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Sleep Data Results for ASV Central
sleep data results of a member looking for some feedback on how he's doing --
"Date range was 5/21-6/21
% of days with device usage 100%
Cumulative usage 244 hr. 7 min.
Total blower hours 245 hr 41 min
BiPap auto SV Statistics
Avg peak IPAP pressure 22.2 cm H20
Avg % of night in periodic breathing 19%
Average time in Large leak per day 33.0 min
Avg breath rate 12.6 BPM
Avg tidal volume 581.5 ml
Avg AHI 23.1
Avg peak flow 37.5 ipm
current back up rate setting 10.0
They had made marks beside avg breath rate 12.6 BPM
Avg maximum leak 148.7
Avg 90% leak 80.7
Avg leak 59.6
Avg large leak 33.0
If there is anything you can tell me about this I would appreciate it!
No one has called me for scheduling an appt but I scheduled one for the neuro who sent me for the test - its next Wed. I just hope he can tell me something. My sleep apnea is central not obstructive."
"Date range was 5/21-6/21
% of days with device usage 100%
Cumulative usage 244 hr. 7 min.
Total blower hours 245 hr 41 min
BiPap auto SV Statistics
Avg peak IPAP pressure 22.2 cm H20
Avg % of night in periodic breathing 19%
Average time in Large leak per day 33.0 min
Avg breath rate 12.6 BPM
Avg tidal volume 581.5 ml
Avg AHI 23.1
Avg peak flow 37.5 ipm
current back up rate setting 10.0
They had made marks beside avg breath rate 12.6 BPM
Avg maximum leak 148.7
Avg 90% leak 80.7
Avg leak 59.6
Avg large leak 33.0
If there is anything you can tell me about this I would appreciate it!
No one has called me for scheduling an appt but I scheduled one for the neuro who sent me for the test - its next Wed. I just hope he can tell me something. My sleep apnea is central not obstructive."
Replies to This Discussion
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Permalink Reply by Mike on -
at first glance (and I'm no pro, let alone a pro at ASV units for those with central apnea), i get concerned that your Average AHI, or times you stop breathing/have apnea-hypopnea in a given hour, is 23.1 -- an AHI above 5 is considered unhealthy, and one of 23.1 is pretty darn high. You're already at a pretty high pressure setting for the IPAP (inhalation) pressure (22 cm H2O) -- I wonder whether your doctor thinks it might be wise to raise your pressure upon exhalation. Maybe that would bring the AHI down.
Also, the leak seems high.
Those are thoughts off the top of my head, but i'm hoping that someone with experience with ASV machines can chime in.
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Permalink Reply by Rock Hinkle on -
His back up rate is probably to low. they need to look back at his previous sleep studies to get an idea of what his average breaths per minute was and adjust accordingly. 10 is very low in my opinion. The average person has 15-20 breaths per minute. Someone with complex apnea might have even more due to the high co2 levels. That's just my opinion though. Without knowing what the interpreting tech saw it is very hard to know for sure.
I had a pt a while back. We followed all ASV protocols to no avail. Finally when we were about to give up I counted every breath he had taken that night during each 30 second epoch. The average was 22 breaths per minute. I changed his back up rate to 22 and he was fixed. I got lucky but it might be what this pt needs.
Also this pt has to know that this therapy may not work. complex apnea is just that way
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Permalink Reply by Rock Hinkle on
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That IPAP of 22 is the IPAP max Mike. ASV works a little different than normal PAP. You have an IPAP max and an IPAP min. as well as EPAP and a back up rate. The max is a floating rate, up to it's fixed peak, like on an auto system. IPAP min and EPAP are always the same like a CPAP. If a pt has any flow limitaion the IPAP max will go up and down accordingly as an auto would. It can go as high as 30cmwp unless the range is set lower. The back up rate controls breaths per minute and helps to assist in breathing to fight the central apneas. If his events are indeed CSA in origen raisng the EPAP will not do him any good. It might even make him worse as it could flush more co2 out of his lungs and increase his CSA.
Mike said:at first glance (and I'm no pro, let alone a pro at ASV units for those with central apnea), i get concerned that your Average AHI, or times you stop breathing/have apnea-hypopnea in a given hour, is 23.1 -- an AHI above 5 is considered unhealthy, and one of 23.1 is pretty darn high. You're already at a pretty high pressure setting for the IPAP (inhalation) pressure (22 cm H2O) -- I wonder whether your doctor thinks it might be wise to raise your pressure upon exhalation. Maybe that would bring the AHI down.
