RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(08-08-2020, 08:28 PM)Primalyogi Wrote: I can’t buy an ASV without a prescription I’m told; I checked that out when I bought the resmed (as I had a prescription in order to purchase the CPAP and asked if I could just get an ASV and was told that I could only get it by prescription)
That would certainly be true if you were buying it new from an in-country vendor. @Sleeprider pointed you to a US vendor of secondhand machines, who's likely to care less about those formalities across national borders.
But again, there are cardiac contraindications for ASV, so it may make sense to pursue that prescription. At least in the states, any doctor can write the prescription, so perhaps your GP could check your ejection fraction to confirm ASV is safe for you and then write you the prescription.
In the States, insurance would require a sleep study showing complex or central apnea before they'd pay for an ASV. I don't know how your medical system would handle that kind of approval, so you might be stuck with a sleep study unless you want to pay out of pocket.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
@SleepRider & other commenters, thank you, 
I think other people have said it best; I need a different machine but I need to convince a doctor that I need it in order to get it.
I have to wait until I get a new test done - when and if that occurs - I will update the thread once something happens - because as @Sleeprider has said; other than continuing to revere titrate (which is getting uncomfortable and I'm waking up a lot more at night) I need a more sensitive - lab test and I have to figure out how to get that done because I can't get a Bilevel or ASV without a prescription
My doctor isn't there yet because she needs her version of proof - <quote> the machines algorithm isn't reliable </ quote >
At least I have learnt a bit, if I am honest not enough to break the part of me that is giving up because its so hard to get help... but I will read the links provided to me, better my understanding and have studies to back me up when I say I am having central and a bad night sleep... hopefully I'll get the right kind of study and it works.
Wish me luck because... I have been waiting for 54 days for my test so far (since the referral was sent to the hospital) and I had been booked yet... anyway I have said it all before.
I'll let you know if something happens (I get a test booked or whatever) but at the moment I am just going to be as comfortable as I can and accept I am not going to get a good night sleep for a while.
08-08-2020, 10:10 PM
(This post was last modified: 08-08-2020, 10:14 PM by Primalyogi.)
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
I have recently had an echo-cardiogram and a stress test using an echocardiogram by a cardiologist and I had no issues reported issues other than I am very unfit and it my max at stage 3/5 in the test. But there is nothing wrong with my heart... my brain and nervous system... *shrugs* wouldn't surprise me
Thank you for clarifying the concept of in-country vs international; I didn't recognised that supplier was over seas, I only just checked the list.
Sorry i'm a little slow... which is pathetic for a high performing, high scoring, programmer who used to be a software development manager looking after some big brands in australia (Sydney Morning Herald) managing up to as many as 15 IT professionals - but I haven't worked for 6 years since I got sick - my mum died of ALS and dad due to heart disease both within 4 months in 2014. I have been unemployed since then. Anyway none of that is important.
and I have been bought both of my machines (Philips DreamStation and resmed Airsense) because they were both not covered by insurance and I am unemployed so my partner bought me the machines... to get a ASV or Bilevel and not have to pay 7000AUD you have to go through the public system which takes years to do.. that's what I am fighting... I could just buy it and try the overseas thing, but my partner won't go for it.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Anyway thank you for all for your help.
I think the take away is that - I don't know what I am doing - while we helped the numbers; my sleep quality is still really bad - and it seems I either have the settings wrong or need a different machine - because with the bad sleep quality I have, I would rather sleep on the couch than in bed with the machine - which is akin to killing yourself slowly...
So I need a lab test done as that's my only path to a different machine... and even then I am not sure I can afford it...
Any Australian's know a good sleep clinic in Sydney??
Feeling very defeated..
but still thank you everyone for taking to time to try and help, not many people have done that for me in my life and I really appreciate it.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
About mid-December, you experienced an increase in CA that continued to presence. Be sure to look back at your settings history and see what changed. An option that is much less expensive than ASV has been successfully used by several members to reduce CA, increase tidal volume and minute vent to relieve onset of therapy induce central apnea. Have we ever discussed the used of enhanced expiratory rebreathing space (EERS)?
08-09-2020, 08:07 AM
(This post was last modified: 08-09-2020, 08:35 AM by Primalyogi.)
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
What changed is I went from a 2014 rental machine to a new 2019 machine; settings were the same because that was before I started changing things.
You mentioned EERS but in passing...
