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[Treatment] Nearly new ASV machine settings
#11
Amazed and astonished? These are wonderful machines for the right patient. It looks like you had some pretty heavy pressure spikes - how do you feel?

DeepBreathing
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#12
(05-15-2015, 08:27 AM)DeepBreathing Wrote: Amazed and astonished? These are wonderful machines for the right patient. It looks like you had some pretty heavy pressure spikes - how do you feel?

Funny you would ask, I am feeling better in some ways, but the pressure spikes are nasty, I have to say.
I am thinking of lowering max PS, to 10. I get the air blowing out my mouth and waking me up when the spikes hit.

Any idea if that would work??

Storywizard

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#13
(05-15-2015, 10:00 AM)storywizard Wrote: I am feeling better in some ways, but the pressure spikes are nasty, I have to say.
I am thinking of lowering max PS, to 10. I get the air blowing out my mouth and waking me up when the spikes hit.

Any idea if that would work??

Hi storywizard,

Yes, for a person with healthy lungs a Max PS of 10 will likely be high enough to do all the work of breathing during what would have been a central apnea. This information had been posted on the ResMed website before it was re-designed to be more sales-oriented but less informative.

I suggest permanently lowering Max PS to 10 unless you have a lung condition like COPD.

If you have a lung condition then I would suggest consulting your doctor but lowering Max PS to 10 at least temporarily, and occasionally wearing at night a recording pulse oximeter to verify your SpO2 is not dipping below 90% during the times the machine is treating central apneas.

If the Flow waveform (Flow is the estimated the rate of airflow into and out of our lungs) is zero during a pressure peak, this was an obstructive arpnea, which is most commonly caused by having rolled flat onto our back.

If the Flow is start/stop intermittent this is caused by intermittent obstruction.

If during a hypopnea the Flow waveform is steady, with smooth inhalation and exhalation - but the Minute Volume (the amount of air breathed per minute) is too small (is significantly lower than your recent Minute Volume) even though PS has become maxed out - this is when the ASV machine has managed to change a central apnea into something we might call a central hypopnea, and a higher setting for Max PS might have been able to treat the hypopnea more completely.

To see these details in the Flow waveform one has to zoom in until 5 or 10 minutes fills the screen. Also, the vertical scale on the flow needs to be zoomed in, to show only about -75 Liter per minute to about +75 L/m.

Raising the Min PS setting will tend to raise your average SpO2.

I think an ideal setting for Min PS is one which will help keep the average SpO2 staying between 94% and 96%. (Just paying attention to the average SpO2 during each hour or so, not paying attention to momentary dips.). I think averaging 98% and above for most of the night may cause problems like interfering with prescription medicines; it creates higher oxidative stress on the body, which long term would be bad for our health.


Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#14
Thanks for that vsheline...

Have to say I am light headed today, but no massive energy drop...

Storywizard
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#15
When the pressure spikes on my machine, I just toot it out in the morning. Tongue Rooty toot toot.
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#16
(05-15-2015, 04:19 PM)JVinNE Wrote: When the pressure spikes on my machine, I just toot it out in the morning. Tongue Rooty toot toot.

Oh, that's what that is...lol Cool

Storywizard

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#17
Really interesting results, and It again points to a max PS of 8.0 to 10.0 since the data show a 95% IPAP at 16, which is a +10 on your EPAP. Pressure support of 8.0 is considered enough to accomplish all the respiratory effort of a healthy person. 10 is a nice safety margin. This first night is a great result and a few more nights of data wouldn't hurt, but I think PS +10 max makes a lot of sense.

Stephen, you are to be commended for overcoming so much adversity in making this therapy work for you. Your doctors refused to acknowledge your complex apnea, and you persevered and kept trying through a second Auto CPAP trial, and finally took the advice you found on this forum and the other one, to move on to ASV. It's great to see this has finally come together for you, and shame on those doctors that are more concerned with proving they are right than considering the data these machines produce.
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#18
(05-15-2015, 04:19 PM)JVinNE Wrote: When the pressure spikes on my machine, I just toot it out in the morning. Tongue Rooty toot toot.

I wear a full face mask but with a mask liner so that leaks do not cause mask burping/trumpeting. Makes leaks far less bothersome.

The high pressures also tend to cause us to swallow a certain amount of air which is normally just passed through the system.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#19
Story, I didn't see this thread until just now.

I am so very proud of you. You have gone far and beyond anything you should have had to endure to get to where you are. Good job. Great job.......

The details such as the proper PS will wash out, but look at what you did!

Congratulations.
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#20
(05-15-2015, 10:22 PM)retired_guy Wrote: Story, I didn't see this thread until just now.

I am so very proud of you. You have gone far and beyond anything you should have had to endure to get to where you are. Good job. Great job.......

The details such as the proper PS will wash out, but look at what you did!

Congratulations.

Thanks RG, If I was not an old guy I would blush...:-)

It has been hard going on CPAP twice and getting the same runaround...I am taking the loaner Autoset10 back next week, but will not tell the DME anything other than it does not work for me..

Thanks for the ongoing support...

Storywizard

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