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[Pressure] TheWallofSleep's Therapy Thread
RE: TheWallofSleep's Therapy Thread
On a separate note: I finally got a tens unit and have been using it about twenty minutes on each leg and a little on the lower back each night before bed. So far I do not know how much it is contributing to minimizing fluctuations during sleep, however, I do notice that it helps before falling asleep. The restless sensations in the legs do appear to be minimized. I need more time to tell exactly how and where this is beneficial.
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RE: TheWallofSleep's Therapy Thread
it'll be interesting to see your charts after a week or two of use. can't tell much from a single 2-hour chart but stats look good. the cluster of hypopnea early on might be SWJ but if not, a soft cervical collar should straighten that out (or adjusting the collar if you're already using one). I wouldn't change anything on the basis of that one short session but most people need more than 4ish cmw to treat out obstructive apnea and hypopnea (although your median of 4.46 suggests otherwise if your longer term use continues at this pace). I haven't re-read this thread so I don't remember how much oa you had on your previous machine but if you see oa and obstructive h, your might incrementally raise epap. you can watch your flow limitation stats to compare night to night but ignore the 1.0's as they're mostly a consequence of the way asv addresses ca. as for reducing pressure, only one way to find out. if me, I'd try reducing max ps to 12 and if no increase in ua, I'd continue to reduce it incrementally. if ua increases, incrementally raise it. one change at a time, but I'd also try raising min ps to 4 (and possibly as high as 5, depending on results) to see if it helps with the hypopnea.

glad to hear you're tens unit helps with the restlessness. I use it when I feel rls coming on in the late afternoons and it seems to result in dramatically less plm during sleep. I went about a week without using it and I started seeing my respiratory response to plm show up in my flow rate again; it took a couple days of tens for it to stop showing up.

keep us posted. I'm very interested to learn whether tens helps anyone else with plm. and once you have some full nights under your belt, scroll through your flow rate at a 10 minute view scale to see if you see or don't see the repetitive pattern indicative of plm.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: TheWallofSleep's Therapy Thread
Hey congrats on finding an ASV. First at bat isn't bad looking, but there's always improvements to be found.

Humidifier and heated hose aside, you're running ASV Auto, so you have EPAP Min/Max and PS Min/Max plus the Ramp.

Tell us what exactly you're running please. I couldn't see it in the chart, it was a few lines down from your shot frame. No issues but just want to see what you ran to guide us if tweaks are in the making. BTW I'd note these settings down and keep a running pressure set info and such. Just to keep track of what you tried.

ASV Auto mode is likely a keeper. Myself on OSCAR charts, I keep it minimal and actually duplicate other PAP views more or less unless there's a need. Events, Flow Rate, pressure, leaks are the top ones. FL meh, we're not expecting to tune for FL, at least I didn't. And FL either falls in place or not. Priority is CA and OA.

PS: try without Ramp of any sort, I find it messes with CA and created an extra variable that was a pain more than a help. We don't need stinkin' training wheels.

Coffee
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: TheWallofSleep's Therapy Thread
Thank you. I will update on the PLM if anything changes. Currently I am using ASVAuto. The first night was on the default settings.
Last night, see attached, was:
Min EPAP: 4
Max EPAP: 15
Min PS: 4
Max PS: 12

Tonight I am going to increase min EPAP to 5cmw. After I see what that changes, I will address raising min PS


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RE: TheWallofSleep's Therapy Thread
OK yep I copy. The chart looks excellent as it is. But if you want a slight air increase or feeling you need to address the lingering Obstructive or Hypopnea, then EPAP Min is where that likely would be found.

Me personally though on raising PS Min I found can make it less comfortable for very little positive change. I'd suggest EPAP Min bump and letting it go at that for maybe a week and see how it improves or not. You might find that one EPAP Min bump is good or more than good enough. And at that, this bump for comfort reason mainly IMO.

Congrats on a great chart.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: TheWallofSleep's Therapy Thread
I have been using ASV for about a week now. At first I was not getting any better results, then I started playing with EPAP min which gave me better results, I felt more rested than normal, then I played with EPAP min some more last night which gave me my worst night on ASV. My initial mindset was to set EPAP min, then play with PS. After the first night, I lowered the PS Max from 15 to 12, and Max EPAP has always been 15, other than that all I have done is gradually increase EPAP min.

This is last night. I woke up incredibly groggy, with a migraine throughout the day. All in all, it feels exactly like I slept with no machine at all.
It appears I have met my attachment data cap, who do I speak to about removing some of my earlier charts?


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RE: TheWallofSleep's Therapy Thread
I would appreciate some opinions on setting PS for ASV. My tidal volume has been consistently on the lower end when I had APAP/VAuto, but I could not increase PS as it would cause a spike in centrals, with ASV this is obviously no longer as big of a problem. I found some threads explaining PS and its uses (FL, Vt, etc.) but not a ton regarding titrating PS range for ASV. Thanks
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RE: TheWallofSleep's Therapy Thread
The data looked ok except for that choppy flow rate aspect.

Consider this, take 2.0 off your EPAP Max and add them onto PS Max with nothing else edited. See if that helps out.

It'll net the same IPAP range but we'll shift the EPAP range to a bit shorter and making it end sooner, while PS takes over a bit sooner with a slight top end boost that you aren't hitting anyway. I think your Max IPAP was 18 on this chart.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: TheWallofSleep's Therapy Thread
PS your charts, attachments are under your UserCP. There, the left side is called menu. Look 3/4 down the list to see manage attachments.

   
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: TheWallofSleep's Therapy Thread
(08-10-2021, 10:49 PM)SarcasticDave94 Wrote: PS your charts, attachments are under your UserCP. There, the left side is called menu. Look 3/4 down the list to see manage attachments.

Will do, thank you. I thought it would be a moderator action since we cannot modify or delete posts. 

I'll post charts once I get them.
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