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Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
#41
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
As described above, last night's charts attached.


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#42
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
Have you ever tried letting the machine work as it is intended to? Ie increase PSmax so the machine attempts to treat the central apnea? I would be curious to see the effects.
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#43
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
IMO this pressure set looks more like a BPAP Auto than SV auto. By the AHI number, you're treated.
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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#44
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
(08-03-2021, 01:32 AM)Geer1 Wrote: Have you ever tried letting the machine work as it is intended to? Ie increase PSmax so the machine attempts to treat the central apnea? I would be curious to see the effects.

I tried this last night after a panicked realization that it's been almost a year of trying to treat this (and starting to feel like an idiot for believing I could). I woke up with no brain fog, could hold a full-on conversation within a couple of seconds. I felt like I slept well for the first time ever. Yet I became very tired very early in the day, and my data doesn't look good. Worst AHI I've ever had. I think I just got awoken from light sleep or had some sort of fluke. 

Image attached. What can I do to treat the CA? I'm guessing that because the pressure appears to more or less max out when there's an event, it needs to go higher and can't, so I'm increasing the PSmax by 3 tonight. But I'm completely guessing. I've also attached a cluster of events, and some uneventful flow rate (looks good!).

What do you think? 

(08-03-2021, 02:33 AM)SarcasticDave94 Wrote: IMO this pressure set looks more like a BPAP Auto than SV auto. By the AHI number, you're treated.

Apologies for the late response, I didn't get the email notification and fell out of the habit of checking back daily. My laptop also broke so I was MIA from the internet for a while.

I'm sorry if I've not been clear, I'm trying to treat UARS which doesn't necessarily get reflected in the AHI much. I've had "treated" AHI since before I even got my machine I think.


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#45
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
No need for an apology. You might have had AHI treated in the past. I'm of the opinion it's not treated now. 10.x AHI, that's half Central and half Hypopnea, this after treatment via the Respironics SV Auto isn't looking too good or headed in the right direction. You may actually have to use this SV Auto to treat Central Apnea. Just myself stating an opinion, I'd not accept that trainwreck as anything but a mess. To treat this, the settings will need to change, if that's what you want.

EPAP should be higher than straight 7, maybe 7-12 or so. This should address Hypopnea, if they're Obstructive based. PS likely needs to be more than just 3-6, likely the PS Max going up to 9, 12, somewhere about there.
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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#46
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
Pretty much what Dave said.

Set PS 3-13 so you don't handcuff the ASV.
Also I see some clustering, loosely but there, are you using a collar?
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#47
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
(08-18-2021, 10:00 PM)SarcasticDave94 Wrote: No need for an apology. You might have had AHI treated in the past. I'm of the opinion it's not treated now. 10.x AHI, that's half Central and half Hypopnea, this after treatment via the Respironics SV Auto isn't looking too good or headed in the right direction. You may actually have to use this SV Auto to treat Central Apnea. Just myself stating an opinion, I'd not accept that trainwreck as anything but a mess. To treat this, the settings will need to change, if that's what you want.

EPAP should be higher than straight 7, maybe 7-12 or so. This should address Hypopnea, if they're Obstructive based. PS likely needs to be more than just 3-6, likely the PS Max going up to 9, 12, somewhere about there.

(08-18-2021, 10:21 PM)Gideon Wrote: Pretty much what Dave said.

Set PS 3-13 so you don't handcuff the ASV.
Also I see some clustering, loosely but there, are you using a collar?

Thank you both! Yes I use a collar.

Yeah the first ASV night was a bad one for CA. I think H was just mislabeled CA. I've attached a zoom of the majority of the H events of that night, but they're all the same. 

I also attached last night, where I raised the max PS by 6. 

- CA is extremely improved. AHI looks good
- Only one H event, which looks like a CA. Also attached.


It's maybe worth knowing as well that I awoke at 7.25 to take some medication and slept again after, so the snoring event then and some events soon after aren't valid as I was awake or falling asleep. Considering the CA cluster is like "one big event", even 1.8 AHI may be quite over-representative.

I'll post immediately after this to show some more photos:
- Flow rate doesn't look great
- Flow rate zooms show some issues like flat tops at times


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#48
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
So attached is an hour-long block empty of tagged events, flow rate is noticeably a bit erratic. Also attached is a zoomed flow rate I found.

Both of those suggest to me that PS min should be increased by 0.5 or 1 or so?

Also given the cluster of CA still present, maybe my PS max should be increased by 0.5?

Finally, on the pressure graph, it says PS is always lower than 6. Which seems weird. There are a few times the max IPAP goes up, but the actual IPAP doesn't seem to change much. I don't know what I'm missing, but it seems to suggest that the extra max PS wasn't even used which doesn't line up with the massive AHI change.


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#49
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
For myself when I was on ResMed's ASV, I preferred having a range for EPAP. I let EPAP take care of Obstructive events and then PS with increased IPAP took care of my Central events.

Saying this as putting the suggestion to add EPAP Max of some sort to give it a range. Maybe just to start with, try EPAP Max 10, see how it goes.
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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#50
RE: Seemingly little correlation between EPAP (or PS) and AHI or flow rate. [UARS]
Thanks Dave. I don't get any obstructive events with the constant EPAP, and obstructive events haven't really been an issue during my therapy. What is the benefit to adding a higher max to the EPAP?

Do you agree with raising the max PS by 0.5 to see about the odd central I still had last night? Is my PS actually working given what it claims my max PS was compared to my settings?
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