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Titration study
#21
RE: Titration study
Well< according to Oscar, my events are 1.78 and below, I have even had a few night @0. This ASV machine really does work well for my Apnea!   I can now use pillows as noted in my info which makes for much better comfort.  According to sleep aps I am stirring quite often.  I will post last night data.  Let me know if you have any suggestions.According


   
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#22
RE: Titration study
Can you repost with flow limitation chart visible. It appears you are having moments of high flow limitation and it appears to be driving pressure up substantially (00:45, 5:10, 6:15, 8:15). This appears to be a partial obstruction issue and raising EPAPmin is probably what you should try (thinking 8 cm min). It could also be a positional related issue where different pillow selection or maybe trying a soft cervical collar could be helpful.
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#23
RE: Titration study
Going after flow limits on the ASV may be difficult. Most ASV users have at times shaggy grass FL charts. IMO it may not be worth the chase.
Dave

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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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#24
RE: Titration study
    . This is from 12/25

I will list several flow limits from the 95% column:

12/25 above .46
12/24 .13
12/23 .10
12/22 0 and 0 AHI
12/21 .13 and 0 AHI
12/20 .11
12/19 0 and 0 AHI

Let me know if you would like any further info, and as always, thank you everyone.
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#25
RE: Titration study
The clustering of flow limits suggests some chin tucking/positional issues may be present. That is a lot of rise in EPAP pressure, and even though your event rate is low this is something to pay attention to.
Sleeprider
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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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#26
RE: Titration study
Snore must be driving the pressure up as well. We rarely see ASV pressures being driven by flow limitation and this indicates that you have both a central and obstructive issue. The obstructive side could be because EPAPmin is too low or could be a chin tucking/positional apnea aspect (or both).

Your median EPAP was 8 cm and appeared to bounce off that level much of the night and all 4 major restrictions occurred at/or below that level, this appears to be indicating your airway is prone to collapsing at/below that pressure. I think you should try EPAPmin of 8 cm to see if it avoids/minimizes these issues.
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#27
RE: Titration study
I am using a soft cervical collar, according to my sleep app I am not snoring much, 3 to 5 minutes each night.  I will try raising the pressure as you suggest.
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#28
RE: Titration study
Sleeprider,

I am currently using nasal pillows (which I really like) and a soft cervical collar.  Last night was the worst night since switching to the ASV.  I am wondering if last night could be food related.  It could have been a red meat night, sleep is not always wonderful when I consume red meat.

Just as an fyi; I noted when I traveled to sea level that all my numbers were much better.  And, I noticed in posts here that elevation is a culprit with apnea.  My O2 calculations were a bit low last night as well.  During the day I range from 95 to 97.  At night from 88 to 91. This is on an Apple Watch which closely matches my recording device.
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#29
RE: Titration study
Your EPAP pressure is consistently over 6-7 cm, so that may be your minimum. The machine is doing what is needed to avoid an event, and having no trouble getting there. It might be helpful to zoom in on the transition where the pressure is happily solving your issues at under 8-cm and see why it goes straight up to 12-15 cm.
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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#30
RE: Titration study
It appears that during the extremely high pressure times that my flow limit are low, tidal volume is up, snore is down, mask pressure is up and respiration is up. I could try a chin strap tonight to experiment.  

Your recommendations are always appreciated!
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