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Resmed ASV vs Dreamstation ASV
#51
RE: Resmed ASV vs Dreamstation ASV
Thanks for your comments and your insights, again. I really appreciate you taking all the time to go over things and comment on it. I just wanted to express my gratefulness for that.

Some small things, you mentioned:
'Since PS should be overcoming this flow limit, and you immediately recover to normal breaths after the CA'
Does that imply the PS is (still) too low?

The TiMax is an interesting remark, you sparked a new idea in my mind and I went in to validate. It seems that the higher my 95% and 99.5% insp rate is, the more flagged events I have. At some level this makes sense of-course. That begs the question: If a higher insp rate is a high event rate, does lowering insp rate also lower the event rate? Lets find out.

I looked at most nights and found my 99,5% insp rate is about 2.4. So as a first test I figured a TiMax at 2.4 would be a good starting point. I went ahead and did that last night (screenshots below).

I did manage to get a night with a very low custom flagged event count, which I consider to be good and I also use it as baseline for indications of a good night. Tonight I want to lower to 2.2 and see if it improves even further. ]

I do have one question though: Why would you say mess with TiMax, and not with Cycle? As that would also make epap triggered faster right? So the effect might be similar?
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#52
RE: Resmed ASV vs Dreamstation ASV
I'm not advocating higher PS. I'm saying there is some transient obstruction that may be positional.
TiMax affects the maximum time IPAP will be maintained during inspiration. Cycle sensitivity, makes the Vauto more sensitive to expiratory flow and cycles the machine somewhat sooner AFTER expiration is detected. In your case, you seem to keep sucking air during these very long inhales and cycle would not affect that, however, by setting Ti Max correctly, you terminate inspiration and preserve expiration time. This is a trick normally used in COPD, but it seems applicable. An important observation is that when inspiration time rises, so does tidal volume. So you don't need the longer inspiration time to acquire a normal breath, you just don't spontaneously cycle.
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#53
RE: Resmed ASV vs Dreamstation ASV
Very interesting! I will slowly scale down TiMax and investigate data further.

This still doesn't explain the many artefacts that seem to happen, maybe I just move a lot, maybe its restless (leg) syndrome, I'm not sure.

I'm talking about for example this, there seem to be so many irregularities, it kind of grinds my gears a bit:
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#54
RE: Resmed ASV vs Dreamstation ASV
Well, I can't begin to guess since that would be a matter of observation or testing. I think there is an argument that perfectly normal is abnormal. Irregularities in respiration and between individuals seems to be the rule not the exception.
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#55
RE: Resmed ASV vs Dreamstation ASV
Game on. At least my overall feeling slowly improves, which is also comforting considering I opted in for MMA surgery. This increases hope it might help, and that I might possible get off PAP permanently.

I will titrate TiMax down 0.2 tonight, and then depending on data .1 or .2 nightly until I get close to the med/95% numbers.
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#56
RE: Resmed ASV vs Dreamstation ASV
That sounds like a Ti Min number. I assume you mean 2.2?
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#57
RE: Resmed ASV vs Dreamstation ASV
Interesting, the overall events seem a lot lower - but after lowering again last night there is one single cluster with a ton of events that brings up the average a lot. Breathing seems to be a lot better, more regular now. I'm not sure what the pauses after expiration mean, but most of the flags here don't look very bad. Funnily on 'bad nights' there are a lot of these events it seems, and on good nights there are less.
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#58
RE: Resmed ASV vs Dreamstation ASV
That is a user defined parameter.  What do you have it set to? What problems are you experiencing that need monitoring outside the normal apnea definition parameters?
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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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#59
RE: Resmed ASV vs Dreamstation ASV
According to other threads I found I have set it to:
50% at 5s
20% at 3s

Outside of apnea I guess there are no problems I know of except possible extensive movement, allergies, concentration issues etc, but I still wake up tired - less than before - but tired still.
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#60
RE: Resmed ASV vs Dreamstation ASV
I think adjusting TiMax has had a positive effect on therapy outcomes, especially if you are feeling better. We are only looking at flow rate and volume charts, and it would be interesting to see if there was any SpO2 response. Not a big deal, but I think this may be the trick you were looking for. Don't get too lost in the charts and numbers; this is excellent therapy.
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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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