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Using my ASV causing breathing problems during the day
#1
Using my ASV causing breathing problems during the day
Hey guys, I'm new to this forum but I figured this was the best place to post this since you guys might know enough about this kind of thing to help me out. I was actually referred to this forum by dakinindanorfwest on reddit, so thanks again if youre reading this!


So I've been using a ResMed Aircurve10 ASV to treat my central sleep apnea for about a year and a half now and its been going fine up until recently. About a month ago I noticed that having it set to the "ASV" setting wasn't helping me breathe as well as I'd like during the night, as there were many frequent pauses and stutters in treatment and my AHI was still fairly high. So I did some research and found out that you can change the settings from "ASV" to ASV-auto" which as i understand it essentially does all of your breathing for you during the night instead of trying to coax it along like on the "ASV" setting. I have it set to: Min EPAP 9, Max EPAP 15, Min PS 5, Max PS 15, as suggested by a user on another sleep apnea forum.

Basically the long and short of it is that changing my machine to these settings really did help me sleep better during the night, and I would wake up feeling 10x better than I usually did. But now I have a new problem where during the day I'm constantly catching myself not breathing and have to manually get myself to breathe for a while before I'll do it automatically again, and even then my breaths are super shallow and weak. I've done some research on it but there isnt all that much info about it on the web, but apparently its something called "sleepy brain" where your brain gets too used to your machine breathing for you at night and stops sending the signal to breathe to your lungs, even during the daytime. It's been getting worse each day and I'm starting to feel really dazed and tired, almost like I have daytime sleep apnea now or something.

Do you guys have any experience with this kind of thing? I've been looking around for a solution to this problem for weeks now and I still don't have a solid idea of what I should do about it. Should I change my settings back to the original "ASV" settings? I can't go to a doctor because I'm not on my parents insurance anymore, so any advice that you guys could offer would really help out.
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#2
RE: Using my ASV causing breathing problems during the day
You somehow clicked/enabled a faint grey font colour in your posts.  Please post again, and use the little coloured checkerboard in the masthead just above the text box to select a more easily discernible colour.

Edit: Okay, that's odd, it now seems to be fine...maybe it was on my end. Ignore, pls.
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#3
RE: Using my ASV causing breathing problems during the day
You somehow clicked/enabled a faint grey font colour in your posts.  Please post again, and use the little coloured checkerboard in the masthead just above the text box to select a more easily discernible colour.
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#4
RE: Using my ASV causing breathing problems during the day
I actually changed it real quick after realizing that it was unreadable after posting haha. Sorry I don't typically use many forums like this so I didn't realize I had to pick a font color.
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#5
RE: Using my ASV causing breathing problems during the day
We often don’t breath for periods during the day when concentrating or for some other reason, your awake breathing is so much more irregular than when asleep. I do not think it has any relationship to your settings changes on the ASV
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#6
RE: Using my ASV causing breathing problems during the day
pmartin12, the ASVauto setting enables automatic EPAP pressure adjustment. You are using ASV auto mode with Min EPAP Min 9.0, EPAP Max 15.0, PS min 5, PS max 15. In ASV mode, your settings would only allow a fixed EPAP pressure. With ASV auto EPAP can increase to resolve OA or UA events as needed. The machine does not take every breath for you, but continues to provide a minimum PS of 5.0 and allows spontaneous breaths, but provides more pressure support as needed to mitigate hypopnea or triggers to higher PS for central apnea. ASVauto is the mode we recommend to most users, however there have been a few that find fixed EPAP with ASV mode more comfortable.
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#7
RE: Using my ASV causing breathing problems during the day
I have had a similar problem during the day as you have experienced.  I don't have that problem as much anymore but I might have a solution for you.  I am getting into better shape and fitness.  This has greatly improved my breathing and I purchased a fitbit charge 2 that monitors my sleep and it will also help with daytime breathing.  There are many types of fitness trackers out there and you need to find one that is right for you.  Whether you exercise or not, I would choose a fitness tracker that tracks your sleep and daytime breathing or it will prompt you when to breathe more.

I hope this helps.
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#8
RE: Using my ASV causing breathing problems during the day
Do you have access to your data via Sleepyhead? Since you're feeling much better on ASV-Auto, and that's really what matters, I'm not interested right now to see whether a change in settings will help. I'm more interested to see if you have any instances of possible periodic breathing. Sleepyhead would pick up concerning breathing patterns, and period breathing can show up in people with centrals, so that's why I mention it.

Obviously, if you're concerned with breathing changes, the standard advice would be to see a doctor as soon as possible. I understand you're not on your parent's insurance anymore and that may not be the most enticing option, but it's worth mentioning.

I am NOT an expert on this, so take everything here with a grain of salt, just trying to help as best I can. If you have Sleepyhead data, something interesting may be to look at your breathing when you know you're awake (right before falling asleep is easiest) to see the difference between awake and sleep breathing. For most people, it seems like the flow rate for awake breathing is shockingly irregular, whereas (treated) sleep breathing is generally regular. My understanding is that while awake, your body may pause breathing for a short period of time to focus on a specific task, and then will resume breathing right after. All of which would occur without you being aware of it happening, because generally we don't focus on our breathing while awake. It seems possible that your daytime breathing issues could be related to daytime centrals, and you're more aware of them because you're thinking about it more. It also seems like others have had experience with adjusting to ASV/BiPAP and *theorize* something about your body adjusting to new "proper" CO2 levels because you're now sleeping efficiently and getting the right trade-off during the night, so daytime breathing is adjusting to this in some way, so your body might breathe differently and cause some form of irregular breathing or short breath. For these people, they seem to have mentioned the issue goes away after a little while. Again, this is what some people with personal experience with your issue have mentioned on variously threads when I searched, so it may or may not actually be the case at all. It's also possible you have some heart issue which could be related, which is why I mentioned seeing a doctor if possible above.

Anyways, not sure if this helps at all, but I hope it helps in some form.
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