Help with Oscar data newly diagnosed 55 AHI

[Gideon]

SleepRider stated that you are heading toward getting an ASV and I agree.  Here is a Wiki article about medically justifying it.
http://www.apneaboard.com/wiki/index.php...P_Machines

Get a collection of the No EPR charts and show them to your doctor.  I would make an appointment and sat that your current therapy is failing badly and you need to discuss a new strategy.

You are successfully treating essentially all your obstructive events, and at the same time significantly failing to resolve your central apnea.

The one thing you can try is the EERS therapy, where you alter your mask to re-breath a bit more CO2.

[mmcf]

Again, I'm grateful for the guidance and support.

No known heart problems and no symptoms to warrant testing beyond a standard pre-op EKG a couple years ago which was negative. I did see central apnea can be due to CHF. Yikes! 

Sounds like I'd best make an appointment soon with my FP doc taking a collection of No EPR charts to justify a referral for an in-lab sleep study.  I'll also start trying to find someone with experience in complex or central apnea... living in a semi-rural area wish me luck on that one (ask the DME?)

SarcasticDave94's advice to "minimizing the pressure variations on your current machine" seems to be reiterated by Sleeprider's "settings to 5.0 minimum and 7.0 maximum pressure" so I'll try that tonight.

Fortunately I am insured. The Wiki bonjour referenced will be helpful as I know all too well the hurdles and delays they'll throw out.

BTW, EERS therapy sounds god-awful especially with my claustrophobia. 

Thank you!

[Gideon]

EERS should be no more claustrophobic than the mask you choose to modify.

[Sleeprider]

The vast majority of our members using ASV have idiopathic complex apnea, with a few having opioid related centrals due to a pain regimen. All that means is that many people can develop treatment emergent central apnea, or have complex apnea with unknown causes, not related to CHF. Since your profile indicates you are female, and perhaps a smaller individual (as opposed to overweight), you actually meet a common profile we see. You don't fit the usual physical prototype of a person with obstructive sleep apnea, yet you have moderate or severe sleep apnea that manifests as centrals on CPAP. You're not alone. If you share a general geographic location, we can try to direct you to resources, but there is no obligation to do so.

[SarcasticDave94]

Best wishes on success. If there's any assist I can give regarding ASV, I'll be glad to help, pass on experience, etc.

[mmcf]

To all - your time and attention is a testament to the good in people. Thank you.

Yes, I am a smaller individual and it's somehow comforting to hear I meet a common profile.

I live on the Central Coast of California between Santa Cruz and Monterey. Any recommendations would be appreciated...  

My claustrophobia manifests with extreme anxiety and a sense of suffocation. I'm doing better with the nasal pillows than I anticipated but still struggle some with the CO2 re-breathing I'm getting now. 
bonjour - sure hope you're right if I end up needing EERS... thanks for the reassurance.

[mmcf]

Disappointing sleep on several levels.
I woke up after 6+ hours to find the mask & hose next to me... guess I was so tired I forgot to put it on. After being up about 15 minutes I realized I felt so awful and tired I was willing to blow off (pun unintended) morning obligations and try to get the 4 hours credit for insurance compliance.
I went back to bed but unfortunately my 4 hours on the machine gave me only 3.98 hours credit so I lost a day of compliance.  The other .02 hours shows up as today instead.

Even worse is the 41 AHI. I'd set the minimum pressure to 5 and maximum to 7 per my understanding of advice given.

Unless someone advises differently I'll try again tonight with the same pressures.

   

[Sleeprider]

The sooner you inform your doctor that you have severe central apnea at 41/hour, the sooner he can start arranging for a bilevel ASV titration trial. CPAP is not your answer.

Let's try 5 minimum 5 maximum or CPAP mode at 5.0.

[Sleeprider]

If you are looking for ASV out of pocket to resolve this problem immediately you may want to consider:
Resmed Aircurve 10 ASV bipap $700 on Craigslist in Orange County (Garden Grove), CA.

This is pretty rare and about 1/2 price compared to Supplier #2.

[mmcf]

Primary questions:
Is the Resmed S10 AirCurve ASV w/ Heated Humidifier one of the machines being recommended for me?
(without other words or acronyms in the name)

Has anyone ever complained about a chemical sensitivity type reaction to the plastics used that we're breathing through especially the hose? (fever, headache, nasal congestion... I can still smell the hose 8 hours later)
_______

Last night  I had the usual centrals and CSR but at least thankfully back down to 17.9 AHI  And some large leaks (I know they effect AHI data.)

I awakened early on in a panic feeling air starved. I turned up the max pressure to 8 from 7 probably sometime during the first large leak that lasted 15 min. it seemed to help me feel like I was getting adequate airflow to calm the anxiety The 3 later short leak spikes were likely my messing with the nasal pillows after awakening again feeling air starved but less so without the panic because I could feel some air coming in. I'm uncertain whether my sense of air starvation is the result of apnea or the mask moving out of position from the P!0 band stretching with use?

I'll try Sleeprider's recommendation of 5 min 5 max tonight. And try not to turn it up again.

After a phone call my FP MD sent me a referral for a consult and in-lab sleep study. Now I'm on day 2 of waiting for a call back from an accredited sleep clinic 20 miles from home with 4 board certified sleep physicians on staff and good Google & Yelp reviews. Haven't been able to reach a live person though... not a good start.

re: the suggestion to go out of pocket is something I've been strongly considering. I'm a bit too OCDish about used from a private party. So I've looked at Supplier #2s listings and want to confirm the Resmed S10 AirCurve ASV w/ Heated Humidifier is what is being recommended here? 

I retired early 18 months ago mostly due to brain fog so money is tight but I'm at the end of my rope physically and emotionally. 

As always, I'm grateful to each of you.