EPR, Central Apnea, and Aerophagia

[rpierce]

Thanks. Any thoughts on the hip pain issue? The better I sleep, the less I wake, the more I’m in the same position…

[Sleeprider]

Ibuprofen or Advil. I'm knocking on 70 and have dealt with a few things on bursa pain. It's inflammatory and that is what you have to beat.

[stevew77]

I had been trying to get an ASV to treat my central apneas and CSR. Lincare got me one but then wanted to take it back because Medicare reversed their approval since my sleep study did not show at least 50% centrals. Lincare knew I had CSR but did not think it would help. My sleep tech contact at the sleep clinic talked to her contact at Apria who had another patient in a similar situation who also had CSR. My doctor wrote a new prescription for an ASV noting that I had CSR. I got a new ASV from Apria within two days!

[rpierce]

How did it work for you? What are your central index and AHI looking like now that you’ve got ASV?

I’m at well over 50% centrals. But I’m now running into a problem where much of the time I’m in the AHI 5-10 range, but will randomly drop below 5. So I’m questioning whether I will run into trouble getting this approved.

[SarcasticDave94]

Practice complaining your lil heart out. Even if the CPAP therapy is helpful, you do not want to tell them anything positive about it. Emphasis is on all the negative and failings. This is not telling you to lie, just an emphasis on negatives.

[stevew77]

I'm assuming you are using a ResMed apap. I found that when I had a Resmed AirSense 10 Autoset my AHI was almost always lower when I had EPR set to 1, vs. 2 or 3. I could not tell much difference with comfort unless I turned EPR off, and then I felt I had to work to breathe out completely. I suspect my tidal volume was lower as well. I have an ASV now and have Pressure support set for 3 to 15, but that is on an ASV and not an AirSense. I suspect the breathing profiles are much different.

[stevew77]

rpierce, not sure your referring to me, but ASV does not list central apneas, for one of several reasons, including because it takes care of them before they usually happen. I love my ASV, and unless you have even more issues, such as COPD and other breathing issues that require an iVAPS, ASV works wonders. It does not always treat all obstructive apneas perfectly, (what does?) but it minimizes them and mostly eliminates central apneas. My SpO2 has never been higher and more consistent while sleeping. If you can get an ASV, go for it if you can. Just make sure you breathe regularly and what is comfortable for you, because it will adapt to your respiratory rate when you are falling to sleep, and during the night as well. ASV works great for me. And it might even work better for some with obstructive apneas because it apparently gets in front of them, and even if your insurance does not cover it, but you can pay for it. Some do just that.

[SarcasticDave94]

Yep exactly. My ASV therapy was fine until emphysema based COPD got somewhat worse, affecting breath timing. ASV Auto was the way to go for me when it worked. The biggest flaw in the ASV from ResMed is they don't allow manual control of the trigger and cycle. There was no way to sync the ASV to my breath timing because of that. The ResMed 10 AirCurve ST-A that I tried worked and felt almost exactly like my ASV Auto, just with a static EPAP and the addition of those manual timing continue.

[stevew77]

ASV should track your breathing when you fall asleep, and during the night. But if ST-A works better for you, go for it!

[stevew77]

My ASV is wonderful. I suspect you will get it approved if you are above 50% centrals. After all, you are already using an apap. Go for it!