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Would appreciate advice on ASV settings please.
#1
A night this week on:
http://imgur.com/zQgefSE

(and please could somebody explain how I get an Imgur thumbnail piccie to display in a post - it's not an option Imgur offers me and I still don't know how do it after more than a year. Oooops...)

Sleep quality is OK, nothing to be concerned about, but I am aware it could be better. Oxymetry is very good. So - I am interested but not obsessed! about improving the situation.

Should I fiddle with my EPAP or PS settings to deal with these flow restrictions? The flow restriction events are set as 75% restriction for 10 seconds or more - 59 events this night, max of 37 seconds). What do people think please?

Also, with current settings of auto-ASV EPAP 10-13, PS 3-10, the Sleepyhead graphs show that the IPAP only reaches its max of 23 for just a few seconds this night, instead it usually maxes out at around 22. Is that just a minor incompatibility between the Resmed 10 ASV and Sleepyhead, or does the machine have a good reason for not going up to max?

Thank you for any opinions.
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#2
Add an "i." before the host name and .jpg to the end of the URL: http://i.imgur.com/zQgefSE.jpg

[Image: zQgefSE.jpg]
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#3
(05-31-2016, 11:02 PM)chill Wrote: Add an "i." before the host name and .jpg to the end of the URL:

Hello Chill - thank you! Now I will be able to post a pic in the future.

Anyone any ideas about my OP please? (ever hopeful)
..................................................................................................

All my opinions are only as an xPAP user trying to help other xPAP users.
No suggestions I may make should be taken as professional advice.
If you have medical concerns please consult a doctor


My current pressures: Auto-ASV. EPAP 10-13. PS 3-10

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#4
When you say this is typical, do you mean that the flow limitations are typically clustered within a time span of about an hour, as in the night you posted?

It makes me wonder whether it's caused by some positional change, such as rolling onto your back or tucking your chin, impeding the flow of air until you move again.
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#5
(06-01-2016, 12:45 PM)tmoody Wrote: When you say this is typical, do you mean that the flow limitations are typically clustered within a time span of about an hour, as in the night you posted?

It makes me wonder whether it's caused by some positional change, such as rolling onto your back or tucking your chin, impeding the flow of air until you move again.

I'm with tmoody. In addition to what he says about being on your back or tucking your chin, maybe you are putting pressure on your mask and constricting nostrils. I know you have a FFM but unless you are breathing through your mouth you could still have a problem with your nostrils.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#6
Hello Rich B and tmoody - thank you for the replies

(06-01-2016, 12:45 PM)tmoody Wrote: When you say this is typical, do you mean that the flow limitations are typically clustered within a time span of about an hour, as in the night you posted? It makes me wonder whether it's caused by some positional change, such as rolling onto your back or tucking your chin, impeding the flow of air until you move again.

Yes, the flow restrictions are typically in clusters lasting sometimes for up to an hour, usually about 10 minutes though. However I can't do any more about making sure I don't roll on to my back or left side (left & back were equally bad on my diagnostic test). I could be tucking my chin in and I have already tried a soft cervical collar of the correct size but, combined with a FF mask, I found it intolerably restricting. Felt like I was back on an Emergency trolley with an oxygen mask and cervical restraints. Ughhhh - no thanks...

(06-01-2016, 05:24 PM)richb Wrote: I'm with tmoody. In addition to what he says about being on your back or tucking your chin, maybe you are putting pressure on your mask and constricting nostrils. I know you have a FFM but unless you are breathing through your mouth you could still have a problem with your nostrils.
Rich

Yes (ENT issues and chronic allergic rhinitis) I am virtually exclusively a mouth breather. Have tried all known nasal potions and sprays, not helped.


So Fellow Hoseheads! I am back to asking for advice please re adjusting my machine pressure settings so that it will be able to cope with these flow restriction events when it has to (not needed every night - for example last night was AHI zero and very few flow restrictions). The ASV is so flexible that I feel confident that I would be able to find a 'sweet range' to do this and I'd be v grateful to hear ideas about EPAP and PS settings to try and achieve it.

Thanks again
..................................................................................................
All my opinions are only as an xPAP user trying to help other xPAP users.
No suggestions I may make should be taken as professional advice.
If you have medical concerns please consult a doctor


My current pressures: Auto-ASV. EPAP 10-13. PS 3-10

Post Reply Post Reply


#7
The events are obstructive, and almost by definition should respond to higher EPAP or an increase in the minimum PS. The thing is, we don't want to create a new problem by resolving one that occurs from occasional changes in position. Consider how you are feeling under current therapy to decide if changes are worth trying. I would suggest increasing PSmin by 1.0 to start, and observe any changes.

Also, here is a tutorial on using Imgur to post screenshots. https://sleep.tnet.com/reference/tips/imgur
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#8
Apologies all round - I think these flow restrictions may be, at least partially, artefact.

I have just done what I should have done before my original post. I have been tinkering with the 'Preferences' 'CPAP' 'Custom flagging' in Sleepyhead - setting the flow restrictions to different levels and for different durations and then looking at the resulting SH graphs.

The results make little sense, for example, setting Flow Restriction to '75% for more than 10 seconds' gives me *more* flagged events than a setting on '25% restriction for more than 10 seconds", and etc. Repeated anomalies, with different settings, that don't seem to be logical.

In SH Mark describes this custom flagging as 'an experimental method of detecting events missed by the machine'. I now think that the Resmed ASV may not be compatible with this experimental method - even though I do seem to experiencing some sort of flow restriction at the time of these flagged events - both because they arrive, most nights, in batches (so one can guess positional and/or sleep stage i.e. REM) and because they are often at the same time as my recorded 'hypopnoeas'.

So I now think this experimental 'flow restriction' flagging is not reliable enough with my machine to use as a reason for any changes in pressure settings and I have now switched it off.

Sorry to waste people's time.
.............................................................................................
All my opinions are only as an xPAP user trying to help other xPAP users.
No suggestions I may make should be taken as professional advice.
If you have medical concerns please consult a doctor


My current pressures: Auto-ASV. EPAP 10-13. PS 3-10


Post Reply Post Reply
#9
You conducted an experiment. Your results produced a good discussion. This was not a waste of time.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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