Hypopneas

[SirGaspAlot]

Question: Ive been on ASV for just over a month now, my Central are zero, obstructives reduced to 1 or none most nights, but hypopneas average between 15-20 a night, sometimes to over 30.

I recently changed my Setting to: PS to min-5, max 15
Epap to minimum 7, MAX 25
I didn't see an IPAP choice. (Must be because its an ASV).

The first night on PS of 5 my AHI was 1.8, all hypopneas. Didn't make any changes and it jumped to 3, all hypopneas this morning.

I don't believe theres anything oxygen intake-wise to be concerned with, but I do have a new sleep Dr. scheduled appointment for December 24th (Merry Christmas to me) and I am going to see if I can get a SP02 monitor for my Dreamstation.

my question is this, should I even be concerned about the hypopneas at all? If so, what can I do settings wise? So far, it doesn't seem to be improving.

[palerider]

Question: Ive been on ASV for just over a month now, my Central are zero, obstructives reduced to 1 or none most nights, but hypopneas average between 15-20 a night, sometimes to over 30.

I recently changed my Setting to: PS to min-5, max 15
Epap to minimum 7, MAX 25
I didn't see an IPAP choice. (Must be because its an ASV).

The first night on PS of 5 my AHI was 1.8, all hypopneas. Didn't make any changes and it jumped to 3, all hypopneas this morning.

I don't believe theres anything oxygen intake-wise to be concerned with, but I do have a new sleep Dr. scheduled appointment for December 24th (Merry Christmas to me) and I am going to see if I can get a SP02 monitor for my Dreamstation.

my question is this, should I even be concerned about the hypopneas at all? If so, what can I do settings wise? So far, it doesn't seem to be improving.

ipap=EPAP+PS
And, yeah, hypopneas are a problem. try bumping up your epap.

[Pugsy]

IPAP is simply a byproduct of EPAP plus PS so no official setting per se but instead you get your IPAP depending on what EPAP and PS does.
When PS increases a lot for centrals then your IPAP will increase.

What do do about the hyponeas depends on if they are a problem first and if you are sleeping decently and feeling decent then they may not be anything worth worrying about.

We assume that hyponeas are usually obstructive in nature and when that is the case usually IPAP is what we increase but with the ASV and variable PS you can't really do much with PS to give you more IPAP consistently...so instead you push IPAP up by increasing EPAP a little. So more minimum EPAP and I wouldn't do much of a jump...maybe 0.5 more minimum EPAP to start with.
Now sometimes those hyponeas can be central in nature and we can't really tell for sure with what we see on the reports.
If going by the odds though...they will be obstructive in nature.

With ASV a person has to be even more in tune with the give it time thing because any little adjustment in settings the body sometimes needs a bit of time to get used to. More patience is needed.

So...you could maybe increase the minimum PS to force IPAP up or your could try a little more minimum EPAP.
Given that your minimum PS is already 5...if it was me I would go with more minimum EPAP especially since the minimum EPAP is relatively low as it is.
Think of minimum EPAP like you would think of the minimum setting on an apap machine. It needs to be high enough to be a baseline sufficient pressure to hold the airway open in the first place and prevent the common obstructive collapses and be high enough to give the machine a good enough head start when it needs to go higher for the more stubborn events.
All this is assuming those hyponeas are obstructive in nature.

When you make changes...always factor in how you are sleeping and feeling and not get tunnel vision with just the numbers....and always give any change at least a week or so unless you have disastrous results of some sort.

[SirGaspAlot]

Ok, I will give it another week then and go from there. Thank you as always.