Central Sleep Apnea

[stevekuk]

I seem to be in better shape that cruzer, but was looking for a thread to try to find some answers about CSA.  I was diagnosed with complex apnea with both OSA and CSA but only medium bad (16 AHI).  I have a smart, big name doctor and he followed the standard route and prescribed vpap - cpap autoset, even though I inquired about aircurve ASV.  After over a month with VPAP,   events/hr are down to 2 to 4, but the Resmed airsense auto with either OSCAR or ResScan says over 90% are CENTRAL SLEEP APNEA.  I did get a run of Cheyne-Stokes. 1) IS THE DESIGNATION OF THE EVENTS AS CSA RELIABLE or could some be OSA?  2) If my AHI is 4 or below, should I just not worry about the CSA, or getting another machine.
Many thanks for answers - This is a fantastic forum.     -Steve

[sheepless]

the system says ahi under 5 is okay, so you won't likely get much support from a doctor or insurance for asv. most resmed flagged csr is not csr but periodic breathing. if your's is true csr, you may have a leg to stand on for asv. however, most doctors rely on an old and flawed study used to preclude asv from people with the kind of heart conditions that produce csr. catch-22. start your own thread and post a couple 10 minute views of your csr to see if folks think it's csr or periodic breathing. if you want to try asv, you will probably have to do as I and others have and buy a used one from a private source.

[sheepless]

I'll add that I have mixed apnea, roughly 50-50 ca and oa. apap brought my ahi down from more than 72 to around 6 or so but I continued to feel awful. I bought a used asv, reducing my ahi to under 1 and I felt better but for a reason unrelated to apnea, not enough. then I bought a used vauto getting ahi under 2, mostly due to trigger set to very high. for reasons I won't go into now I alternate between asv and vauto. the point is that it does seem possible to treat ca to some degree with machines other than the asv that is the only mode of the three actually designed to treat it. what you decide depends mostly on how you feel.

[stevekuk]

Sheepless(?)   Many thanks for answer.  Most sounds correct and some expected.  WHat kind of HEART CONDITIONS cause csr (central) events?   I have afib, aflutter and pacemaker...   Steve

[cruzer43]

I think they have it backwards.....

Sleep apnea puts a strain on the heart which in turns causes various heart problems.
I don't believe that heart problems cause apnea.
They are coincidental not causal.

I have a weak heart.  I believe that my weak heart came from undiagnosed apnea.  
I don't believe that my apnea came from my weak heart.

By the way, If you would like, we could continue the conversation through email.  I have something that might interest you.
My email address is rgcruze1966@gmail.com.

If not, that's fine.

Cruzer43

[sheepless]

probably my fault but I'm getting a little confused who's responding to who here. since this is cruzer43's thread, you (stevekuk) should bring up your questions in your own thread.

stevekuk, I have zero medical expertise so take what I say with a grain of salt. to my knowledge the heart issue viz. asv is congestive heart failure. could be other things as well for all I know. as I understand it a new study is underway that may remove the heart warning with respect to asv. even so, since you have some of what I assume are pretty serious heart issues, you'd be wise to discuss carefully with your doctor before trying asv.

cruzer43, I'm not sure what you're referring to. yes, as I understand it apnea can cause heart problems. idk if heart problems can cause apnea but if I gave that impression I didn't mean to. the last few posts indirectly relate to an old apparently flawed study that doctors rely on to avoid prescribing asv to some people with certain heart conditions.

I'm also not sure who you want to continue the conversation with but this is your thread so this is a good place to do it.

[cruzer43]

Didn't know I was replying to everyone.
Meant to reply only to Stevekuk.
Thought it was a private message.
My bad.

[SarcasticDave94]

Correct. CHF is incorrectly linked to ASV. The mishandled SERVE-HF study was slated to be replaced this year but it's delayed. With I did my echocardiogram in 2017 to get cleared for ASV, I had the LVEF of 55%, passing was 45% and up LVEF. I think it was 2020 when I got a new cardiac doc, and he had me do a new echocardiogram with chemical stress test. It found a LVEF of 63%, after 2 years on ASV. It also gave me a heart condition, PVC.

LVEF = left ventricle ejection fraction
PVC = preliminary ventricular contraction

[Sleeprider]

If you need reading material to fall asleep better, I am working on a Wiki dealing with the health warning from SERVE-HF and the updated ADVENT-HF study that has not shown an increased health risk from use of ASV. http://www.apneaboard.com/wiki/index.php...nd_Summary All wiki editors are invited to contribute.