Resmed Aircurve ASV vs Phillips Drean ST autoSV H/C DS

[SarcasticDave94]

I thought I could see them on my ASV. Guess I could pull up a chart to see. Let me check my stuff.

[SarcasticDave94]

Here they are on one of mine

[attachment=21779]

You may post a recent screenshot to see if we spot anything of value. And you might need to check into your OSCAR settings to see if you may have those graphs Off.

[raylock1]

Operator error   I found the place to add or delete graphs (lower right hand corner under last graph displayed).  Thanks for confirming that I needed to look further.

[SarcasticDave94]

You're welcome.

[raylock1]

The ASV has certainly seemed to reduce AHI's to almost nothing.  However, flow limits seem to be greater than before.  Here is a screen shot of yesterday.  Should I be concerned about this  or just accept it?  Btw, I believe the cluster of H's in the early morning occurred when I was waking up or already awake.

[SarcasticDave94]

For me, FL were always low to none per nightly session. My EPAP Min was at my Median I think, for both air splint and elimination of air starvation.

I forgot your limitations on pressure adjustments, but mostly to address FL, a bump in pressure may reduce them. I think EPAP Min may be where the bump could go. BTW a bump up in pressure doesn't need to be a whole number step, it can be fractional. In the case of ResMed's, this is 0.2 steps. That's what I'd do, a fractional bump, of 0.2 and evaluate the results.

Note that right now you're running PS starting at 0. I'm sure you knew that. You may try adding that pressure fractional bump to either EPAP or PS and gauge it. If you don't like the results of the bump, revert to prior settings. To me, the EPAP felt different than PS, given that I see EPAP as fairly constant and PS being on inhales. Given that, I'd think EPAP bumps may affect FL more. BTW EPAP Min is supposed to be your lowest pressure that will stabilize the throat via an air splint.

Near waking clusters may have been SWJ or sleep/wake junk due to the handoff of respiratory control from sleeping to waking.

[Sleeprider]

With ASV we often see flow limitation where the machine is triggering a breath. Since you are not breathing spontaneously for these triggered breaths, the breath shape is often flat-topped following the machine pressure rather than leading it. We can see on your charts that where flow limitation occurs, they are very brief, an during high pressure support. Note your 95% flow limitation is 0.0. In these cases we ignore the flow limitation. This is normal, and we don't want to chase flow limitation at the risk of upsetting a functional ASV setting for your central apnea. Please do worry about FL unless you see a persistent flow restriction rather than individual spikes.

[SarcasticDave94]

Sleeprider pointed out the aspect I forgot, the 95%. That does change my prior answer to monitor the FL numbers and log complaints if they occur.

[sheepless]

as an asv user I'll echo a few things already mentioned. I don't trust the flow limitation numbers with asv because of all the 1.0's which I understand to be the machine responding to centrals. idk how the stats are calculated but they'd be seriously overstated if the 1.0's are included. even so, there is no entry under your 95% so they're much less (many fewer?) than it appears. your chart looks pretty good to me. if you're concerned about flow limitations or your inhales being longer than exhales, you might experiment with higher min pressure support, currently set at zero.

[raylock1]

Thanks everyone for the input.  It is greatly appreciated