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Replaced my ASV, not happy, need help
#21
RE: Replaced my ASV, not happy, need help
Ok, hope I can get all this--lots to absorb. I tried a collar and really hated it, so will hold off on that for now and see if the other measures work.

I am about 5' 6" tall. And yes, I'm tired, and sleepy -- what brought me to XPAP in the first place (after trying just about everything else). Though less tired and sleepy since I started ASV, even with the hiccups.

For tonight I will set EPAP min at 6.4 (can only do even decimals) and max at 12, and set PS max at 11 -- You didn't mention it but unless someone objects I will lower PS min to 3 so I don't get blasted out right at the start.

Please let me know how you want me to organize the charts from here -- I can always do 2 screenshots to get everything in.
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#22
RE: Replaced my ASV, not happy, need help
(10-31-2019, 05:04 PM)bemused Wrote: Ok, hope I can get all this--lots to absorb. I tried a collar and really hated it, so will hold off on that for now and see if the other measures work.

I am about 5' 6" tall. And yes, I'm tired, and sleepy -- what brought me to XPAP in the first place (after trying just about everything else). Though less tired and sleepy since I started ASV, even with the hiccups.

For tonight I will set EPAP min at 6.4 (can only do even decimals) and max at 12, and set PS max at 11 -- You didn't mention it but unless someone objects I will lower PS min to 3 so I don't get blasted out right at the start.

Please let me know how you want me to organize the charts from here -- I can always do 2 screenshots to get everything in.

Good work thus far!   It is a lot to absorb but your powering through it well.

"EPAP min at 6.4 and max at 12, and set PS max at 11 ...  I will lower PS min to 3" 
Great. Calculated, smallish incremental changes.   This should provide good comparison results and I expect some improvement. 

When we are done, to gain the best on-going night's sleep you will want PS Max as low as you can get it and still not struggle from CAs or Hypopneas.  I think you could drop try dropping PS Max down to even as low as 9 to help lower some AHI event chaos and reduce Leak struggles (mine is set at 7.4, last AHI=0.13).  But if you are happier at 11 for sure leave it there.        

On the chart Layout: Right now for the primary top of the chart view I recommend continuing with exactly the same layout you posted 4 hours with these two tweaks:
  • Also make visible the all-important Minute Vent chart even if you need to use the mouse to squash down the height of a few charts to make room.
  • Down at the bottom of the OSCAR screen about two inches from the left edge of your screen, click on the Event flags pull down arrow (the down arrow right next to the short Green bar and "LL").  After clicking the down arrow click the slider to turn off "OA" flags and turn on "UA" flags.
This layout will help us drill into the airflow topics and probably give us all we need to see until we get your AHI back down low (and hopefully your Minute Vent up) and are ready for fine tuning work.   

Have a great night sleep!

WillSleep

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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#23
RE: Replaced my ASV, not happy, need help
(10-31-2019, 03:41 PM)WillSleep Wrote:
(10-31-2019, 02:47 PM)Sleeprider Wrote: Chart organization would be better with Events, Flow Rate, mask pressure and leaks prioritized.

Hi Sleeprider, 

I asked her to organize the chart this way because the primary set of biggest unknowns to sort out at the moment have to do with Tidal Volume, Minute Vent, Inspiration Rate, Expiration Rate, etc.    So far I think the 'find the right pressures' work looks pretty 'run of the mill' and between the traditional we do not yet need the other charts to sort out steps on that.  So far, the more traditional layout charts (including the historic example of a good night) she included in the first few posts plus this layout focusing on Minute Vent paints a pretty good picture to work from.  

Though I should have also asked her to include Response Rate even if she needed to scrunch up the other charts a little to make it fit.  

WillSleep

I would like to hear you comment on the variation of respiration rate in the presence of hypopnea in this chart  The variables for tidal volume, and BPM  are related and often offset each other to result in a fairly steady Mv. For hypopnea, I would expect Tv to show a reduction, but I'm a bit surprised to see the variation in BPM without apnea, but more to the point, if these metrics are going to be meaningful, they need to be at a much closer scale.  I see where you are going, but would use Mask Pressure rather than total pressure  and try to get zoomed in to about 2 minute intervals to see what going on.

[Image: attachment.php?aid=16652]
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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#24
RE: Replaced my ASV, not happy, need help
(10-31-2019, 06:26 PM)Sleeprider Wrote:
(10-31-2019, 03:41 PM)WillSleep Wrote:
(10-31-2019, 02:47 PM)Sleeprider Wrote: Chart organization would be better with Events, Flow Rate, mask pressure and leaks prioritized.

Hi Sleeprider, 

I asked her to organize the chart this way because the primary set of biggest unknowns to sort out at the moment have to do with Tidal Volume, Minute Vent, Inspiration Rate, Expiration Rate, etc.    So far I think the 'find the right pressures' work looks pretty 'run of the mill' and between the traditional we do not yet need the other charts to sort out steps on that.  So far, the more traditional layout charts (including the historic example of a good night) she included in the first few posts plus this layout focusing on Minute Vent paints a pretty good picture to work from.  

