Should one even care about the FL graph on ASV machine?

[SarcasticDave94]

That's fine, and thanks for posting it. I'm not intending to critique, I was just curious on settings. I'll look at your charts again and see if anything come to mind. I'll look at them as I did my own and see what may pop out.

[Michaely6]

Ok thanks. When I get home, I will post the most updated charts that reflect my current settings

[SarcasticDave94]

OK I'll check in later and see what you've got out there.

[Michaely6]

Ok here is a screenshot from my use on the Aircurve ASV. As you can see, the FL graph is all over the place as usual.

Dave are you 100% sure that your FL graph data is turned on?  And is a zero reading on the FL graph and consistent thing for you? haha I just never seen anyone with an Aircurve ASV have a zero FL graph. I'm still using sleepyhead so I dont know if it will look the same in Oscar. Sleeprider and Bonjor, what do you think of Dave's zero FL graph on the ASV based on your discussions on the FL graph regarding the ASV machine and does anything stick out to you regarding my screenshots on the machine?

[Sleeprider]

Michael can you resize just a bit to get the mask pressure in, or replace pressure with mask pressure? A glance that these charts suggests that flow limitation is not well correlated with pressure support, and your respiratory flow rate variations seem almost random. AHI is good. I don't recall if you ever commented on results with Vauto or other bilevel that has an adjustable rise time. Could you briefly review your PAP experience on how we got to ASV?

[Michaely6]

Michael can you resize just a bit to get the mask pressure in, or replace pressure with mask pressure?  A glance that these charts suggests that flow limitation is not well correlated with pressure support, and your respiratory flow rate variations seem almost random.  AHI is good. I don't recall if you ever commented on results with Vauto or other bilevel that has an adjustable rise time.  Could you briefly review your PAP experience on how we got to ASV?

I pretty much got on ASV because I was having alot of centrals on regular Bilevel (Vauto). Most of the centrals did go away after adjusting trigger time to very fast but I feel like i get better sleep on the ASV as opposed to the Vauto which is why i am sticking with the ASV for now.

[SarcasticDave94]

I'll check OSCAR but I'm pretty sure everything is reporting accurately. I can check later tonight and post findings.

[Sleeprider]

That information helps. You feel better on ASV so we can go with that, and your minimum pressure is 15/9.0 (PS 6). Your newest chart shows PS is frequently higher than the minimum setting, while EPAP changes within a very small range, so you are getting ASV benefits to maintain minute vent. There are some big spikes in flow rate that seem to relate to pressure support at 01:00, 01:40 and 02:20 that might deserve a closer look. Otherwise, most of the night looks reasonable. I agree with SarcasticDave that the machine seems to be responding mostly as expected. It is really hard to correlate flow limitation with flow rate and PS at this scale, so I guess I'm not much help. I will say, that flow limits don't even show up in your 95% statistics, so I don't think they are significant, even though the spikes look dramatic. These are simply brief individual breaths that don't even affect a statistically significant part of your respiration. They may be central events that in the first breath do not get an adequate pressure support response. It takes several breaths for PS to increase to max, so those initial events may appear flow-limited.

[sheepless]

for comparison, here's an example of asv flow limitations with the smallest possible entry in the 95% column.  as I have eyeballed these for a year or so, it's hard to imagine the 1.0 fl's are counted but I haven't been able to check this.  the main point being that while they may still contribute to feeling lousy, they don't look too bad in your screenshot.

[SarcasticDave94]

Note again my short sessions while dealing with bronchitis has messed up sleep pretty drastically. Anyway, yes, my FL chart was functioning correct. Here's another nap session with a few FL blips. I say nap because that's my sleep for the present.