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I was recently (2 months ago) diagnosed with severe sleep apnea with an AHI of 102 during my sleep study. The doctor mentioned that it seemed to mostly consist of Central SA with some instances of obstructive SA. I purchased an Airsense 11 APAP and they set it to a range of 5-20, according to my GP who ordered the sleep study.
I noticed my AHI went down to 5-10 but I couldn't sleep with the full face mask. I bought the nasal mask and it fit well but I still had some difficulty falling and staying asleep. I finally went with the nasal pillows however I noticed my AHI reached 20-30. I went back to the nasal mask and it still keeps climbing. Last night it was at 52.67.
I notice when I start to nod off, I just stop breathing and honestly, I'm feeling pretty terrified. I just had a procedure done on my heart to correct an AFib and I get arrhythmias and tachycardia when my AHI is this high.
Can anyone shed any light on the situation? I'm going to schedule an appointment with a doctor / sleep specialist but it's Sunday today.
Oscar data is attached.
I'm afraid to wear my apap tonight as I heard it can develop into Complex SA with CSA
That is some heavy duty central sleep apnea, and you need the Resmed Aircurve 10 ASV or the older S9 VPAP Adapt. I suggest the older machine that provides the same ASV therapy as the 10 series, but will be used and relatively cheap to buy. My expectation is that your doctor will concede you failed CPAP but it could be months to get additional sleep studies and the machine you really need. Meanwhile, you should just try static CPAP pressure at 6.0 with no EPR. That has the best chance to reduce the centrals. To understand more about how ASV works, read the Resmed titration guide starting at page 28 https://document.resmed.com/en-us/docume...er_eng.pdf
If you want to solve this now, look up the"RESMED S9 VPAP Adapt BIPAP #36007 Bi-level PAP" on DotMed. It has 8600 hours and is listed at $550. Use of this machine can not only solve your problem, but quickly establish efficacy so your doctor can take the shortcut to a prescription. Keep your doctor informed of your progress and let him know the results of your attempts on the Airsense 11 autoset. You need to trial fixed, low pressure just to eliminate the possibility it works. Your sleep study tells us everything we need to know. CPAP does not generally treat central apnea. The titration manual will show you the information you need to discuss this with your doctor.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Although these basic APAP machines sometimes reduce the occurrence of central apnea they are not capable of treating them (they will not force you to take a breath if brain doesn't want to). With your initial diagnosis of 102 AHI and most of them being central it seems kind of ridiculous they didn't consider ASV to start with, ASV is the best treatment for central apnea.
For now we might be able to lower your AHI by turning EPR off. I would recommend trying min pressure = 6 cm, max pressure = 12 cm, EPR off, ramp off.
03-20-2022, 06:42 PM (This post was last modified: 03-20-2022, 09:11 PM by SarcasticDave94.
Edit Reason: VERY VERY STUPID AUTO CORRECT!
)
RE: AHI of 52.67 on APAP (Airsense 11)
Ah the nice purple trainwreck of Central Apnea. ASV will treat this as has been mentioned.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Thank you so much for the response! I bought the resmed s9 vpap and hopefully it will help. I will try the pressure you mentioned on the airsense and keep my fingers crossed. Thank you!
If you bought the Resmed S9 VPAP Adapt, that is an ASV. The default settings will be Vauto mode, EPAP min 4.0, EPAP max 15.0, PS min 3.0 and PS Max 15.0. We would narrow that down based on chart results. The Resmed Clinical Titration Guide has those settings for ASV-auto setting on Page 28. It will solve this.
A special note on the S9. You must lock the SD card before putting it into your computer to prevent system files from being written on the card, and unlock the card before putting it back into the machine. The S9 machine will format a card with unexpected files, while the Airsense 10 does not have this problem. Be sure to request the Resmed S9 VPAP Adapt clinical manual from the forum here https://www.apneaboard.com/adjust-cpap-p...tup-manual
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Machine: Remediated Dreamstation APAP-CPAP Mode Mask Type: Full face mask Mask Make & Model: Airfit F20 Humidifier: Built In CPAP Pressure: CPAP 15cmH2O CPAP Software: OSCAR
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
How high altitude do you live in Colorado? High altitudes can both cause and worsen already existing central sleep apnea. How long have you lived in CO?
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
(03-20-2022, 08:48 PM)Sleeprider Wrote: If you bought the Resmed S9 VPAP Adapt, that is an ASV. The default settings will be Vauto mode, EPAP min 4.0, EPAP max 15.0, PS min 3.0 and PS Max 15.0. We would narrow that down based on chart results. The Resmed Clinical Titration Guide has those settings for ASV-auto setting on Page 28. It will solve this.
A special note on the S9. You must lock the SD card before putting it into your computer to prevent system files from being written on the card, and unlock the card before putting it back into the machine. The S9 machine will format a card with unexpected files, while the Airsense 10 does not have this problem. Be sure to request the Resmed S9 VPAP Adapt clinical manual from the forum here: Link
Thank you! I have this all saved and will put this in and see how it goes. I really appreciate it!
Please follow the directions from these people.
