AHI looks good, but still feeling bad

[croc]

I'm the same. I can't stand a pressure above 6.4 or I'll get serious bloating, belly pain and even indigestion. I've tried PPIs and Gaviscon along with lifestyle remedies to no avail. I hope you find a solution!

[PeaceLoveAndPizza]

Note for those with GERD that meds will not solve the weak sphincter muscle problem. They only moderate the creation of stomach acids. The only solution I have been given for my similar issues is surgery to tighten the muscle.

[nh00]

PeaceLoveAndPizza, are you considering moving forward with the surgery? I didn't know previously that it was an option.

[manacles]

I'm the same. I can't stand a pressure above 6.4 or I'll get serious bloating, belly pain and even indigestion. I've tried PPIs and Gaviscon along with lifestyle remedies to no avail. I hope you find a solution!

I've had almost the exact same problems as you with aerophagia but was able to create a solution for it. I just posted it in the forums and would be interested if my solution could potentially work for you.

[LennySleeps]

I've had almost the exact same problems as you with aerophagia but was able to create a solution for it. I just posted it in the forums and would be interested if my solution could potentially work for you.

I just tried your solution and it worked great for me! Thanks so much for putting it out there!

[nh00]

My sleep doctor recommended another sleep study round to see if I was a good candidate for another machine. Here are the results:

- 51 apneas: 12 obstructive, 38 central (apnea index of 12.6). 30 hypopneas (hypopnea index of 7.4). Apnea-hypopnea index of 20. RERA of 0. RDI of 20 events/hr. No cheyene stokes.
- Since I was unable to tolerate pressures, CPAP was not attempted for long.
- Initial BiPAP caused rise of central apneas.
- BiPAP ST "demonstrated optimal control" of symptoms.

The recommendation now is to proceed with a BIPAP S/T machine, which I'm quite confused about. It seems like there are no newer machines that are just a BIPAP S/T, and that these have been replaced with ASVs - hopefully I will be put straight onto an ASV or similar so that I can stick with ResMed. Does anyone have experience being recommended this type of machine? I tried speaking to the Dr's assistant about going straight to an ASV, but it seemed like that wasn't an option (would need a repeat study, allegedly).

Anyway, I'm happy to have my physical feelinsg confirmed by this sleep study: normal CPAP was not tolerable and was probably causing treatment-induced central apneas. On to the next step.

[SarcasticDave94]

The likelihood is they're going to treat you for Central Apnea, since your CA 38 is over half the events besides Hypopnea.

ST means Spontaneous Timed, and is actually for COPD patients. This was the old method to treat Central Apnea, and was somewhat helpful due to the timed backup breath rate. The ResMed ASV is specifically used for Central Apnea treatment, and it's much better than ST in this case.

The ResMed AirCurve ASV is bilevel, has Auto backup breath rate, and will treat all Apnea, not just CA. Request this device and refuse ST.

[nh00]

The likelihood is they're going to treat you for Central Apnea, since your CA 38 is over half the events besides Hypopnea.

ST means Spontaneous Timed, and is actually for COPD patients. This was the old method to treat Central Apnea, and was somewhat helpful due to the timed backup breath rate. The ResMed ASV is specifically used for Central Apnea treatment, and it's much better than ST in this case.

The ResMed AirCurve ASV is bilevel, has Auto backup breath rate, and will treat all Apnea, not just CA. Request this device and refuse ST.

Thanks for your reply, Dave. Any advice on navigating the conversation about requesting an ASV? I imagine they will say insurance might not approve it or something similar - should I insisit that they try anyway? These are often difficult conversations to "win" in my experience.

[SarcasticDave94]

You could try this approach. Use ResMed info about the machines as the indicator what you need.

"AirCurve 10 ASV
Leveraging adaptive servo-ventilation (ASV) to target a patient’s recent minute ventilation, the AirCurve™ 10 ASV offers truly personalized therapy for obstructive sleep apnea (OSA), central and/or mixed apneas and periodic breathing. Auto-adjusting pressure support is designed to treat central breathing disorders, while auto-adjusting EPAP is suitable for upper airway obstruction."

"AirCurve 10 ST
The ResMed AirCurve™ 10 ST bilevel device with backup rate provides exceptional patient–ventilator synchrony, reducing the work of breathing so patients remain comfortable and well-ventilated. Designed to nurture patient engagement, the AirCurve 10 ST is an ideal choice for reliable, cost-effective noninvasive ventilation when alarms aren’t needed."

The ASV mentioned Central Apnea treatment, the ST is a basic ventilator but in CPAP class.

Back in 2017 when I had a sleep study showing 124 CA to 24 OA, they placed me on a Philips Respironics DreamStation. It was absolutely terrible, increased CA. I called in to talk with the sleep office, taking my print off the study, highlighting CA, OA, etc. I asked if they wanted to treat the CA or ignore? They said they'd begin the process to ASV.

Maybe follow likewise. Tell them about ASV.