Central Apnea Index of 2 Yet Dreaming of ASV

[Sleeper396]

For approximately 120 days of treatment with a ResMed AirSense Auto Set 10, I have an average Central Apnea Index of 1.8, and an average total AHI of 2.2. My only major issue remaining is fragmented sleep sessions (3-4 per night with 2-3 bathroom wakeups). I also take meds for an enlarged prostate which does not help when it comes to bathroom wakeups. Nevertheless, this is a real improvement from before my APAP treatment. Should I be happy with where I am now (having treated most of my moderate/severe sleep apnea -- CA's and OA's were equally split during my sleep study, and OA's are basically fully-treated now, while CA's are, of course, typically inconsistent each night). Due to posts on this board, I dream about an ASV solving all of my problems and allowing me to sleep though most of the night (not likely with my enlarged prostate condition and mature age). Given the already low Central Index, should I abandon my dream of an ASV as not being realistic, and likely not doing all that much to better my condition? Should I be happy with where I am?

[Sleeprider]

Your therapy thread provides the context to answer your current question and it's tempting to merge this question there http://www.apneaboard.com/forums/ThreadT...ce?page=11 With settings of 9.6-14.8 with EPR 1, you do have a chronic low CAI that will not qualify for insurance reimbursement for ASV, however if you were able to source an ASV machine, it would completely clear up the central apnea and hypopnea leaving you with near-zero events. Whether that would translate into better, less fragmented sleep is something we can only guess. We know that in addition to treating central apnea, you would also benefit from bilevel treatment of the flow limitations which cause your inspiration time to be longer than expiration time. This is a classic indication of flow limitation which is more likely the source of your sleep fragmentation and fatigue, as it is associated with increased respiratory effort.

It is possible that using EERS would also help with the central apnea and flow limits, but this is not a widely recognized solution, and requires a DIY fabrication. If you want to try ASV, the best approach is to assume it will come out-of-pocket, and try to source a machine using the SearchTempest search engine which searches Craigslist for any range you choose, or perhaps looking at inventory on DotMed where ASV is frequently listed for $400 to $800 and several members have sourced machines. Either the Resmed S9 VPAP Adapt or Aircurve 10 ASV will provide the algorithms you need.

[Sleeper396]

Thank you, Sleeprider.  I will take your comments under consideration, and appreciate the guidance.