should I try AVAPS/IVAPS for shallow breathing?

A recent sleep endoscopy found “very shallow breathing even with arousal”. I’m on ASVAuto and it’s not working well enough. Settings are pressure support 6-16 and EPAP 9-15. Compliance reports show my sleep apnea is adequately controlled by the ASVAUTO machine. Sleep study shows I’m doing great...except I don’t feel great .
2-3 days a week I wake up and feel pretty bad. Not a lot of energy. I mope around the house and can’t think as clearly as I’d like. I don’t like to exercise on those days. The compliance report doesn’t register anything suspicious on those days. On a good day I can hike up a mountain for an hour without any problems.

Should I try ivaps/avaps now?
Is IVAPS better than AVAPS?
What settings should I use on one of these machines?
Do you know anyone that could give me a written prescription for avaps or ivaps without seeing me in person so I can see if 1 will work?
Do you know of any good deals on an ivaps or avaps - either new or used?

Currently using resmed 9 vpap adapt on asvauto . F&P Simplus full face mask. Located at Snowbird, Utah (7800’ elevation). compliance report is great - 0 leaks. 7:34 average usage, AHI 0.8. Minute ventilation median 5.6 , 95th% 7.8, max 13.8. Respiratory rate median 10, 95th 14, max 18. Tidal volume max 1209, 95th 782, median 554.

Thanks!

What did your doctor say about the "very shallow" breathing? About your daytime problems? It seems wise to follow up with the doctor before considering an AVAPS or IVAPS machine.

In the data you provide, your median tidal volume looks fine, but your respiration rate looks somewhat low. More about RR here:

https://www.sleepfoundation.org/sleep-a ... atory-rate

Do your good/bad days correlate with changes in your median RR? This, too, might be a good thing to discuss with your doctor.

cpaputah wrote: ↑

Wed Oct 20, 2021 10:58 am

Should I try ivaps/avaps now?

Depends, what are your SpO2 readings overnight?

cpaputah wrote: ↑

Wed Oct 20, 2021 10:58 am

Is IVAPS better than AVAPS?

Yes.

cpaputah wrote: ↑

Wed Oct 20, 2021 10:58 am

What settings should I use on one of these machines?

Whatever's appropriate for your height.

cpaputah wrote: ↑

Wed Oct 20, 2021 10:58 am

Do you know anyone that could give me a written prescription for avaps or ivaps without seeing me in person so I can see if 1 will work?

nope.

cpaputah wrote: ↑

Wed Oct 20, 2021 10:58 am

Do you know of any good deals on an ivaps or avaps - either new or used

Not offhand.

cpaputah wrote: ↑

Wed Oct 20, 2021 10:58 am

On a good day I can hike up a mountain for an hour without any problems.

Not to ignore your RR, but could you be exercising too strenuously? Among light/moderate/strenuous, moderate is often best for restful sleep. How old are you?

Do you consume caffeine? Take any drugs? Is your diet healthy?

Has the pandemic affected your mood or social engagement?

thanks - not exercising too strenuously. some days I don't exercise, other days I just walk for an hour or less with no elevation gain. for a while I wasn't exercising much at all (over a year ago for a few years).....same problem. So I don't think over-exercising is the culprit. Healthy diet, 160 lbs and 6' tall. no recreational drugs. some caffeine some days, light amounts before noon only. this issue has been ongoing for 10 years so not pandemic related. All I know is it seems to be sleep related. bad days start with a bad nights sleep. good day starts with a great night of sleep. I looking at my respiratory rate and couldn't find a correlation between bad days and lower respiratory rate. The very shallow breathing seemed very strange to the ENT who did the sleep endoscopy because he has done lots of them. It was only when I went to sleep with propofol and he's done this procedure with hundreds of patients and I was by far the outlier.

o2 readings low as I sleep - , unless I am on 2 liters oxygen AND VPAP.

To answer your question that's in the title, NO.

https://www.mdapp.co/tidal-volume-calcu ... depth-408/

Ideal tidal volume for your height is 468ml-624ml. your median reported above is smack dab in the middle of the range, so if you blew a ton of money on an iVAPS, it wouldn't do you any good, and it would be less comfortable compared to the ASV.

Perhaps you don't have 'shallow breathing'.

You might want to talk with a pulmonary doctor.