OSA vs CSA

[mvyvoda]

Hello - new here. I have looked at symptoms for both types of the two commons apnea categories and fully understand the technical definitions of both. Can you highlight the differences in the two? I get the similarities. I am trying to understand a diagnosis. 

Thank you,
Mark

[SarcasticDave94]

Welcome to Apnea Board,

Obstructive is based on physical blockage of the airway while Central does not have a physical blockage such as throat collapse. Central Apnea are typically flagged as Clear Airway on PAP machines because again no blockage just not breathing, which itself is typically due to too little carbon dioxide in the bloodstream to trigger a breath.

If one is given a diagnosis of Obstructive Apnea, then the best answer to address this is likely a CPAP or Auto CPAP/APAP or some that need higher pressures then a Bilevel/BPAP. A relative few have other needs like CA, and if CA is the true diagnosis, the best answer there would be is ASV as it is Bilevel and pressure support with a backup rate. For an ASV to be medically needed, the sleep study would show 50% or more of the events as central or mixed.

PS if you have your sleep study report, you can post redacted detailed reports here. You should get this even if it's just for your personal health file. And once you get your PAP, use OSCAR to create reports on usage. And best answer on machine brand is ResMed; most users respond better to the therapy and it tends to be more comfortable. If you need CPAP, consider the ResMed AutoSet, BPAP consider VAuto, and even for ASV and CA, ResMed is better.

[mvyvoda]

If one is given a diagnosis of Obstructive Apnea, then the best answer to address this is likely a CPAP or Auto CPAP/APAP or some that need higher pressures then a Bilevel/BPAP.

And best answer on machine brand is ResMed; most users respond better to the therapy and it tends to be more comfortable. If you need CPAP, consider the ResMed AutoSet, BPAP consider VAuto, and even for ASV and CA, ResMed is better.

Extremely helpful. I have OSA and will be purchasing ResMed as you suggest. I am self-diagnosing and do not hold anyone on this forum liable and also understand this is not the recommended or wise way to go about this procedure. That being said, can you highlight when one would need a BPAP vs CPAP? 

I am looking at Airsense 10 Autoset or AirCurve 10 VAuto. Why would I choose one over the other?

Thank you Dave!

[Gideon]

Welcome to AB

OSA results from physical restriction of the airway.  CPAP air splints the airway open at what is actually very low air pressure

CSA results from no effort to breathe.  Causes include drugs (narcotic pain meds), brain injury, stroke, seizures, other, and the more common not enough CO2 in the blood (this is the number 1 driver for our breathing.)

You have a choice of machine within a machine class, the classes are

1. CPAP, applies a single "fixed" pressure, or varies this single pressure based on need (Autp CPAP).  Used for OSA.  Our Preference is for the ResMed AirSense 10 AutoSet or the AutoSet for Her which has an extra mode that you may or may not use.
   
2. BiLevel/BiPAP, applies two fixed pressures, one for inhale and one for exhale. Also used for OSA, but for the more difficult cases, used when user 'fails' with CPAP (above)
   
3. BiLevel with Timed backup.  These initiate a breath for you and are designed to manage COPD and other breathing disorders.  You do not want one of these.
   
4. ASV, Technically a BiLevel with Backup but with an algorithm that is designed to treat Central or complex (a combination of OSA and CSA) Apnea.  The only machine that actually is designed to treat CSA
   
5. NIV, non-invasive, and invasive ventilators.  These are machines used in hospitals and rarely in-home settings for Covid and serious breathing issues.  You will not be getting one of these
   

Very likely you will be told that THIS is the machine that you will be getting and you have NO choice.  You have a choice and it is important.  Here at AB we mostly prefer the ResMed brand for one and only one reason.  Users with ResMed machines typically get better therapy than other brands.  There are many reasons for this.  That said we occasionally find a user that nails their therapy with a PR machine.  That said we generally prefer the ResMed machines because they provide more options via their implemented algorithms whichresult in better therapy.

[Gideon]

The reason we recommend the ResMed AirSense 10 AutoSet (Auto CPAP) is that ResMed's implementation of EPR allows the equivalent of 0, 1, 2, 3 cmw of pressure support. A BiLevel allows anything from zero to quite high pressure support. Pressure Support is simply the difference between inhale and exhale pressures. Pressure support is the best method of treating hypopnea, flow limits, RERAs, UARS. for many the PS of 3 achievable on the AutoSet is sufficient.

[mvyvoda]

Thank you everyone for the help. I am excited to be a part of your community. Additionally, I will be following up with request for guidance. Hopefully when I am educated with experience I will be able to pay that forward. xoxo

[SarcasticDave94]

Agreed with Gideon on the machine reasoning. It's the correct method to determine machine need. And believe me, YOU are the one to decide brand. Do not ask, tell them you want ResMed AutoSet unless other higher level machine is found necessary. Even so, the brand is ResMed. Get doc onboard and choose DME/supplier by whether or not they will issue ResMed. If they say Respironics are the same, then go elsewhere, because they are both PAPs but they are not identical to ResMed. We've seen the difference in the OSCAR charts. You ask, we answer. Much like Radio Shack but more entertaining and with coffee.