[Equipment] Central Apnea

[gbbarrie]

I have been using a Resmed Aircurve 10 ST A since Jan 9 2020 after a sleep test and complaining that I was having problems using a c-pap machine - I used to wake gasping for air and pulling my mask off, they decided to change me to a bi-pap machine and that did away with the waking short of breath but my AHI has not really changed that much and I am always tired during the day I honestly feel better when I am not using the machine but I was told to persevere  with it and I am. My average AHI is 37 some nights are lower and some are in the 40`s . I would appreciate any feedback.

[Crimson Nape]

We could offer better help if you will post an OSCAR Daily screenshot (use F12 to take it) that is representative of an average night. Please make sure that you are using the latest release of OSCAR, which is 1.3.0. This version addresses some anomalies with your CPAP model.

[sawinglogz]

That's astonishingly high AHI on CPAP! It means your current settings aren't working for you. Did your doctor know the AHI when he/she told you simply to persevere?

[Sleeprider]

The ST-A is not the right machine for your central apnea. You should be using ASV which is a less expensive machine. Please read the Resmed Sleep Clinic Titration Guide https://document.resmed.com/en-us/docume...er_eng.pdf This document will tell you the intended purpose of each of the machines in the Resmed lineup. Let's compare ST-A (page 34) and ASV (page 28).

The ASV is intended to treat Central or mixed apneas, complex sleep apnea, and Periodic Breathing (PB)
The ST-A iVAPS or ST modes are intended to treat COPD, Restrictive thoracic or neuromuscular disease, pulmonary disorders, obesity hypoventilation syndrome and other respiratory conditions.

The Titration Guide will help you to understand and optimize your machine, but more importantly it demonstrates you have likely been prescribed the wrong device. If you do not have difficulty breathing an adequate volume of air due to pulmonary disease or the listed disorders, then you should have been put on ASV which works brilliantly on central and complex apnea patients. I think you are using ST mode on your ST-A and we can try to help you optimize those results, however you really should be complaining to your doctor to make a correct and recognized prescription for your specific problem. with the ST-A, you are the round peg being driven into a square hole.

[SarcasticDave94]

Yet another wrong machine for Centrals.

What's all the settings being used now? I've used ST-A a bit and we can get you maybe a bit better experience, but you need ASV.

[Ratchick]

What the others have said. ASV is specifically designed for centrals and I'm infuriated that any doctor would leave a patient with that level of events and not do something (says I, the person who just spent most of a year with those levels of apneas and higher while on CPAP waiting for ASV).

As others have said, post some charts to see if the more knowledgeable members who have had experience with BiPAP can at least try and make things a bit better for you. Also

[gbbarrie]

           

I have attached screen shots as requested hope this is what you wanted and hope this will give me something to discuss with my Dr.
My machine is a loan machine so I am not sure how happy they would be with me messing about with settings but they are approachable
so I might call them and discuss it with them but I think they are most likely to refer me back to my Dr.
Thanks for your input.

[Ratchick]

Goodness that looks like it feels awful...

I can see for myself that the machine is completely limited to a fixed pressure and it looks like you have the ramp on. Do you need that in order to get used to the higher pressures? If not, it's probably going to be suggested that you turn it off, because during that 20 minutes, you aren't at the full therapy pressure and if you are having events, the machine doesn't mark them.

Other than that, I'm going to leave those members familiar with the Resmed VPAPs to help with settings.

[Dormeo]

Do you have some way of knowing that these hypopneas are central in nature (rather than obstructive)? For example, did you have a bunch of central hypopneas flagged in your sleep study? Anything else you can tell us about how your doctor arrived at the diagnosis of central apnea?

[Dormeo]

p.s. I'm not questioning the diagnosis but trying to understand more about your current condition.