PLEASE help with settings for ASV coming tomorrow. OSCAR data attached.

[hopeforusall]

Good information about the donation page. I am aware of Stripe. It seems fine. If they somehow hack into my account and take my billions I still have all that buried pirate treasure, right? Just need to remember where I buried the map : 0
Anyway, I will do the credit card route later today or tomorrow.
Thanks!

[hopeforusall]

SuperSleeper, I just did a donation of $50 through Stripe. Once submitted, it went to a page that stated, "Your donation transaction is now complete." Please let me know if you did not get it. Otherwise, thank you for this forum!

[hopeforusall]

Hello Sleeprider, I hope this finds you well!
You seemed to welcome a follow-up last month and when I attached what I believe is an extremly important update, I did not hear back. I assume that you thought the rest of the information was for Supersleeper about my donation. Please check the folllow-up at the link below, or the copied text with a little update after that.

https://www.apneaboard.com/forums/Thread...hed?page=2
POST #17 05-05-2023, 03:21 PM

I will respost the summary here with a brief update if that is ok...and THANK YOU!!

FROM 05-05-2023, 03:21 PM
#2) Sleeprider: I had a parent pass away and things have been nothing short of crazy. Last time we spoke, the ASV was not working well at all. I adjusted the PS MAX down to about 12.2 and the oxygen desaturation has gone from severe hypoxia to hypoxia. That is obviously a good thing. The absolutely inexplicable part is what happens when awake and trying to sleep. You had seen one of my reports with a median Tidal Volume of around 1,000 and median respiration rate of around 9 and you thought it an aberration. I have attached some actual examples of these events showing it is happening every time I try to sleep, which include 'jolts' to the system like adrenal rushes and SpO2 levels plummeting to severe hypoxia ranges. This happened prior to the ASV but I had no markers or data to show things like Tidal Volume or Resp rates. Are Tidal Volumes higher when awake? Have you seen anything like this before?
(IMAGE ATTACHED)

P.S. UPDATE: All of the ASV data shows when I am trying to sleep but awake, I noticed the Tidal Volume charts look like mountains instead of being close to Target Vent, the Tidal Volume Median is always well above 1,000, and Resperation Rate Median is as low as 8. This continues endlessly when trying to sleep to this day, and it is limiting my ability to sleep to 3-4 hours a day. I have NO idea what it means. More current examples (data jpg's) can be sent upon request. Can you PLEASE offer any thoughts?

[Crimson Nape]

hopeforusall - I have merged your last post into this thread, since both deal with your therapy. Please keep all your therapy posts and question in one thread.

- Red

[hopeforusall]

Crimson Nape: I did the new distinct thread so as to catch the attention of Sleeprider. I posted an update weeks ago but I believe he was confused by the donation stuff. I just hope he will see it (he had offered a follow-up). Thanks!

[Crimson Nape]

All threads with a new unread post have a green arrow to the left of the thread title. He will notice it.

- Red

[hopeforusall]

Thank you Sir Nape!!!

[Sleeprider]

Well, I'm much more likely to see a new post in a thread where I have already replied, because I follow those threads. A new thread may or may not be noticed. So once again, the red neck (Crimson Nape) has helped us. I have had a very busy day full of sunshine and pool floating, so it took me a while to get here. I'm still at a bit of a loss to explain the extraordinary tidal volume and long inspiration/expiration times. I think it might help to look into some zoomed images of respiration so we can follow what's happening with the breathing rate (flow rate) and machine response (mask pressure). I don't know that it is useful to analyze data from such short sessions when you do not sleep. The only Oscar graph we saw with you using CPAP was only a 14 minute session. For some reason, you do not seem to tolerate PAP therapy long enough to make any useful recommendations.

[hopeforusall]

Thank you for responding Sleeprider and I am glad you had a bright, bright, bright, sunshiny day! And yes, thank you to Sir Nape.

To clarify an important point, once I get to sleep on the ASV (since lowering the PS MAX to around 12, things seem to be much better when asleep. I have attached 2 OSCAR screens (from sleep), one of about 1 hour 45 minutes and the other about 8 hours (and although I believe I slept for much of that time, I do not know exactly how much). The numbers seem to be more normal and the severe hypoxia becomes hypoxia (87%+ SpO2 as opposed to before, 70%+ SpO2). Please refer to the 2 attached sleeping reports.

What is destroying me is when awake and trying to sleep. For the hours it takes to finally nod off, I get these surges (as shown with the SpO2 data attached in the previous files) and oxygen plummets. This happens over and over. After about 30 minutes (while awake and getting the surges) I end up resetting the ASV (turning off and on) to give it a fresh start. I could leave the machine running without a reset although another issue is that after 3-5 hours of this nightmare I often end up removing the mask completely (using both N20 Nasal and F20 full masks). That is why there is not a ton of sleeping ASV reporting.

The crucial idea is that the ASV is not helping when I am awake.  Could changing some of the settings help? Why would the ASV help when asleep but fail otherwise? What about a different type of PAP machine?

I can see about getting some zoomed images of respiration if that might help. In the meantime, do you have ANY idea or suggestions or insight? I am absolutely desperate for something!
Thank you again! And again! See you in the pool...

[Sleeprider]

Wow, a nearly 8 hour session! The ASV seems to prompt you to take a breath and maintain your rate and volume at more normal levels. I don't have any sure-fire setting changes for you to try, and most of your comfort issues occur before you fall asleep. Some people find they can use a lower PS max and still have the 'prompt' they need to maintain respiration. You can try dialing back PS max and see if you can find a threshold that works better to avoid the surges, while still providing good efficacy in sleep.