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+--- Thread: [CPAP] Beyond ASV with Overlap Syndrome! (/Thread-CPAP-Beyond-ASV-with-Overlap-Syndrome)
RE: Beyond ASV with Overlap Syndrome! - SarcasticDave94 - 11-25-2019
Makes sense on inverse not necessarily being an issue. Thanks for comments.
Focus on machine medically intended use makes perfect sense Sleeprider. So noted.
Wild thing happened. I stumbled across some YouTube guy Respiratory Coach, watched a tutorial on COPD he did, and commented on this situation. He made a tutorial touching on overlap syndrome and my info from comment involved and although he accidentally assumed I was on ST, he compared ST mode to AVAPS. Pretty cool I thought.
Thanksgiving time can be busy. No rush. Enjoy it and be safe.
RE: Beyond ASV with Overlap Syndrome! - SarcasticDave94 - 11-26-2019
FWIW if it's worthy of posting, I can link that respiratory coach YouTube, or provide it. I still think it's pretty cool to comment on his COPD tutorial and he makes one about my asking about Overlap, with his focus on apnea in this scenario.
RE: Beyond ASV with Overlap Syndrome! - Sleeprider - 11-26-2019
Dave, waiting for links or embed.
RE: Beyond ASV with Overlap Syndrome! - SarcasticDave94 - 11-26-2019
Here's that YouTube:
RE: Beyond ASV with Overlap Syndrome! - SarcasticDave94 - 11-26-2019
I may have to wait until disability approval to buy a machine with cash. The pulmonary doc's office has scheduled me for what he says is his only action, a new ASV titration. Handcuffs on this process because of trying to go via insurance paying. It'll be done in mid January. Either way, what I call effective therapy is delayed until the future.
FWIW my primary doc just scripted me as being unable to engage in any work due to severe chronic back pain that also affects back and leg mobility, the no work restriction is to continue indefinitely.
RE: Beyond ASV with Overlap Syndrome! - Gideon - 11-27-2019
What did pulmonologist say about ivaps
RE: Beyond ASV with Overlap Syndrome! - SarcasticDave94 - 11-27-2019
If I want to tango with attempting to get insurance to pay for iVAPS, which for now I must try this route, I'll redo ASV titration in mid January. Very not good but my hands are pretty much tied up with no bucks.
I explained to pulmonary doc ASV isn't working with me, not mechanical failure, missing timing controls which I believe messes with breathing sync is how I presented. He seemed to understand and agreed iVAPS would address it. But he has to have data to do a script edit/change and present case of need to insurance, hence titration. Probably a vague familiarity to almost all AB members.
Upside is Social Security Disability should be approved soon but the time from approval to money in hand is uh questionable on speed if you get my meaning.
Side note I also did a 6 minute walk test at Pulmonary to get oxygen measure to attempt to see if POC needed. Oxy was OK, I forgot if she said 94 or 96, but not bad for COPD just shy stage 2.
RE: Beyond ASV with Overlap Syndrome! - SarcasticDave94 - 11-27-2019
BTW here's the info on what local Apria DME said she can provide if needed, no iVAPS that she's aware of, but a Respironics Trilogy NIV...balloon blower.
RE: Beyond ASV with Overlap Syndrome! - Michaely6 - 11-27-2019
(11-25-2019, 09:17 AM)SarcasticDave94 Wrote: I'll be seeing pulmonary office about this as soon as I can get an appointment.I really wish resmed ASV Machine is not as limited as it is. It does not have the timing feature like VAuto does and also it does not allow you to set PS min or max to any value that you wish to do so instead they max out PS min at 6. I require more PS to get the tidal volume that I feel like I need to feel good but I know the machine is based off of calculating minute vent (which of course factors tidal volume into the equation)
I will be addressing:
1. Inverse I:E Ratio
2. Lack of setting control for timing on the ASV but available and needed to address I:E issue
3. Questionable minute vent numbers.
4. Included will be complaint that ASV and I are no longer on same page, machine and I are in a combat and I cannot use any more than under 2 hrs.
I'm basing my points to address on discussion this thread already contains. Thanks to all again for input. If something is missing that helps, let me know. If you do, thanks in advance. If nothing else to be added that's fine too. I'm sure this Overlap Syndrome (the ResMed AirCurve 10 ST-A iVAPS machine seems sorta rare too) is pretty much uncharted territory for Apnea Board.
Have a wonderful day normal people.
RE: Beyond ASV with Overlap Syndrome! - Sleeprider - 11-27-2019
Pretty good video and Lefty seemed energized to tackle a more difficult problem that is unfortunately mostly overlooked in the sleep disordered breathing community. Interesting he was under the impression that you were using S/T rather than SV, but his characterizations and use of AVAPS is correct. His terminology and targets mostly describe Philips products which target Vt in stead of Vm, or more precisely alveolar volume Va which targets the minus dead space (more relevant to COPD). Clearly his conclusion is to smooth out the variation in all the vent rates using a variable pressure support, rather than the reverse of allowing the patient vent rates to vary while maintaining constant machine parameters for pressure support. It really makes a lot of sense that doctors are caring for a human being and should use the available technology to make respiration constant and less disruptive.
We have discussed your use of ASV, and it seems for the most part effective, however your complaints of lower quality of sleep probably arise from the lack of specific respiratory targets. We can see from your last chart that your RR and volume rates are "choppy". They seem to hit the targets but the rapid response of ASV on a breath by breath basis may not be ideal compared to the slower response and smooth targeting of the iVAPS. Glad you were able to submit this question, and got such a thoughtful response.