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Apnaes: difference between Central / Obstructive ?
RE: Apnaes: difference between Central / Obstructive ?
Davepap, you might want to start a new thread so people can take a closer look at your situation.
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RE: Apnaes: difference between Central / Obstructive ?
Good news: I got the ASV yesterday, brand new and shiny!
Thank you all for the support, it really made the difference.
Welcome in Davepap, I have tried to spell out my problem with the idea that it should help not only me. I hope you got some ideas from this discussion.
Anyway, it has been a bit stressful but educating experience.
Sleeprider, Sarcasticdave, and Domeo have been a great help so far, I think there is still more to discuss.
Dave your bet was correct down to 10!
I must say it is with confidence and pleasure that I put my mask on now.
However, I suspect that we can get better results with some finetuning.
I have some ideas but I will just show the interesting part of the chart and wait for your input ....
Have a good weekend!


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Don't forget the obvious.[Image: bigwink.gif]
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RE: Apnaes: difference between Central / Obstructive ?
I just realized that my ASV was not set to "auto" by the technician.
Maybe I should learn to double-check this guy!
Any returns on my setting will be welcome.
Don't forget the obvious.[Image: bigwink.gif]
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RE: Apnaes: difference between Central / Obstructive ?
When posting charts for your ASV be sure to include the pressure or mask pressure chart so we know how it is responding. The events you had on the first night are related to EPAP being too low, however we would get more insight from seeing the pressure charts. A lot of your problem will be resolved by changing to ASVauto mode, however, in addition to that, the PS range need to be 3.0 min to 15.0 max. Your tech only gave you 3.0-8.0 and that won't be enough to give you a breath when centrals occur. I suspect much of the hypopnea and perhaps apnea are the result of that error.

Change to ASV auto and revise PS min 3.0 and PS max 15.0. I suspect we will increase EPAP min to 6 or 7 but with PS being so low, it's hard to judge this first night of therapy. For what it's worth, don't let that tech ever put his hands on your machine again. It's pretty clear no one you're dealing with has any expertise or experience with this device or therapy.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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RE: Apnaes: difference between Central / Obstructive ?
I am so relieved and pleased that you've received an ASV machine. With help from Sleeprider and Dave, you'll soon be sleeping beautifully. I look forward to reading about your progress and continuing to learn from your experiences.
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RE: Apnaes: difference between Central / Obstructive ?
I'd agree with Sleeprider on the edits. The tech has handcuffed your ASV a bit by limiting PS. Open it up to the PS default he mentioned and give it the ASV Auto mode. This makes EPAP a range and it'll be so much better, then actually EPAP PS and IPAP have ranges to seek out events. Ooh turn off the Ramp please. You'll thank me later.

And one last thing, blowback. If your ASV gives a hard blow when you drift off to sleep, oblige with a blow back, literal through the mask. If you get this blowback need...You'll know and remember.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Apnaes: difference between Central / Obstructive ?
Yeah, the only ones who know how it works are you all!
There must be a load of CPAPers who get their installation without ANY follow up AR ALL.
I asked what is the reason for having them transmitted to central storage/surveillance:
"just for the money, to control/ensure usage" was the, at least honest, answer.

Anyway, I am getting tweaking under control. A little advice may do the rest..

I changed to autoasv and also changed the pressure setting, resulting in 2.5 AIH !!
High pressure turns me into a leaky rubber boat, I am on EPAP 6-8 , I will need to turn that up .. how much?
AI 4-1, same thing?
The RAMP is costing me apneas turned it down to 5 minutes. I know it should be zero but I still need to get used to the machine :-(

I include a detail of 1:37 1:41, what happened there?


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RE: Apnaes: difference between Central / Obstructive ?
That's a very busy machine. Explain how you got to PS min 4.0. I don't think you will need higher EPAP pressures. Your actual AHI is close to zero, and most of those hypopnea are coming out of ramp.

I can see some amplified breathing as you initially start therapy, and the flow rates and minute vent are quite high. This minute vent and respiration rate are being "learned" by the ASV to maintain therapy 90 seconds later, because it uses your baseline to set those parameters. The solution is to wait a minute or two before masking up, and let your respiration settle, before putting on the mask. That way your respiration is much more like the time before you drift off to sleep and you should get fewer wild spikes of minute vent and perhaps the hypopnea.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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RE: Apnaes: difference between Central / Obstructive ?
Correction
EPAP min = 6
AI min =4
Don't forget the obvious.[Image: bigwink.gif]
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RE: Apnaes: difference between Central / Obstructive ?
I'd almost say make EPAP min 4 or 5 just so you'd erase the Ramp completely. The ASV Auto would find and stop these Hypopnoea. Most of your events are sneaking in on the Ramp. As is, Ramp of 4 is not that far away from EPAP 6. In PSI, it's a fractional difference between 4 to 6 cmH2O.
4 cmH2O = 0.05689337333713944 PSI and
6 cmH2O = 0.08534006000570916 PSI.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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