[CPAP] Does the infarction affect the breathing in the device?

[Sleeprider]

I'm downloading now, but let me just tell you something we have learned about central apnea. It is consistently inconsistent.

I don't know how that will translate to Polish language, but what it means is, you cannot rely on an improvement in results to be meaningful in the long run. You will continue to experience very high and perhaps somewhat low AHI. You will still need ASV for consistent results.

[WhyMe]

PS' F12 in Oscar is not working (I have PC). How do I send current Oscar data?

F12 by itself isn’t the command - you also need to hold down the function button at the same time.  Alternatively, there is a print screen command in the OSCAR menus at the top of the screen.  Darned if I remember if it is under File commands or one of the others though.

[lech]

PS' - What does "Preferred Member" mean? VIP?

[lech]

I was at the pneumologist today. 

Summary:

1) Before myocardial infarction and after myocardial infarction, I had a leaky apparatus (i.e. this is not a difference in the results), but central apnea appeared only after myocardial infarction. So it is obvious that the cause of my condition is a heart attack and that I now have also another type of apnea - central.
2) In a few days I will be undergoing diagnostic tests at the hospital, I will sleep in the hospital connected with a lot of cables and devices, including the ASV type.
3) The doctor assumes that it will end up using not my ASV apparatus, but a respirator, i.e. a non-invasive ventilation (NIV) device. If I understood correctly, it is a camera that has even more functions than the ASV, for example, it doses the size of the breath. 
So I will remind my wife of a cosmonaut at night. 

[Sleeprider]

The technology he is talking about is also called the ST iVAPS, and the machine is the Resmed Aircurve 10 ST-A. This is an alternative to ASV and can provide pressure support on a breath by breath basis to maintain the aveolar volume. It is used in both pulmonary disease and central apnea. These are not in wide-spread use, but I think there are a couple forum members that use it.

Here is some information about the ST-A https://www.resmed.com/us/en/healthcare-...0-sta.html Note that it is not for complex or central apnea and Cheyne Stokes Respiration like the ASV or Pacewave CS: https://www.resmed.com/us/en/consumer/pr...0-asv.html

For some reason, doctors often choose the wrong machine, and I can't explain it. The ASV is designed to resolve your type of central apnea and CSR. The ST-A is designed for people with pulmonary disease that need the pressure support to take an adequate breath. That is not your problem.

[lech]

@ Sleeprider

It left me worrying that two professionals (you and my doctor) have different opinions. Maybe everything will turn out well after the examination in the hospital, for now the doctor's opinion is a preliminary hypothesis.

PS 'I will try to get the results of my research in the hospital and I will send them to you.

[Gideon]

This tidbit is from ResMeds Titration guide.  
Note that iVAPS (intelligent Volume-Assured Pressure Support) Maintains a preset target alveolar minute ventilation and iVAPS (intelligent Volume-Assured Pressure Support) Maintains a preset target alveolar minute ventilation ASV (adaptive servo-ventilation) Targets the patient’s minute ventilation

CPAP choice to treat OSA, CA, obstructive or pulmonary restriction
The Auto CPAP such as the AirSense 10 AutoSet is typically the initial machine of choice for treatment of obstructive apnea and hypopnea
Just to clarify The VAUTO, ASV, S, and the ST are all BiLevel machines for treating three different conditions, they are NOT interchangeable. They are not a choice between them to treat a single condition.
They should be chosen to treat the specific condition that the user has, Here are the various CPAP machines and what they are designed/intended to treat
This info is from the ResMed Sleep Lab Titration Guide

• CPAP (continuous positive airway pressure) Fixed pressure delivered with optional expiratory pressure relief (EPR). It Treats OSA
  

• AutoSet/APAP (automatic positive airway pressure) Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas. It treats OSA
  

• AutoSet for Her/APAP Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas along with an increased sensitivity to each flow-limited breath, providing a more comfortable therapy for women. Increases sensitivity to each flow-limited breath, providing a more comfortable therapy for women (OK for men too). It Treats OSA
  

• VAuto Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas; Pressure Support (PS) is fixed throughout the night and can be set by the clinician. It Treats OSA, non-compliant OSA
  

• S (Spontaneous) Senses when the patient is inhaling and exhaling, and supplies appropriate pressures accordingly. Both treatment pressures are preset: inspiration (IPAP) and expiration (EPAP). It treats Non-compliant OSA and COPD
  

• ST (Spontaneous/Timed) Augments any breaths initiated by the patient, but also supplies additional breaths if the breath rate falls below the clinician’s set “backup” respiratory rate. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions
  

• T (Timed) Supplies a clinician-set respiratory rate and inspiratory/expiratory time, regardless of patient effort. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions
  

• iVAPS (intelligent Volume-Assured Pressure Support) Maintains a preset target alveolar minute ventilation by monitoring delivered ventilation, adjusting the pressure support and automatically providing an intelligent backup breath. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions
  

• ASV (adaptive servo-ventilation) Targets the patient’s minute ventilation, continually learning the patient’s breathing pattern and instantly responding to any changes. It treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
  

• ASVAuto Provides an ASV algorithm plus expiratory positive airway pressure (EPAP) that automatically responds on the patient’s next breath to flow limitation, snore and obstructive sleep apneas. It Treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
  

• PAC (Pressure Assist Control, also known as Pressure Control) The inspiration time is preset in the PAC mode; there is no spontaneous/flow cycling. Inspiration can be triggered by the patient when respiratory rate is above a preset value, or delivered at a set time at the backup rate. It Treats Neuromuscular disease (NMD), pediatric patients
  

[lech]

@ Fred Bonjour 

So what are we choosing for me?

[Gideon]

with ASV and Central Apneas we want to keep pressures low as much as possible, and then supplement with High Pressure Support only when needed to "Force" a breath.
COPD is a constant problem, it requires a higher differential between IPAP and EPAP constantly to continually "Force" a breath, every breath.

Based on our present knowledge, that you have Central Apnea, SleepRiders analysis is correct and as such the ASV is the better machine for you.

[Sleeprider]

Lech, your tidal volume is consistently 440-460 mL and your minute vent median is 6.75 to 9.25 L/min. You have excellent pulmonary volume and function except for the central apnea. This very good volume is in spite of the central apnea and periodic breathing. There is not a lot of flow limitation, and volume is consistently good when you breathe. You don't need help with maintaining your minute vent or tidal volume due to a restrictive or neuromuscular pulmonary condition...you need help with central apnea and periodic breathing which is the purpose of ASV. I don't know how to make it more clear than to quote what Resmed intends for the therapeutic use of their machines.