[CPAP] High AHI but technician says all OK...

[SarcasticDave94]

Speaking about the ResMed Aircurve 10 ASV I was using, it will address CA and OA. An AHI of 7-8 is not clinically successful. Here in the US at least, AHI of 5 is considered treated with the machine. You still have apnea that needs addressed. Central apnea that is not treated will contribute to poor health. The CA events will reduce oxygen levels and are a cause of other heart and lung problems. For me, apnea is something to address fully.

[Benzi]

Speaking about the ResMed Aircurve 10 ASV I was using, it will address CA and OA. An AHI of 7-8 is not clinically successful. Here in the US at least, AHI of 5 is considered treated with the machine. You still have apnea that needs addressed. Central apnea that is not treated will contribute to poor health. The CA events will reduce oxygen levels and are a cause of other heart and lung problems. For me, apnea is something to address fully.

Thanks for the explanation. Was it hard to get used to, or does it feel like a regular CPAP?

[SarcasticDave94]

It's not far off the feel of a standard CPAP, but it is different. I found the ASV is sensitive to leaks, so you have to get mask fit and adjustments within a better controlled aspect than what you may get away with on other machines. The ASV can sometimes give a nasty hard pressure blow when you're drifting off to sleep, within the sleep wake junk area. You'd need to implement a blow back to get the ASV to back off. That's a literal blow back by you through the mask to get the ASV to back off. Some are bothered by oscillation or pressure pulses used to check for events, but I was not bothered. Once pressure settings are optimized, you should get AHI of 2-3 very consistently, say about 5-6 of 7 nights always, but almost never at 5 AHI.

[Gideon]

Here in the US AHI of 5 is considered treated. That means your sleep was disturbed on average, once every 12 minutes. Do you consider having your alarm clock going off every 12 minutes through the night treated? What about every 4 minutes? That equates to once every 4 minutes. That is an AHI or 15 which is the standard in other countries. My goal is to get everyone down to an AHI of 2-3 max.

[Benzi]

Thank you all for the information and support!

I managed to talk to the sleep doctor (because of the Corona situation, the clinic is making it possible to meet the doctor on the phone, which seems to have shortened the waiting time).

When he heard that I'd put on weight (2-3 kg) recently, and had a cold in February, he said those could very well have contributed to the raised AHI. When I mentioned the possibility of ASV, he sounded shocked ("that's for people who have trouble breathing, not for you"). He told me to lose weight (duh) and raise the max pressure to 12. I guess that if the rise in pressure doesn't help, losing weight may. Trouble is I've never quite got the knack of losing weight quickly....

I know this goes against the advice of some members of the forum, but please wish me luck! (I'll update you in any case)

Benzi

[SarcasticDave94]

It's similar to my original pulmonary doc, a tactic to avoid supporting you and avoiding the work the doc will need to do so you can get on the ASV path. I'm not sure what you have as options in your country, but maybe get a second doc's opinion or this current doc's superiors. Malpractice comes to mind, but what do I know. You will have a fight so be prepared. Best of luck to ya.

[Gideon]

I understand how your doctor is addressing your (almost non-existent) obstructive apnea. How is he planning on addressing your central apnea?

[Sleeprider]

It sounds like your doctor is unaware that most of your events are central.  What we've got here, is failure to communicate.

[Benzi]

I understand how your doctor is addressing your (almost non-existent) obstructive apnea.  How is he planning on addressing your central apnea?

I sort of asked him but didn't get an intelligible answer. Basically it was "try this and I think it will help". He thinks my problems are the result of my weight and the cold I had. I guess I'll have to try it and go back to him if it doesn't help. Unfortunately I got the impression that using an ASV to treat apnea isn't in his toolbox. In any case I'm searching for another sleep doctor to get a second opinion.

[Benzi]

I'm not sure he knows what central apnea means....