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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 4:05 am

Joined: Mon Nov 16, 2020 11:02 am
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Just figured it out (I think). LOL....


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 4:13 am

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Here's another.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 4:14 am

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And another. Not sure if I can put more than one image per post?


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 4:17 am

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Last one for the 18th of November. Note I changed my setting on the 12th of November so I'll get some screen shots of a day before I changed the settings. Hopefully someone will direct me on how to put several screenshots on one post, if possible. Thanks.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 5:03 am

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Here's one from 10/16/20.

A summary of my history. I have Lyme Disease. Been dealing with it since year 2000. Adverse reaction to the Lymerix vaccine in 1999 caused it. Everything was OK with my sleep until 2015. This is when I was diagnosed with sleep apnea. Tried the CPAP at first, couldn't tolerate it so I went to a dental appliance which didn't help much. Then I was diagnosed with central sleep apnea as well as OSA. That was in the 2017 timeframe. This is about the time I was put on an ASV machine. No matter what my doctors did, I would wake up feeling beat up, exhausted, like I went through a extreme workout while sleeping. Awake with headaches, dried out mouth and sinuses and complete fatigue. I do take opioids for the pain from my Lyme Disease. I've read that opioids can affect breathing patterns in some people when sleeping. I'm not on a high dosage and I'm managing it without issues. I also have severe seasonal allergies. However, just moved to Florida last year to get away from the cold New England winters but my allergies seem to be worse. I have severe nasal congestion which affects my breathing when lying down. I do have slight case of asthma. My nose always feels stuffy and nothing helps. Believe me, I've tried it all. Use the Neti Pot for the headaches and it helps. I've been reading up on UARS as I recently did a breathing test and my lung function is normal. My breathing issues seem to be upper respiratory. I've also been told I don not have a large opening between my tongue and my soft palate. Personally I think this could be part of my problem but my doctors dismiss it on a regular basis. Lastly I do have acid reflux which is under control with medication.

Normally I don't share my medical history in an online platform. However, since my doctors haven't been able to figure out my sleep issues and I'm getting sicker by the day, I thought it was time to reach out to those who might be experiencing the same type of issues I am. So thank you in advance to those who respond in an attempt to help me with this sleep issue.


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Pugsy
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 6:19 am
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PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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Make your events graph larger and the other graphs slightly smaller.
They can be resized so they are more or less equal in size. Need to see the Events also.
To do more than one attachment in one post all you do is attach another image.
I don't remember if there is a limit to the number of attachments but you can do at least 3 in one post.

Don't worry about sharing personal history....you are pretty much anonymous here and about the most I could figure out is you are likely some guy named steve who moved to Florida from the NE. I bet you aren't the only one. :lol:
The steve idea comes from your ID here and not from your history.

You included a lot of graphs that aren't particularly helpful. Lots of work for you and us.
What we need...the stuff on the left side which you did well and these graphs on the right
Events (which you did but it's too tiny to see)
Flow rate
Pressure
Leak

So can you repeat last night's detailed report in that format? Resize the other graphs so the Events graph is available better. To resize just hover your mouse over the bottom line of each graph until you see a little plus sign and then click and drag vertically.

Your Oct 16 report with high hyponea clusters...I am thinking most likely not asleep when the hyponeas were flagged so I would discount that night.

Your flow limitation graph is obviously active which if we were seeing a report from any other machine than ASV I would be worried but ASV machines will make a nothing FL graph look just awful. It's just the way they record the flow limitations. I know this from my own personal experience with regular cpap/apap machines and the ResMed ASV (which I used for about 3 years). So the flow limitation graph I just shrug my shoulders.
Your nasal congestion could also be a factor in a little bit of the ugly of any FL graph.
Which is why I don't put it on the list of graphs to show from an ASV machine. I already know it will be ugly and it not mean much.

I would be really nice if you had a detailed report from a non ASV machine trial but I imagine you don't have one of those available unless you still have one of those machines in your possession.

Oh....I don't doubt your allergies are worse with your move. I would be surprised if they weren't. Lot of new potential pollens down south. I lived in Alabama for some years and it was just awful for my nose.

I see a lot of sleep fragmentation here...where you stopped and restarted the machine so I know you woke up to do that.
How many times do you think you might be waking up during the night? Why?
Do you take naps during the day?
Any other meds besides what you mentioned.
Do you drink alcohol withing 3 or 4 hours of bedtime?
While the opioids could be a factor in the central apneas...the machine should be able to deal with them and you likely need the medication to have any chance of sleeping and we need to sleep first and foremost before any of this matters.

