Central sleep apnea periodic breathing

[vsheline]

But that can add up to a lot of pressure (25 cmH2O in my machine, up to 30 in others), and sometimes high pressure can cause problems in addition to leaks. Problems like an excessive amount of central events, or aerophagia (excessive air swallowing), or pressure on inner ear causing tinnitus or vertigo or loss of hearing, or can worsen eye pressure, or if the lungs are damaged in an accident or are diseased and develop a hole pressure can dangerously worsen pneumothorax (air buildup inside the chest cavity). Sometimes best to use as little pressure as needed.

...

Underlined area, above- a concern of mine. ...

I do have a somewhat large bullae on my lung (unchanged according to second CT), but was told by pulmonologist not to worry about his suggested increase in pressure. He also was curious as why I had been prescribed auto, commenting that CPAP would have been prescribed by him.
...
In any event, he spent a couple of minutes with me, looked at titration table, recommended increase to 9-15cm, due to REM showing at 9 but did not comment nor was asked about the sats at 9, because at that time I did not know 'diddly' about it.

I prefer CPAP to APAP for various reasons.

But in light of your post I am a bit concerned about the effect on my lungs in light of the bullae there. One doctor said, without reference to any discussion of xPAP, that I may be subject to pneumothorax at some time and it would have to be addressed immediately and to call 911.

Ted, the CPAP therapy will not cause a lung to pop a hole - blowing up a balloon usually requires much more pressure than your CPAP therapy, and common coughing can produce way more pressure than a CPAP machine can produce.

But if, from an accident or cough or whatever, if one of the bullae do develop a hole, then typically the hole acts as a one-way value, letting air leak into the chest cavity but not exit, and the slow buildup of pressure in the chest cavity will slowly collapse one or both of the lungs, possibly leading to death. So if you ever suspect a pneumothorax is starting, you will need to call 911 immediately to summon an ambulance. Preferably, have someone else do it, so you won't have to talk much. And do not use CPAP therapy again until your lungs have healed and your doctor says it is safe to return to CPAP therapy.

[richb]

... Doc has suggested re-titration with a focus on CAs and periodic breathing but a date will not be available for a month.

Is that all your doc said? If so, I am beginning to wonder if doc is a board-certified sleep doctor. You've never answered that question as I can recall.

This is what he has:
Board Certifications

American Board of Internal Medicine/ Subcertification Sleep Medicine
I think you can get the "sub certification" in 12 months.

[tedburnsIII]

... Doc has suggested re-titration with a focus on CAs and periodic breathing but a date will not be available for a month.

Is that all your doc said? If so, I am beginning to wonder if doc is a board-certified sleep doctor. You've never answered that question as I can recall.

This is what he has:
Board Certifications

American Board of Internal Medicine/ Subcertification Sleep Medicine
I think you can get the "sub certification" in 12 months.

Good that doc's certified in sub-specialty, rich!

Cheers,

[PaytonA]

Is that all your doc said? If so, I am beginning to wonder if doc is a board-certified sleep doctor. You've never answered that question as I can recall.

This is what he has:
Board Certifications

American Board of Internal Medicine/ Subcertification Sleep Medicine
I think you can get the "sub certification" in 12 months.

Good that doc's certified in sub-specialty, rich!

Cheers,

When it comes to doctors board certified in sleep medicine, that is all well and good but I see it kind of like AHI. It is not the whole story. Yes it is great that the doc has had the training but frankly I would just as soon have a doc who is intelligent and can put 2 and 2 together and come up with something other than 5 (maybe 3 ).

I appreciate a doc who can put things together and come up with a new idea and who listens and learns. It is also important to me that the doc has been seeing a good number of sleep disturbed patients for a reasonable length of time and maybe that he or she is a hosehead too and hopefully one that had to struggle with his/her therapy.

Best Regards,

PaytonA

[richb]

Doc wants to rule out a bad machine producing my CAs. I will be getting a loaner machine for a week or so. I already know that if the memory card is out of the machine for a night only a bare minimum of data can be saved. In fact when I left the card out one night the machine said I had an AHI under 5 since no CAs could be recorded. I have already used my machine for more than 30 days straight so I am in compliance insurance wise. My plan is to use my own memory card and create a new profile on Sleepyhead. I can then see how my CAs respond to lower pressure. I plan to change the machine back to Bi-Pap and use an EPAP of 5 and IPAP of 9 to start with. These are the starting numbers for my ramp up at current settings. Does anyone have any comments or suggestions?

[quiescence at last]

when you leave your card out, you get the exact same score, just not the highly detailed data. so, that night you really did have an AHI < 5.

QAL

ps. if you want another night under 5, just leave the card out. if you want a score under 2, lock your card, and then put it in. if you want an AHI < 0, put the card in backwards. ignore the horribly unfunny jokester

[richb]

[attachment=1578][attachment=1577][attachment=1577][quote='quiescence at last' pid='120917' dateline='1436410171']
when you leave your card out, you get the exact same score, just not the highly detailed data. so, that night you really did have an AHI < 5.

QAL

If only that were true. I left the card out for 2 nights in a row, Both reported AHIs under 5. No CAs. The next night with the card in I had an AHI of 38 all CAs.

Rich

[richb]

[quote='quiescence at last' pid='120917' dateline='1436410171']
when you leave your card out, you get the exact same score, just not the highly detailed data. so, that night you really did have an AHI < 5.

QAL

If only that were true. I left the card out for 2 nights in a row, Both reported AHIs under 5. No CAs. The next night with the card in I had an AHI of 38 all CAs.

Rich

Here is the typical night.

[quiescence at last]

and how did you feel after the nights that you did not have the card in.

Sleepyhead overview should show the same thing, and RESSCAN should as well. your report for one of the nights does show approx. 2 per hour CAs.

again again. yank that card out for a couple more nights.

QAL

[richb]

and how did you feel after the nights that you did not have the card in.

Sleepyhead overview should show the same thing, and RESSCAN should as well. your report for one of the nights does show approx. 2 per hour CAs.

again again. yank that card out for a couple more nights.

QAL

I didn't feel any different for the 2 nights that the card was out. I feel crappy most of the time and I have HBP in the AM. I think the machine needs the card to store the data while it is testing for CAs. This might be like quantum physics but in this case if you don't measure it it doesn't happen. If a tree falls in the woods when no one is there does it still make a sound?