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[Shadowpup] ASV Therapy Thread
#21
RE: First Nignt on AirCurve 10 ASV Disappointing
AHI still poor compared to last four months.  May have nothing to do with sleep as my resting heart rate was around 80 all night.  That is compared to long term normal of 50.  Body temperature overnight +0.2F, so that is very normal.  Time for a pause in this AHI pursuit until my vitals return to normal.  Thanks for everyone's suggestions.  Drifting back into the shadows for now.


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#22
RE: First Nignt on AirCurve 10 ASV Disappointing
Before you disappear, I'd like to get a closeup look at the respiration rate (2-minute zoom) in the flow chart. The idea is to get a zoomed view of some of these clusters as they begin, so hopefully some normal respiration leading to the sudden obstructive hypopnea or UA. The onset of these events is not gradual, so we should be able to see exactly what happens from a respiratory volume point of view at the horizon of the event.

With regard to your therapy, since we have been unable to adequately help you, please follow-up with your doctor. I am completely convinced the events are obstructive. These won't go away just because you stop therapy. If you find differently, let us know. When monitoring your heart rate, are you able to correlate the time of the obstructive clusters, with the increase in heart rate?
Sleeprider
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#23
RE: First Nignt on AirCurve 10 ASV Disappointing
I agree the events are obstructive.  I should have been more clear.  I am continuing my therapy, just stopping a quest for lower AHI until my vitals return to normal.  Peak resting heart rate of 99 bpm occurred about 0030 hours.  Most of the rest of the night the resting heart rate was around 80 bpm for an overall average of 80 bpm.  At 0030, there was a small cluster, but not unlike the others that were at 80 bpm.  100 bpm occurred during rem sleep.
As you can see, the ASV jumps in and restores breathing, only to have my respiratory effort fail once the ASV backs off.

Thanks for your interest and help.  I am not giving up.  Curing sleep apnea is a piece of a much more dangerous health condition being addressed.  Rest assured I am going to get this sorted.  I'll just be working on it from the shadows in the landscape of life.


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#24
RE: First Nignt on AirCurve 10 ASV Disappointing
Interesting to see how the events progress. If you want to see that with the ASV response on a breath by breath basis, use mask pressure instead of pressure and you will see how the ASV jumps in even more clearly. I see obstruction in those closeups, with arousal which clears the airway for several breaths, then a return to the obstruction. The pressure support with up to 25 cm pressure is making very little impact during the apnea and hypopnea.
Sleeprider
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____________________________________________
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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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#25
RE: First Nignt on AirCurve 10 ASV Disappointing
the flow rate pattern, the fairly uniform periodicity of events, the ineffectively swinging pressure support & the fact that your obstructions do not respond to pressure or a collar, suggest the possibility of movement, as in periodic limb movement.
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#26
RE: First Nignt on AirCurve 10 ASV Disappointing
If you are getting these results every night and still have the Autoset then try it for another night to see what happens and post those results. Maybe post up some of your older autoset data too (any cases showing what appear to maybe be positional apnea like this).

If these are purely positional, obstructive apneas then what could be happening is that the Autoset was no match for the positional apnea, you would have an couple apneas then have an arousal because of them. The ASV blasting away to try and keep the airway open once it starts to close might be doing just enough to keep you in a state of sleep (or deeper state of sleep) extending the length/occurrence of these apneas. You can tell from your data your airway rarely closes fully but with the autoset that might have been a different story.

This theory is based on the machine capability but also because you say that you believe you are sleeping better even though your AHI is higher. If it happens to be the case then your results aren't actually disappointing but rather encouraging and you just need to figure out the rest of the puzzle. Too hard to diagnose further without knowing what your past autoset results etc looked like though. Conversely if you weren't having what appeared to be positional apnea before than it would seem unlikely to me that they are now an issue just because of changing machine type.
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#27
RE: First Nignt on AirCurve 10 ASV Disappointing
(08-12-2020, 10:36 AM)Sleeprider Wrote: Interesting to see how the events progress.  If you want to see that with the ASV response on a breath by breath basis, use mask pressure instead of pressure and you will see how the ASV jumps in even more clearly.  I see obstruction in those closeups, with arousal which clears the airway for several breaths, then a return to the obstruction.  The pressure support with up to 25 cm pressure is making very little impact during the apnea and hypopnea.

Mask pressure is a better look.  Thanks for the tip.  That quick response is probably what keeps me from completely waking.  I'll keep on trying.
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#28
RE: First Nignt on AirCurve 10 ASV Disappointing
(08-12-2020, 01:45 PM)sheepless Wrote: the flow rate pattern, the fairly uniform periodicity of events, the ineffectively swinging pressure support & the fact that your obstructions do not respond to pressure or a collar, suggest the possibility of movement, as in periodic limb movement.

You are correct about movement.  I do turn to my side from time to time.  However, I have had three sleep tests since Jan 2020.  No periodic limb movement.  I have a movement monitor on my hand and that indicates random movement, but not a lot of them.  Thanks for taking the time to help.
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#29
RE: First Nignt on AirCurve 10 ASV Disappointing
(08-16-2020, 08:07 AM)Geer1 Wrote: If you are getting these results every night and still have the Autoset then try it for another night to see what happens and post those results. Maybe post up some of your older autoset data too (any cases showing what appear to maybe be positional apnea like this).

If these are purely positional, obstructive apneas then what could be happening is that the Autoset was no match for the positional apnea, you would have an couple apneas then have an arousal because of them. The ASV blasting away to try and keep the airway open once it starts to close might be doing just enough to keep you in a state of sleep (or deeper state of sleep) extending the length/occurrence of these apneas. You can tell from your data your airway rarely closes fully but with the autoset that might have been a different story.

This theory is based on the machine capability but also because you say that you believe you are sleeping better even though your AHI is higher. If it happens to be the case then your results aren't actually disappointing but rather encouraging and you just need to figure out the rest of the puzzle. Too hard to diagnose further without knowing what your past autoset results etc looked like though. Conversely if you weren't having what appeared to be positional apnea before than it would seem unlikely to me that they are now an issue just because of changing machine type.

Thanks for your insightful post.  The Autoset is gone.  I used it 125 days.  Would have been less, but for COVID related delays for a hospital test.  Summary data for those 125 days:
Ave hours/night 5:30
Compliance 84%
AHI 6.09
Obstructive index 3.59
Hypo index 1.39
Clear Airway index 0.14
% CHR 2.49%

The last three nights on AutoSet:


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#30
RE: First Nignt on AirCurve 10 ASV Disappointing
Those obstructive clusters look to be positional.
http://www.apneaboard.com/wiki/index.php...onal_Apnea
http://www.apneaboard.com/wiki/index.php...cal_Collar
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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