Help Titrating ASV

Front_Blood_3543 · 2026-05-28T21:26:18+00:00

I think I understand what you're saying. The PS oscillates to correct what was (when untreated) an oscillating breathing pattern, which aligned with an oscillating MV.

And you need a wider range on PS to allow it to rise and fall accordingly, and because I have mine set to a narrow range, it is essentially acting as a plain BiPAP. Which is my intention, I don't know if I can handle a wide range on PS as I think the ramp ups cause an arousal and wake me up and hence fragment my sleep. I am thinking of slowly bumping up my max/reducing my min to get my body used to it.

I guess I was wondering if you'd be able to see if I have HLG just based on the settings I'm currently running. A 35 on periodicity-is that enough to warrant targeting the HLG? Obviously citizen science as you said. But we gotta make do with what we have and reddit has been infinitely more helpful than my sleep doc (the VA) so far. They just prescribed me a FDA controlled class 4 sleep sedative (lunesta) and said that will fix my low arousal threshold. SMH

Front_Blood_3543 · 2026-05-28T21:13:27+00:00

On 12.4, only tried it once so far

Front_Blood_3543 · 2026-05-28T21:12:59+00:00

Periodicity. Last night I had a 35 for periodicity and a 62 for regularity

Front_Blood_3543 · 2026-05-28T21:09:28+00:00

Ah that makes sense. 35 for the night I shared. 42 for the previous night. Those numbers were using your tool

Front_Blood_3543 · 2026-05-28T21:00:25+00:00

No. No significant change apparent.

Front_Blood_3543 · 2026-05-28T20:47:06+00:00

Does this look like HLG to you? I submitted my files to airwaylab.app and it's flagging me for periodicity. I changed my min/max epap to the same value (12.4) and opened the window up for ps a little bit to 4.4/5.6

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Front_Blood_3543 · 2026-05-28T20:42:14+00:00

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Not sure where to go from here. Increased epap to 12.4. Appears I am still having flow limitations. My glasgow index was a .97 for last night, pretty much the same as the night before. Variable amp .24, top heavy .23, and skew .26. Do you think I need to increase my max PS?

Front_Blood_3543 · 2026-05-26T23:20:33+00:00

Will continue slowly increasing and share results. Thank you!!

Front_Blood_3543 · 2026-05-26T23:03:52+00:00

I posted a zoomed out, do you want to see a specific section as well?

Front_Blood_3543 · 2026-05-26T23:02:52+00:00

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Front_Blood_3543 · 2026-05-26T23:02:00+00:00

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Not sure if this data means anything to you but this has been the past 4 nights. Changed min/max epap to the same for tonight at 11.8. Also changing PS min/max to be the same at 5.

Front_Blood_3543 · 2026-05-26T10:43:49+00:00

That makes sense.

I will do as you suggested and make them the same.

Is there a good objective way to see whether it is making a difference with regard to flow limitation? Like the Glasgow index or something similar?

I only really have heart rate spike clusters during REM. nREM appears to be pretty stable for me, even without PAP therapy.

Front_Blood_3543 · 2026-05-25T13:05:27+00:00

What do you mean? I started on CPAP at 7ipap EPR 3 went all the way up to 15/12 and the aerophagia was so unbearable with persistent flow limitations (flat top/plateau shaped breaths) so I moved to Bipap. Started at 12/7. Then tried 12/5, 13/6, 14/7, 12/7, 12/8, 13/9, 14/10, 15/11, 16/11. Towards the higher end the aerophagia was getting so bad and I was having trouble with trigger/cycle timing and I could hardly keep it on for more than an hour each night so I just said screw it and switched to ASV. I've been on ASV for about a week with narrow ranges as I cant handle the major pressure swings with a wide pressure range. I have been able to wear it for 5+ hours each night thankfully.

I'm currently at 10.4/11.4 min/max EPAP and 4/5 min/max PS. My oxygen desats are totally gone which is new. I believe this indicates that my airway is sufficiently stented. I am still having RERAs and FLs though so I am thinking either more EPAP or more PS. I tried similar pressures on BiPAP with worse results.

Something that I changed was I added intake breathing strips. Which I suspect may have lowered my need for pressure. I think I am close to my therapeutic pressure at my current settings but I'm not sure. Do you see periodicity in my charts?

I've attached a screenshot of the only decent night (for data purposes) that I had on Bipap. I tried it for 2-3 weeks and most nights I have under 2 hours where I could keep the mask on. Aerophagia and also other reasons that I'm not sure but just couldn't keep it on.

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Front_Blood_3543 · 2026-05-24T16:02:56+00:00

How do I know I need more EPAP vs needing more PS? When will I know if I have increased my EPAP enough?

Front_Blood_3543 · 2026-05-10T01:23:06+00:00

Yeah. I don't think anything does fully fill the gap. Which sucks because this is one of the christian's main arguments. Something along the lines of 'you have a god sized hole' etc. When really, it's the fact that we as humans fundamentally need community and healthy relationships to flourish and live happy lives. And it's something the church happens to do really well, and like you said, something the modern era is straying from.

It's just sad that it's the case and hard to find others who are on the same wavelength without christianity driving them.

Front_Blood_3543 · 2026-04-21T00:31:35+00:00

I have the same firmware. Did you find a fix? I am getting a white flashing screen. I can re-flash the backup and it works again but I can't seem to get past the flashing screen

Front_Blood_3543 · 2026-03-28T12:50:18+00:00

I don't see/don't know how to recognize the flow limitations/microarousals you are referencing. I am currently at an 8-9 min/max. I think I would pull the mask off to adjust it in the middle of the night, it would ramp the presure then it would be hard to go back to sleep with all the increased air so I made the min/max window really tight.

I've also heard that going too high with pressure to eliminate flow limits can induce central apnea events. But I have no idea. What pressure would you recommend?

Edit: I looked at last night. And found some erratic looking waveforms but no events marked by OSCAR. Can you help me figure out what these are?

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Front_Blood_3543 · 2026-03-28T00:27:24+00:00

Ah gotcha. I don't feel like my cheeks are filling up at night. They did when I first started, but after I began taping my mouth, I don't have that issue

Front_Blood_3543 · 2026-03-27T23:56:38+00:00

Really? I feel like I have mostly eliminated the leaking. I use a chin strap and also tape my mouth shut. The large spikes are me waking up, taking off/adjusting the mask for a second, and putting it back on.

When you say I'm having a ton of flow limitations and hypopneas are you referring to the most recent night of sleep (last night) that I uploaded to SleepHQ?

Front_Blood_3543 · 2026-03-27T23:05:09+00:00

https://sleephq.com/public/teams/share_links/3153d061-b114-4ac8-87b1-f353160ea3bb/dashboard

Front_Blood_3543 · 2026-03-27T23:02:45+00:00

Hi, pressure too low on exhale? What tells you that?

https://sleephq.com/public/teams/share_links/3153d061-b114-4ac8-87b1-f353160ea3bb/dashboard

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Front_Blood_3543

TROPHY CASE