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[Treatment] Getting used to new ASV
#1
I just started using my new Resmed Aircurve 10 ASV for my mostly central apneas diagnosed from my recent sleep study. I am having a hard time getting used to the pressure variations. It seems that if I pause my breath even for just a moment, the machine surges air into my nose and mouth. Also, although the sleep study reported that they got the apneas under control in the titration, my AHI's have been 6.8; 15.4 and 10.8 for the first three nights. Does it take a while to adjust. I seem to be just as tired in the morning as usual. Thanks.
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#2
(12-18-2015, 06:50 PM)jmpower4 Wrote: I just started using my new Resmed Aircurve 10 ASV for my mostly central apneas diagnosed from my recent sleep study. I am having a hard time getting used to the pressure variations. It seems that if I pause my breath even for just a moment, the machine surges air into my nose and mouth. Also, although the sleep study reported that they got the apneas under control in the titration, my AHI's have been 6.8; 15.4 and 10.8 for the first three nights. Does it take a while to adjust. I seem to be just as tired in the morning as usual. Thanks.

I would discuss this with your doctor as soon as possible. I'm on the same machine, and have been for almost a year. It's supposed to learn your breathing pattern and easily match it.
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#3
Welcome to the forum.

The ASV is supposed to provide a pressure pulse when it detects a pause in breathing. It,s just that it can't tell the difference between the sleeping and awake states and will sometimes try to assist when you don't really need it. If you find this happening, just blow back hard against the pressure. The machine will get the message and back off.

It would be helpful to know the details of your setup - perhaps you could update your profile. Tell us your maximum and minimum EPAP, maximum and minimum pressure support (PS) and the maximum IPAP.

I'd also suggest you get hold of the Sleepyhead software (link at the top of the page) and attach some screen shots so we can see what's going on and maybe give you some more specific advice.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#4
Hi jmpower4,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and getting used to your new machine.
trish6hundred
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#5
This is supine position.


       
(12-18-2015, 08:08 PM)DeepBreathing Wrote: Welcome to the forum.

The ASV is supposed to provide a pressure pulse when it detects a pause in breathing. It,s just that it can't tell the difference between the sleeping and awake states and will sometimes try to assist when you don't really need it. If you find this happening, just blow back hard against the pressure. The machine will get the message and back off.

It would be helpful to know the details of your setup - perhaps you could update your profile. Tell us your maximum and minimum EPAP, maximum and minimum pressure support (PS) and the maximum IPAP.

I'd also suggest you get hold of the Sleepyhead software (link at the top of the page) and attach some screen shots so we can see what's going on and maybe give you some more specific advice.

Reply
#6
G'day jmpower4

The way the Resmed ASV machines work (according to their literature from their old site), all those unclassified apneas and hypopneas are obstructive in nature, and this is normally treated by increasing the pressure. The apneas are quite long in duration and occurring in large clusters, so your blood oxygen is probably desaturating excessively. Those pressure swings must be disruptive as well. Putting this all together, you probably wake up feeling like a train wreck after a night like this Sad .

I'd suggest a serious talk with your doctor to get these things under control, as the therapy is probably counter-productive at the moment. Things I'd consider in your situation:

1. Change the machine from ASV to ASV Auto mode
2. Change your EPAP settings to EPAPMin = 10 and EPAPMax = 15
3. Change the PS to PSMin = 3, PSMax = 10

Changing the EPAP should help control the apneas and hypopneas, and reducing the range of the PS should reduce the size of the pressure swings, which will be less disruptive. The other thing you could do immediately is to sleep on your side - this often gives a big improvement in obstructive apnea.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#7
Thanks for your reply. I did sleep on my side ( actually both sides last night and got 0.0 events and 0.0 AHI. Do you think that this is a accurate?



(12-19-2015, 10:31 PM)DeepBreathing Wrote: G'day jmpower4

The way the Resmed ASV machines work (according to their literature from their old site), all those unclassified apneas and hypopneas are obstructive in nature, and this is normally treated by increasing the pressure. The apneas are quite long in duration and occurring in large clusters, so your blood oxygen is probably desaturating excessively. Those pressure swings must be disruptive as well. Putting this all together, you probably wake up feeling like a train wreck after a night like this Sad .

I'd suggest a serious talk with your doctor to get these things under control, as the therapy is probably counter-productive at the moment. Things I'd consider in your situation:

1. Change the machine from ASV to ASV Auto mode
2. Change your EPAP settings to EPAPMin = 10 and EPAPMax = 15
3. Change the PS to PSMin = 3, PSMax = 10

Changing the EPAP should help control the apneas and hypopneas, and reducing the range of the PS should reduce the size of the pressure swings, which will be less disruptive. The other thing you could do immediately is to sleep on your side - this often gives a big improvement in obstructive apnea.


But I did feel tired again all day. Does it take a while to catch up on sleep?


(12-19-2015, 11:42 PM)jmpower4 Wrote: Thanks for your reply. I did sleep on my side ( actually both sides last night and got 0.0 events and 0.0 AHI. Do you think that this is a accurate?



