OA events occur, we can consider reducing pressure.
If you want to try bilevel, lets set maximum pressure to 16, EPAP min to 8 and EPAP max to 12, and set PS min to 2 and PS max to 4. Set BPM to OFF to disable the backup breath function. This will cause the machine to act like a standard bilevel. If you can report your AHI and type of events using this setting, we can fine-tune this. These settings will use EPAP between 8 and 12 cm to resolve obstructive events, and the pressure support is more for comfort. For auto CPAP pressure without pressure support, select 0 for minimum PS. I think you can also set 0 for maximum PS, but am not sure.
That's an amazing machine and I know many who would love to have it. A mis-diagnosis doesn't happen often. Can you share the results of your sleep study? Whatever your studies end up showing, you can probably use this machine unless insurance takes it back.
RE: Reset asv
One of the bogus sleep studies showed an AHI of 3 at 11cm. so I've set my machine at Max epap 11 min 8 no ps or bpm. I don't have a setting for the different modes like autp bipap. I'll let you know when I get the new sleep study. The previous had set things up to over titrate so centrals were forced in order to justify more studies.
RE: Reset asv
That should work fine. It will function as an auto CPAP from 8-11 with those settings... Seems like a waste of a $5000 machine, but if it's what you need, it should work. What kind of events were you recording on the old settings? OA, CA, H?
RE: Reset asv
Don't know as I don't have charts until they get Sleepyhead for this machine. I downloaded Encore 2 but I can't get it to read my chip. Have medicare and rent to own machine in eighteen months.
RE: Reset asv
I imagine that if your prescription is changed, Medicare will require an exchange. Not sure what your cost is, but is auto CPAP is the prescription, keep in mind you can buy outright on Amazon for mid $300s for Dreamstation Auto, or high $400 for Airsense 10 Autoset.
I assume you're trying EncorePro2. It's not an easy program, but a number of members are using it with the Auto sv machine. I'm working with JediMark to try to extend Sleepyhead to include your machine. He has run into some Qt bugs that need fixing, so I am expecting this to be a major release when it occurs.
