APAP and central apnea

[retired_guy]

We dont want to overcorrect your apnea".

Excuse me? How would you do that exactly? Get an AHI of -4 or something? Maybe the machine will require you to give a few back? I'm not understanding that too well.

[Ghandi]

Rigth !! then i would say like, well the less apnea i have the best it is for me. And then they play the tape of "You know m.ghandi even ppl without apnea have episode and would be around 2 ahi"

Then i brought up that some part of the nights it would raise to 10 episodes in the same they dismiss that with the whats is important is the ahi for the complete night. So lets say i do apneas when im in REM they would probably feel better that i dont enter rem too much so my ahi remains low and they dont have to adress that.

There was also the my OA are sometimes over 40 seconds and i'm concerned with that. But they played the tape again.

[archangle]

They have a cassette playing "Well your ahi is under five so you therapy is ok, there is no need to change. We dont want to overcorrect your apnea".

Heck, you're lucky. They usually just check compliance and say you're OK. i.e. "you're OK" means insurance will pay and the cash register will ring.

If you want a better pressure setting, that's not up to the DME, it's up to the doctor.

However, it sounds like you're going to have to put your therapy management into the hands of Dr. Gandi.

As for "overcorrecting," if, for instance, they increased your pressure to make a small change in AHI, you might have increased problems with centrals, gas, leaks, etc. That doesn't mean they're doing the right thing, but changes shouldn't be done haphazardly. It's one of the risks of adjusting your own pressure.

[Ghandi]

archangle i agree. I only removed the confort setting of c-flex + for a night and i winded up having a lot of mouth leaks.
Sometimes better is the ennemy of best So the changes must be made with caution.

[archangle]

archangle i agree. I only removed the confort setting of c-flex + for a night and i winded up having a lot of mouth leaks.
Sometimes better is the ennemy of best So the changes must be made with caution.

One great thing about a fully data capable machine is that you can tinker and see the results right away. That's true whether it's you or the doctor.

Sometimes, if you eliminate Flex, you can reduce the pressure setting.

[Ghandi]

I was eleminating flex to see if it would lower my hypopneas. And because it felt like i was increasing pressure without touching the setting and not getting grounded by the DME threatening to tell the doctor.

It think it lowered my hypopneas that nigth. I may fiddle with it a bit when i can stabelize my sleep position.

[CynthiaMueller]

Well it looks like i would have been better served with an auto-pap. But i just purcharsed my machine 2 months ago, so i'm going to be stuck with it for 5 years before i can try auto-pap.

Actually, since you have failed treatment with the first machine, with a new sleep study on a servo machine AND the EXACT correct wording by the doctor to show that the new machine is medically necessary insurance should cover an ASV-BiPAP. The key is to have doctor's notes showing failure of regular BiPAP treatment, sleep study on ASV-BiPAP and prescription showing that the new machine is medically necessary to treat your condition.
Cindy

[Ghandi]

Interesting Cindy
But by the standards i totally comply. I sleep with the machine everyday from 7 to 8 hours and my ahi is lower than 5. 1.0 AHI.
Also hey , i am Canadian.

whats the difference between Cpap and asv?

[CynthiaMueller]

I'm sorry Ghandi. I read the first few posts and thought that you were being treated for the obstructive (with BiPAP) but not central apnea (with a servo machine). (That's my story -I'm extra sensitive to that issue!)

I'm so happy that your condition is under control! I love reading about successful treatment!

The respiratory therapist told me that she had lots of patients with central apnea on regular BiPAP. My new sleep doctor said that if central are caused by the therapy (as opposed to 100% plain central sleep apnea) BiPAP will only make it worse. I thought that the respiratory therapist was a little bit wrong, but I don't know the stories of her patients.

CPAP basically has the one pressure which is constant (my ResMed S9 has the EPR setting which can lower the expiratory pressure by 3). BiPAP allows for a large variation between inspiratory and expiratory pressure. BiPAP with ASV (auto servo ventilation) measures your respiration and changes the pressure according to the pattern of how you should be breathing. It follows your normal breathing such that if on the third breath you only inhale 1/4 of normal, it will deliver the other 3/4. So, it is much more than just the two different ppressures of regular BiPAP.
Cindy

[Ghandi]

So you have a bipap and it's causing you central apnea episodes?
When i asked for bipap the DME told me they did't used it for sleep apnea. They reacted so strongly, like i was out of my mind to even mention the word bipap. So i backed off.
BiPAP with ASV (auto servo ventilation) seems to be marvellous. I'm just a little more irritated that it wasnt suggested to me at all.

I'm complaning but the cpap changed my life. I'm a new man