Also, the leak seems high.
Those are thoughts off the top of my head, but i'm hoping that someone with experience with ASV machines can chime in.
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Permalink Reply by Mike on
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i shouldn't even try to help anyone with ASV until I learn more about it. Thanks for chiming in, Rock!
Rock Hinkle said:That IPAP of 22 is the IPAP max Mike. ASV works a little different than normal PAP. You have an IPAP max and an IPAP min. as well as EPAP and a back up rate. The max is a floating rate, up to it's fixed peak, like on an auto system. IPAP min and EPAP are always the same like a CPAP. If a pt has any flow limitaion the IPAP max will go up and down accordingly as an auto would. It can go as high as 30cmwp unless the range is set lower. The back up rate controls breaths per minute and helps to assist in breathing to fight the central apneas. If his events are indeed CSA in origen raisng the EPAP will not do him any good. It might even make him worse as it could flush more co2 out of his lungs and increase his CSA.
Mike said:at first glance (and I'm no pro, let alone a pro at ASV units for those with central apnea), i get concerned that your Average AHI, or times you stop breathing/have apnea-hypopnea in a given hour, is 23.1 -- an AHI above 5 is considered unhealthy, and one of 23.1 is pretty darn high. You're already at a pretty high pressure setting for the IPAP (inhalation) pressure (22 cm H2O) -- I wonder whether your doctor thinks it might be wise to raise your pressure upon exhalation. Maybe that would bring the AHI down.
Also, the leak seems high.
Those are thoughts off the top of my head, but i'm hoping that someone with experience with ASV machines can chime in.
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Permalink Reply by Rock Hinkle on
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I do still think that an increase in the back up rate might help this person.
Rock Hinkle said:His back up rate is probably to low. they need to look back at his previous sleep studies to get an idea of what his average breaths per minute was and adjust accordingly. 10 is very low in my opinion. The average person has 15-20 breaths per minute. Someone with complex apnea might have even more due to the high co2 levels. That's just my opinion though. Without knowing what the interpreting tech saw it is very hard to know for sure.
I had a pt a while back. We followed all ASV protocols to no avail. Finally when we were about to give up I counted every breath he had taken that night during each 30 second epoch. The average was 22 breaths per minute. I changed his back up rate to 22 and he was fixed. I got lucky but it might be what this pt needs.
Also this pt has to know that this therapy may not work. complex apnea is just that way
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Permalink Reply by j n k on -
I am willing to comment on ideas for simple obstructive patients to tweak their own therapy. But anyone on SV, in my opinion, needs a trusted team made up of (1) an RRT experienced with SV plus (2) either a pulmo doc or a neuro doc (if not a cardio doc, depending) for any meaningful assessment of the effectiveness of that treatment. I don't condsider central-apnea-treatment machines to be patient-tweakable, myself. So I have no comment.
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Permalink Reply by Ron Sowell on -
thanks to all for your thoughts and advice. I am going to doctor Wednesday and it will be interesting to see what transpires. I agree that I need to leave it to the professionals. I just hope I have the experienced RRT and neuro. Will let you guys know what I find out! Thanks - Ron
j n k said:I am willing to comment on ideas for simple obstructive patients to tweak their own therapy. But anyone on SV, in my opinion, needs a trusted team made up of (1) an RRT experienced with SV plus (2) either a pulmo doc or a neuro doc (if not a cardio doc, depending) for any meaningful assessment of the effectiveness of that treatment. I don't condsider central-apnea-treatment machines to be patient-tweakable, myself. So I have no comment.
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Permalink Reply by Mike on
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Good luck tomorrow, Ron. If you do get a doctor who knows his stuff, be sure to pick his brain about each and every aspect of your ASV treatment/ results. Then tell all of us what you learn. we clearly could use some more education on this front.
Ron Sowell said:thanks to all for your thoughts and advice. I am going to doctor Wednesday and it will be interesting to see what transpires. I agree that I need to leave it to the professionals. I just hope I have the experienced RRT and neuro. Will let you guys know what I find out! Thanks - Ron
j n k said:I am willing to comment on ideas for simple obstructive patients to tweak their own therapy. But anyone on SV, in my opinion, needs a trusted team made up of (1) an RRT experienced with SV plus (2) either a pulmo doc or a neuro doc (if not a cardio doc, depending) for any meaningful assessment of the effectiveness of that treatment. I don't condsider central-apnea-treatment machines to be patient-tweakable, myself. So I have no comment.
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