(12-19-2015, 10:31 PM)DeepBreathing Wrote: G'day jmpower4

The way the Resmed ASV machines work (according to their literature from their old site), all those unclassified apneas and hypopneas are obstructive in nature, and this is normally treated by increasing the pressure. The apneas are quite long in duration and occurring in large clusters, so your blood oxygen is probably desaturating excessively. Those pressure swings must be disruptive as well. Putting this all together, you probably wake up feeling like a train wreck after a night like this Sad .

I'd suggest a serious talk with your doctor to get these things under control, as the therapy is probably counter-productive at the moment. Things I'd consider in your situation:

1. Change the machine from ASV to ASV Auto mode
2. Change your EPAP settings to EPAPMin = 10 and EPAPMax = 15
3. Change the PS to PSMin = 3, PSMax = 10

Changing the EPAP should help control the apneas and hypopneas, and reducing the range of the PS should reduce the size of the pressure swings, which will be less disruptive. The other thing you could do immediately is to sleep on your side - this often gives a big improvement in obstructive apnea.

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#8
Sleeping on your side changes the way the loose tissues in the airway will naturally relax / collapse under gravity and hence reduces the chances of the airway getting blocked. Whether it could eliminate blockage entirely I'm not sure, but I suppose it's plausible. Have a close look at the flow waveforms in Sleepyhead and see if there are any pauses which are perhaps not long enough to be flagged.

Quote:But I did feel tired again all day. Does it take a while to catch up on sleep?

Yes, if you've had apnea for a while you likely have a huge sleep deficit and your general bodily functions may be compromised. Some people instantly feel more energy after just one night, but for most of us it's a bit of a journey. In addition, there may be factors other than the straight AHI number at play. You may still be experiencing those pressure swings which will prevent you getting into restful sleep, and there may be leaks or other discomforts.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#9
Here is my data for last night. The past 3 nights I have slept completely on my side and obtained similar data. Does this mean I am out of danger? Thanks
I can nopt attach the new screen shot. It states that I have already used my 200mb of attachment allotment. What should I do?



(12-19-2015, 11:42 PM)jmpower4 Wrote: Thanks for your reply. I did sleep on my side ( actually both sides last night and got 0.0 events and 0.0 AHI. Do you think that this is a accurate?



(12-19-2015, 10:31 PM)DeepBreathing Wrote: G'day jmpower4

The way the Resmed ASV machines work (according to their literature from their old site), all those unclassified apneas and hypopneas are obstructive in nature, and this is normally treated by increasing the pressure. The apneas are quite long in duration and occurring in large clusters, so your blood oxygen is probably desaturating excessively. Those pressure swings must be disruptive as well. Putting this all together, you probably wake up feeling like a train wreck after a night like this Sad .

I'd suggest a serious talk with your doctor to get these things under control, as the therapy is probably counter-productive at the moment. Things I'd consider in your situation:

1. Change the machine from ASV to ASV Auto mode
2. Change your EPAP settings to EPAPMin = 10 and EPAPMax = 15
3. Change the PS to PSMin = 3, PSMax = 10

Changing the EPAP should help control the apneas and hypopneas, and reducing the range of the PS should reduce the size of the pressure swings, which will be less disruptive. The other thing you could do immediately is to sleep on your side - this often gives a big improvement in obstructive apnea.


But I did feel tired again all day. Does it take a while to catch up on sleep?


(12-19-2015, 11:42 PM)jmpower4 Wrote: Thanks for your reply. I did sleep on my side ( actually both sides last night and got 0.0 events and 0.0 AHI. Do you think that this is a accurate?



(12-19-2015, 10:31 PM)DeepBreathing Wrote: G'day jmpower4

The way the Resmed ASV machines work (according to their literature from their old site), all those unclassified apneas and hypopneas are obstructive in nature, and this is normally treated by increasing the pressure. The apneas are quite long in duration and occurring in large clusters, so your blood oxygen is probably desaturating excessively. Those pressure swings must be disruptive as well. Putting this all together, you probably wake up feeling like a train wreck after a night like this Sad .

I'd suggest a serious talk with your doctor to get these things under control, as the therapy is probably counter-productive at the moment. Things I'd consider in your situation:

1. Change the machine from ASV to ASV Auto mode
2. Change your EPAP settings to EPAPMin = 10 and EPAPMax = 15
3. Change the PS to PSMin = 3, PSMax = 10

Changing the EPAP should help control the apneas and hypopneas, and reducing the range of the PS should reduce the size of the pressure swings, which will be less disruptive. The other thing you could do immediately is to sleep on your side - this often gives a big improvement in obstructive apnea.

Reply


#10
Quote:Here is my data for last night. The past 3 nights I have slept completely on my side and obtained similar data. Does this mean I am out of danger? Thanks

Hard to say without seeing the data (see below) but side sleeping might be the answer in your case. Which raises the question of how do you guarantee you remain on your side? Some people wear backpacks to bed or sew tennis balls into their PJs to ensure they stay off their back. It's also probably the case that side sleeping combined with PAP therapy is giving you these good results. If you stop using the machine I suspect you would still have apnea even when sleeping on your side. Your original sleep study should quote AHI for different sleeping positions.

Quote: I can nopt attach the new screen shot. It states that I have already used my 200mb of attachment allotment. What should I do?

There is a graduated scale of attachment allowances depending on how many posts you have. Once you get a few more posts under your belt, the allowance goes up. I don't have the exact numbers at my finger tips (I'm not on my normal computer).
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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