Waxing/waning Oscar Charts

[Apnea23]

Update -

The ASV kept kicking in the very breath I was starting to drift off to sleep, which I understand is normal to begin with. This was very annoying, and happened very frequently. It was almost like it didn't want me to get to sleep. 

This happened every time I woke up and needed to go back to sleep. This probably accounted for the main disruptions of the night.

I didn't mouth tape last as an experiment for the first time with the ASV however my wife said I was mouth breathing at times with whoosing noises waking her up.

Because I only bought the ASV mainly to stop my variable breathing during a certain sleep stage which I believe is trashing my REM which only starts 120 minutes typically after sleep onset, I will set a 30 minute ramp so that the ASV takes it's recent minute vent reading from when I'm actually asleep, so it doesn't think I need pressure blasting me when my breathing drops as I'm drifting off to sleep.

And I'll mouth tape.

I may cap the max pressure and support but havent decided yet. I want the machine to be able to control my variable breathing using whatever tools it wants to begin with, but if it goes gun's blazing it may distrupt me with unnecessarily high pressures, arousals etc.

Minimum EPAP during ramp will ensure during ramp I have no events. This is all about ensuring consistent breathing during REM, eliminating waxing/waning and avoiding variability chaos, mini events and arousals.

I will persist until this works, but I'll take it nice and slow.

Haven't looked at Oscar yet, I'll check later.

[Apnea23]

I looked at Oscar briefly just now.

Looks like the ASV does an incredible job, however the leaks from not mouth taping really effed things up during the first problematic cycle. Less so during the next 2 cycles but still effected to a level that didn't allow good therapy and those sleep stages were all effed up to a large degree.

Very impressive to see how the flow rate during the none leak periods is steady, nice and round etc while you can see the constant pressure changes required to keep it that way.

Tonight should be interesting if the mouth tape keeps the leaks to almost zero like it did with the Autoset and Vauto.

It is clear from what I saw in Oscar that during these specific sleep stages I have always required something more like this ASV to control/manage my respiratory efforts for whatever reason.

I'm hopeful I'm almost there.

[Apnea23]

Update -

3 nights on ASV so far in an attempt to reduce waxing/waning which was causing short events, distruptions, suspected REM fragmentation and arousals using its ability to maintain minute ventilation, responding to each breath and only use higher EPAP and PS when needed, so as to not deliver troublesome levels of pressure for long after it's needed, which tends to lead to problems with elevated heart rate, effected sleep, arousals etc.

The ASV is working and it is clear at each problematic cycle, I require slightly more pressure and the ASV has to work hard constantly to keep my flow rate in check - currently it's the last stage during late morning shortly before waking that is still effected the most. I assume the last REM cycle. But it is dramatically better than using the Autoset or VAuto.

I have been increasing EPAP slightly each night and reduced the minimum PS to 0 which is working well, with better results each night so far.

My main goal now is to ensure all 3-4 REM cycles are not trashed, especially the last one before waking - I think by raising EPAP slightly each night this may achieve that.

The later on these sleep stages are, the more violent/threatening my dreams are, which supports my theory well. This is where most of my respiratory effort is. Before this last REM cycle, my dreams for the first time are often benign in nature and/or sexual, often waking with a prolonged erection which is completely unheard of since starting CPAP in 2021, before going back to sleep. I did achieve this somewhat with fixed pressure and 0 EPR on my VAuto, but to try and tackle that last REM cycle with fixed pressure would require so much that it trashed the rest of the nights sleep beforehand. To confirm, APAP is incapable of responding to my waxing/waning events/arousals, as they are technically not flow limitations nor long enough anyway.

I'm on holiday so won't be able to share my ASV Oscar data until I return. In the meantime I'll keep bumping EPAP by 0.2cm so I'll have some good data to compare when I return.