Mostly Centrals

[jaswilliams]

I think you need a different machine either a bilevel with a backup rate like a Resmed Vpap ST or an ASV machine

[zzzzk]

Unfortunately, central apnea is going to probably be worse with bilevel and higher pressure support. When central apnea events are persistent like this, the course of action is to either use bilevel with a backup rate (ASV or ST), simplify therapy to CPAP which may reduce the event rate, or possibly use EERS to increase rebreathing of CO2 as described in this thread. http://www.apneaboard.com/forums/Thread-...eep?page=2

I am a computer guy, so I understand tech.  I am not an apnea guy, though.  Could you please generally explain why a bilevel and higher pressures are worse for centrals?  Is a bi-level like my old a-flex or c-flex?  The new machine is easier to breath with, but the centrals have gone way up.  

I'm working on sending you a small 2 minute section as you requested.  

Thank you for your help.

[zzzzk]

Unfortunately, central apnea is going to probably be worse with bilevel and higher pressure support. When central apnea events are persistent like this, the course of action is to either use bilevel with a backup rate (ASV or ST), simplify therapy to CPAP which may reduce the event rate, or possibly use EERS to increase rebreathing of CO2 as described in this thread. http://www.apneaboard.com/forums/Thread-...eep?page=2

I am a computer guy, so I understand tech.  I am not an apnea guy, though.  Could you please generally explain why a bilevel and higher pressures are worse for centrals?  Is a bi-level like my old a-flex or c-flex?  The new machine is easier to breath with, but the centrals have gone way up.  

I'm working on sending you a small 2 minute section as you requested.  

Thank you for your help.

Here is a 2 minute (about) sample you asked for.  Thank you for your help.

[zzzzk]

Hello, here is last night at ps1, does not seem to be improving... Recommendations? 

Thank you

[zzzzk]

Hello, here is last night at ps1, does not seem to be improving... Recommendations? 

Thank you

I will try 0 tonight. Does that mean it will just be an auto between two levels? 

Also, I attached my old data from my old machine. I could never get used to it because the sessions never got very long at all. I felt worse. However, the ahi's appear to be less. Does this help in analysis? Pressures? Thank you.

[Sleeprider]

Where do you stand with your doctor in terms of these CA events? Is he aware and what is his feedback. I'm thinking you are getting close to making a case for ASV.

[zzzzk]

Where do you stand with your doctor in terms of these CA events? Is he aware and what is his feedback.  I'm thinking you are getting close to making a case for ASV.

My insurance is not the best.  Doctor way too busy.  Response times can be weeks, that is why I'm asking on this forum for more opinions.  

Is there an asv machine you recommend?  Mask?  The resmed f10 is the only mask that seems to be working for me ok.

I'm trying to get time with the dr.  Thank you for your help.

[Sleeprider]

Either the Resmed Aircurve 10 ASV or Resmed S9 VPAP Adapt (older model) will work well. Supplier #2 is currently getting $1795 for a low-hour Aircurve 10 ASV, and $1049 for the VPAP Adapt 36007, and 1249 for the Adapt 36037.  The 36037 and Aircurve have auto-adjusting EPAP pressure and are more modern machines. Any of these would treat central apena effectively using your current mask.  It looks like your ASV settings should be ASVauto mode, EPAP 6.0 minimum, 9.0 maximum, PS 2.0 minimum, 15 maximum.  You will need a prescription unless you find a seller that does not require it.  The settings are based on your current use of the Aircurve 10 Vauto and recommended settings for ASV titration protocol (see below).  If you can get a prescription, and can afford the machine, it is your solution.  I just don't foresee you resolving the central apnea events at 20 per hour that you are experiencing with your current machine and anything other than ASV.

[zzzzk]

Ok, thank you. I will look into those models.  

I thought I'd post some old data for you to see from my old machine.  Maybe will give some more insight.  I was never able to get the ahi down less than 15 regularly and I was not able to sleep consistently all night, nor more than 1-2 hours at a time, so I gave up.  With the new machine, I can use it all night, but same problem, 1-2 hours at a time and the centrals went way up.  Attached are old data from my old remstar auto a-flex 550P

Thank you for your help

[zzzzk]

Ok, ps 0, better but not enough?