[Equipment] Central sleep apnea - titration study didn't work

[blossom]

Hi there, 
New member of the forum here, writing for my husband. He has had sleep issues his whole life, but only recently did he have an overnight sleep study, where he was diagnosed with (mild) central sleep apnea. He then was scheduled for a follow-up titration study, but it didn't work out - he said he tried both CPAP and BiPAP there, both between 4 and 8 CWP (as low as it could go), for about 10 minutes each, and he still thought the pressure was too high, and he felt like he was suffocating and lightheaded. (the CPAP felt worse than the BiPAP, but both were still unbearable).
He will next follow up with his doctor, but at this point we are both at a loss and feeling very disillusioned - we'd had our hopes up for this. Is there an adjustment period for every user? Does the machine (either CPAP or BiPAP) feel uncomfortable at first, before it gets better? Is there anyone here with central sleep apnea who can provide any feedback, advice, equipment advice (which intervention has worked for you?), or point to any resources for CSA?
Thank you very much in advance.

[SarcasticDave94]

It sounds like you're going to be dealing with the less common Central Apnea. Regardless, request the detailed reports, both diagnostic sleep study and Titration, from the doctor that ordered the tests.

You may post them redacted of your personal info here. Attach them to a post after probably scanning them into you PC. We can help with the diagnosis and the best answer for a machine.

You're in the US, so HIPAA law gives you the right to request and receive these detailed reports. Doctor cannot legally refuse, but they can charge administrative fees. Most will not charge this though. If the doctor refuses to provide, report them to your local or regional medical board.

If it's CA as a predominant status, meaning CA shows at 50% + on the diagnostic, then an ASV is best. It's the one that can treat CA, CA equals Central Apnea. The other machines like CPAP and bilevel without breath backup ratescan avoid some, but will not treat.

He might need to use CPAP and fail for insurance purposes. Repeat fail on bilevel without backup rate, such as ResMed VAuto. They'll try to force an ST machine and there's where I'd suggest refusing and demanding ASV. This scenario is if ASV is the right answer.

They might attempt another Titration with ASV. There's likely going to be an imaging echocardiogram to test the heart for the left ventricle ejection fraction, which needs to be 45% or better to pass.

If the ASV is needed, I'll recommend the ResMed AirCurve 10 ASV, which I myself had for a few years. It's about as easy to get used to as the others. You can edit settings yourself, basically self Titration over as much time as you wish or need.