[CPAP] Mixed apnea

[Gideon]

I believe your centrals are ideopathic. The manipulations we typically apply with PS are unlikely to help.

What is your Trigger Setting?

[void]

Sorry, 
Trigger=High
So if no change will help, should I buy ASV or iVAPS?

[Geer1]

Yes these apnea are clearly not hyperventilation induced and therefore not treatment emergent (if doctor thinks they are). There are no signs of obstruction being present either, your respiratory drive just kicks out for some reason and doesn't restart until something (high CO2 or low O2) triggers significant recovery breathing. 

This appears to be a case of idiopathic or medication/medical condition induced central apnea. One of the first questions should be if you are on any medication that can cause central apnea/respiratory depression (opioids are the most common culprit) and if so if there are alternatives to try.

This machine won't be capable of treating this apnea and Resmed ASV is the best option. I wouldn't settle with another brand. 

It is worth asking your doctor to look into potential causes of your central apnea (especially if you are younger in age).

[void]

Thanks, my O2 ring vibration alarm wakes me and triggers recovery...
I take sometimes Omeprazole for reflux, but it does not seem to help my apnea.
1. Gideon, do you agree with ASV conclusion?
Since Resmed ASV is out of stock everywhere I checked, I would consider other options until I can get Resmed ASV.
2. What should be the initial settings, in my case for:
   2.1 BiPAP ASV
   2.2 BIPAP ST
   2.3 BIPAP IVAPS

[Geer1]

Top of the page there is a supplier list, Resmed ASV are in stock at some of the suppliers.

You don't want ST or IVAPS, large reason being that neither have easybreathe waveform making them uncomfortable. Those are machines meant for people with severe COPD, neuromuscular disorders etc that require significant ventilatory assistance. You just need a machine that will work to kick start your spontaneous breathing and stabilize it which is what ASV does.

Here is Resmed titration protocol where you will see ASV as the choice for central apnea and initial settings.

https://document.resmed.com/documents/pr...er_eng.pdf

[Gideon]

On the absence of non apnea pulmonary issues and no neuromuscular issues ASV is the machine of choice. I haven't seen a clear response that you have no complicating conditions.

[void]

1. What do you think should be the parameters settings for the ASV?
Resmed ASV is not sold in my country so it might take several weeks to ship it from US and get customs release.
2. If I rent bipap st what should be the parameters settings?

[void]

Gideon, you are right I still don't have definitive diagnosis.
When I am awake I don't need ventilation support and my O2 level is normal. Do you think that this rules out iVAPS?