I regress!

[Lambsydoats]

Do these graphs tell you anything helpful?

The time period is for the month of January.

Lamb

[vsheline]

One thing I don't understand is why my healthcare provider (the PA--I am not allowed to schedule an appointment with the MD) isn't as concerned about centrals as he is about obstructives. As you know if you've read many of my posts, I'm more concerned about the CAs, considering it's unknown what's causing them. Could be nothing, but unless someone helps figure that out, how will we know?

On Thursday, the medical assistant said the PA reluctantly agreed to lower the pressure to 8 (from 9) to see if it helps the CAs without wreaking havoc on the OAs.

Hi Lamb,

An average of 2 or 3 Central Apneas per hour of sleep is not considered anything to worry about. (However, if I were taking medications which depress respiration like opiates, I would definitely want to have an ASV machine capable of keeping me ventilated if I were to stop breathing, even if my normal CAI when on pain meds was only 2 or 3, in case I might ever mistakenly take too much.)

More than 5 CA events per hour of sleep is usually considered as warranting treatment. However, I may be more concerned about having 2 or 3 Obstructive Apneas per hour of sleep if the obstructive apneas were lasting a long time, such as 45 seconds or a minute each.

Some patients have no CA events during their "diagnostic" sleep study (when they are not being treated with CPAP) but exhibit more than 5 CA events per hour of sleep after starting treatment. Usually, within a few weeks or months the number of CA events reduces as we become adjusted to sleeping under pressure, dropping below 5 per hour during sleep. This is one reason why doctors are sometimes not overly concerned about more than 5 CAs per hour with new patients.

But if the patient had a significant amount of CA events per hour in their diagnostic study (with no CPAP treatment) or if after a few weeks or months of CPAP therapy the patient is still having more than 5 CA events per hour, then, in my view, the doctor should prescribe an ASV titration and an ASV machine.

Take care,
--- Vaughn

[Lambsydoats]

Vaughn,

Throughout January, I was rarely under 5 CA/hour (8/30), and almost never over 1 OA/hour (6/30--and then still never over 2).

During my non-CPAP sleep study, I had plenty of CAs (11/hour), and my OAs were at 18/hour.

My lowest O2 saturation was 79% during that non-CPAP study.

I don't feel in partnership about my healthcare AT ALL in this situation, with this physicians assistant. I am going to call the other hospital on Monday to talk with them about their process in working with patients. I thought my biggest stumbling block would be the DME, and I got the cream of the crop there.

Thank you again for your help!

Lamb

[vsheline]

Throughout January, I was rarely under 5 CA/hour (8/30), and almost never over 1 OA/hour (6/30--and then still never over 2).

During my non-CPAP sleep study, I had plenty of CAs (11/hour), and my OAs were at 18/hour.

I suggest asking for an ASV titration and an ASV machine. If you are still suffering excessive daytime sleepiness, be sure to emphasize that.

Since you were having CAs (11/hr) before you were using CPAP, lowering the CPAP pressure is unlikely to help.

If your doctor is not being responsive, perhaps you can change doctors.

Good luck,
--- Vaughn

[vsheline]

Lamb,

I think the doctor should not be satisfied with your AHI statistics.

It may be helpful to use ResScan to print out three or four full reports for nights showing large AHI, and ask that your doctor do whatever will be needed by your insurance for approval of an ASV machine.

The AirSense 10 AutoSet For Her could become your backup machine, and the AirCurve 10 ASV would be able to share common parts like power supply, heated hose and filters.