So answer the questions above and post last night's detailed report in the format I mentioned please and then maybe I can come up with some ideas or one of the other forum members will have some ideas.
From what I see so far...your sleep quality is crap which in turn makes you feel like crap during the day.
Now why the crappy sleep quality...that's the million dollar question.
I need to do some research on how having Lyme's disease history could impact sleep quality...not something I am familiar with but it wouldn't surprise me to find out that it messes with sleep as well.

_________________
I may have to rise but I refuse to shine.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 8:15 am

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Ok. Thanks for getting back to me. I made the events screen larger and I took a couple of screenshots of the same screen but I moved the left side of the screen to three different positions so you can see all that data.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 8:15 am

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Ok. Thanks for getting back to me. I made the events screen larger and I took a couple of screenshots of the same screen but I moved the left side of the screen to three different positions so you can see all that data.


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Pugsy
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 9:04 am
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I didn't want you to move the left side stuff.
It's more important to see the AHI stuff on the left than it is the session information. It's easy to see that there was more than one sleep session and approx when they happened just by the flow rate/pressure breaks.

All I really need is what I said and a little bit of the statistics.
I don't need the settings or sleep sessions.

I do need answers to the questions though.

I do suggest you turn off the nap sleep session so the rest of your graphs are more easily evaluate.

Just remove the check mark for the nap session so it gets omitted and redo the report again....minus the nap and don't omit the AHI numbers and bar graph.

Again....just show things like we ask and IF we want something different we will ask for it.
The above report is useless without the AHI stuff.

_________________
I may have to rise but I refuse to shine.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:18 am

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I'm confused. I provided you with a screenshot yesterday that includes the AHI readings. Do you mean to go to the statistics tab and screenshot of that page? I'll provide in just in case. Know that this Oscar is new to me and I'm giving you as much as possible hoping that you can filter through it and provide some input. Here a copy from the statistics screen. Thanks.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:24 am

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Can't you just click on the screenshot if you need to make it larger? That works on my laptop.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:44 am

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Here's everything for October 16th. Note you asked about me awaking throughout the night. Usually get up to go to the bathroom twice. Plus I'm not a great sleeper so I often wake up and lay there with my CPAP on. I notice my numbers usually go higher when this happens. A lot high in some cases.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:45 am

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Here's two more.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:49 am
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Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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I'd suggest sticking with one standard shot for now where the event flag area is a bit taller than you've got now. We can't manipulate the shot like you can. I'll see if I can attach a sample of mine that would be more in line with what's needed.
This is the standard OSCAR shot with my edit of squashing the line stats of Event, Flow Rate, Pressure, Leak, Flow Limit so you can fit these 5 on the shot with left side showing as I have here. This is what I've used for myself in my own titration and evaluations on my ASV treatment for myself.

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_________________
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Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:51 am

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OK I think I got you now. Let me make it bigger. Thanks.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 11:56 am

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Is this better?


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 12:03 pm

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BTW, where's the nap sessions you're referring too?


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 12:04 pm
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Joined: Sat Jul 04, 2020 8:38 am
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Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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A bit preliminary, but I'm seeing a few things that might need addressed. I see patterns of Ramp being used, which I've found is counterproductive to any therapy. There's a large cluster of events at about 2:20 that was under the Ramp pattern. Ramp is equal to less than optimal therapy, number one, but this cluster may also be positional apnea where a soft collar may be needed. I also think your pressure set is too low. It appears that 0-5 PS is not enough to combat events. Let's see your chart that matches a shot like I gave and we can be sure of some things.

If it's as I suspect, PS Max needs to go to 10 or so, Ramp needs to go to Off, and you might want to research a collar. Try looking at this one called Corflex Ultra Cervical Collar: https://www.corflex.com/products/cervical-spine/neck/cervical-supports/ultra-cervical-collar/

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 1:12 pm

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OK thanks. Let me start by turning ramp off and the PS Max to 10. Then we'll go from there as I don't want to make too many changes at once. Reason being I won't know what works and what doesn't. Question about ramp. Say I get up in the middle of the night to use the bathroom. When I turn my machine back on, does ramp start all over again? Thanks.


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Fri Nov 20, 2020 1:18 pm

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Turned ramp off. Here's my current settings:

Min EPAP - 4.0
Max EPAP - 10.0
Min PS - 3.0
Max PS - 15.0

I believe these are pretty much the factory defaults according to another post I read. Are these OK for now? Thanks.


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