Though I should have also asked her to include Response Rate even if she needed to scrunch up the other charts a little to make it fit.  

WillSleep

I would like to hear you comment on the variation of respiration rate in the presence of hypopnea in this chart.
The variables for tidal volume, and BPM  are related and often offset each other to result in a fairly steady Mv. For hypopnea, I would expect Tv to show a reduction, but I'm a bit surprised to see the variation in BPM without apnea, but more to the point, if these metrics are going to be meaningful, they need to be at a much closer scale.  I see where you are going, but would use Mask Pressure rather than total pressure  and try to get zoomed in to about 2 minute intervals to see what going on.

[Image: attachment.php?aid=16652]

Thanks for the Reply Sleeprider.  

All great points and great questions.   However, most a conversation far too precise for the 'interesting' results of the ASV therapy reported in this specific OSCAR chart.  

I also like and use Mask Pressure but not as much as the Pressure chart for these topics because the Pressure chart provides a better view to subtle changes in EPAP.   Actually, I use a monitor flipped 90 degrees setup as 'vertical' mode providing a lot of vertical screen to work with. I use almost all the charts and keep them up all visible at the same time on that tall screen.    Mask Pressure is 3rd down right under Rate Flow.   


"I would like to hear you comment on the variation of respiration rate in the presence of hypopnea in this chart." 

Sure.  Having spent untold hours dissecting the ASV I believe what we are seeing in that chart is primarily driven by 'nuances' in the ASV algorithim rather than being driven by bemused's breathing.  

Notice the vertical synchronicity between the Leaks, Pressure spikes and cycles in the Rate Flow chart.  

I read that chart like .. well if the ASV was an airplane, like the airplane has gone into flat spin. 

The machine over-reacting to situations it shares responsibility in creating, the over-reaction setting up the next cycle, and again another cycle, and and again another cycle and so on.    

ASV PS increase reaction to something real >>  (Leak>Over-Re-action>ASV created Hypopnea) >> (Leak>Over-Re-action>ASV created Hypopnea) >> (Leak>Over-Re-action> ASV created Hypopnea) >> and so on, and so on ... dragging poor bemused down the bumpy road with it.      

While I think we should expect the ASV algorithm to account for a low EPAP Min setting, one factor in our control that both contributed and we can change is that at 4.0 EPAP was too low.  

So.
  • There is no value in seeing this day's chart as worthy of any more inspection. 
  • Bemuse makes the changes mentioned above and then we see what the chart looks like in the morning.    

Maybe we need to add a gif of an airplane in a flat spin to the forum's icons.  Lol.

WillSleep

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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#25
RE: Replaced my ASV, not happy, need help
Gotta love that image, the airplane in flat spin and then being dragged down the bumpy road. Glad to know it was the machine and not me that was out of control. Rolleyes
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#26
RE: Replaced my ASV, not happy, need help
Interesting, I had not thought of the possibility this might be a runaway of the machine algorithm, and perhaps an opportuntiy to just blow back and reset things. Thanks.
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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#27
RE: Replaced my ASV, not happy, need help
I didn't think that myself...blow back could reset the beast if it goes off the rails I suppose, the blow back theory is typically triggered as a solution when user states similar to the drifting off to sleep and the ASV blows hard startling you awake thing

Blow back I guess is the pseudo system reset for pressure, short of a power cycle.

BTW for ones not knowing Blow Back, see my description above. When an ASV user experiences that, several here have suggested users with a full face mask literally blow moderately forceful back into the ASV to "reset" it from false impressions it needs to force a breath.
Dave

OSCAR
Standard OSCAR Chart Order
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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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#28
RE: Replaced my ASV, not happy, need help
it should work with any kind of mask. I know it does with nasal pillows.
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#29
RE: Replaced my ASV, not happy, need help
I'd guess it would but I was thinking the actual blowing nasal only might have been more difficult to do or lessen the desired result. I've not done a blow back via the N30i so I had skewed my thinking that way about full face only-ish.
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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#30
RE: Replaced my ASV, not happy, need help
(11-01-2019, 11:45 AM)SarcasticDave94 Wrote: I'd guess it would but I was thinking the actual blowing nasal only might have been more difficult to do or lessen the desired result. I've not done a blow back via the N30i so I had skewed my thinking that way about full face only-ish.


I propose a solution for users of Nasal Masks and Pillows.  

When ASV pressure is disruptive "Take a Breath"

When ASV pressure builds and is disruptive to blessful slumber just open your mouth and take a refreshing, relaxing slow natural breath. 

Exhale, Inhale, close your mouth and go back to sleep.  





WillSleep

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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