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Read the EERS wiki and let me know if you want to pursue this approach http://www.apneaboard.com/wiki/index.php/Wiki_Home It's not particularly difficult and it is an inexpensive, low-risk potential solution.
08-09-2020, 09:58 PM
(This post was last modified: 08-09-2020, 10:24 PM by Primalyogi.)
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(08-09-2020, 08:19 AM)Sleeprider Wrote: Read the EERS wiki and let me know if you want to pursue this approach http://www.apneaboard.com/wiki/index.php/Wiki_Home It's not particularly difficult and it is an inexpensive, low-risk potential solution.
Thinking about EERs; I have a question.
Am I right in assuming that the the Dreamwear Full Face mask and the F30i mask, (both with a vent at the top of the head that makes up the largest exhaust valve) have more dead space which would maintain additional CO2 compared to say my normal mask which is the F30?
I have about 8 masks, but this was something I noticed one night, I started the night with the dreamwear full face mask, I woke up in the morning, went to get up and took the mask off; but I realised what time it was and wanted to go back to sleep, as its harder to put DW back on than the F30, I grabbed the F30 and quickly slid it on to ensure that I didn't wake my partner - for the rest of the night.
Below is what I experienced :
Whole Night
[attachment=25451]
Dreamwear Full Face Mask (on a Dreamstation, 8-19 pressure, A-Flex)
[attachment=25452]
Exactly the same settings however the F30 mask instead of the Dreeamwear mask,
[attachment=25453]
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Hi Primalyogi,
Clearly the full face mask vs the smaller volume mask is significant, and I can't imagine WHY there is so much difference though. As we breathe when we're awake, we do rebreathe some CO2. So maybe the full face mask more closely mimics or emulates how we breathe without the benefit of the CPAP.
I've been following the thread with great interest, I'm a newbee though, sorry I can't be of more help.
I am curious though.....whether the cause of your issues is not treatable with a CPAP though? In other words, do you have other health related issues that could be at the root cause of your breathing anomalies during your sleep?
The non CPAP issues/causes are much more complicated and more difficult to understand. For instance, have you had your night time Cortisol/Adrenaline checked? Both are serious sleep disruptors that might be caused by other health related issues.
Do you eat before bed? This is a serious disruptor of the Circadian Rhythm, which is your body's clock. However, the Circadian Rhythm is far more important as it controls healing during sleep of quite a few systems in the body. In other words, sleep isn't the only function that the Circadian Rhythm influences. Snacking before bed is a 100 percent guarantee that I will not wake up feeling rested, even just a few bites from an apple destroys my sleep!
There are many Sleep 101 precautions that you might need to follow. Most likely you already follow them as you've been around for awhile and you're likely to be aware of them. The human is a creature of habits after all!
Have you had your CRP (C-Reactive Protein) checked? There are other blood tests that might yield useful and enlightening information although they aren't totally definitive by themselves.
Stress/depression from life situations, family issues or other causes?
Diet, especially Leaky Gut. Basic electrolyte imbalances? Does your body show signs of inflammation which might be caused by an unfavorable Omega 6 to Omega 3 ratio?
Digestion issues, which might be caused by weak stomach acid-our stomach acid gets much weaker as we age. The signs are there if you recognize them. And, you can evaluate this condition at home without a doctor's input. BTW, avoid PPI's (Proton Pump Inhibitors) like the plague, unless you absolutely need them, ditto antiacids! They do far more harm than good!
When we go to a sleep clinic or to our General Practitioner, most (if not all) are not aware of the sleep cycle physics and it's importantance. In fact, I don't believe a Sleep Specialist (that does interpretations of sleep studies) take into account anything other than the data retrieved during the sleep study. I might be wrong-if so, please advise.
Regards,
AB
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(08-09-2020, 09:58 PM)Primalyogi Wrote: I grabbed the F30 and quickly slid it on to ensure that I didn't wake my partner - for the rest of the night.
Definitely looks like way more variable breathing and CA's with the F30 compared to the Dreamwear Full Face mask.
F30 has 34 vent holes in the mask host connector, F30i has 25 vent holes in the cushion and an additional 14 at the top of the head (have both of these). Don't have one, but it looks as if the Dreamware has 17 in the cushion and 16 at the top. Assuming these are similar gauge (hard to tell) you would likely re-breathe more expired air with the Dreamware.
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