[Treatment] 40+ AHI WITH cpap, feeling hopeless

[Bobblan]

Hello all, I am bumping my thread for some new information.


It is regarding Oscar.

I've been extremely tired recently and I've been trying to figure out why, despite 10+ hours of sleep per night, im exhausted and it feels like
I've barely slept and I dont know why.

Im currently on Bipap treatment, and it has been going pretty ok for a long time, but recently I'm exhausted every day, despite ahi ranging from 2-8
(thats low for my standards)

I took a look at my Oscar data and it seems ok, but it doesnt show any central apneas for some reason?

My current machine is A S9 Lumis VPAP 100 ST-A, the reason I got on this from my doctor is because I had absurdly high numbers of central events.

Now that I look at Oscar, I cannot seem to find any central apneas? like the category isnt even there, does anyone know why?

I'm not very good at oscar but im just curious if im on the wrong treatment, or maybe that this machine cant register Centrals, and thats why im so tired?

Attached a picture of what I meant, I cant see a "central" category.

Thank you in advance.

[Jay51]

The "UA's" are most likely central apneas (this is how your machine report them - I have an s9 adapt asv and it does the same thing).  

The only way to get central apneas with either ST or ASV is if the pressure support is too low to trigger a breath.  This may be your case. 

I had the same scenario happen to me.  By using positional apnea techniques, it stopped both the Hypopneas (H's) and UA's.  

Lower pillow height, possibly side sleeping instead of back sleeping (with anything between your chin and chest to stop chin tucking), or using a soft cervical collar.  

• Positional apnea
  

[Sleeprider]

The problem is you are using a Lumis ST-A instead of what you need which is an ASV device. Adaptive servo ventilation would provide pressure support to normalize respiration volume and rate as needed and when needed. The ST-A is simply a fixed bilevel with a timed backup rate that is normally used for people with pulmonary diseases and airway resistance like COPD. There is no doubt in my mind, you have primarily central sleep apnea and are using the wrong device. Compare the intended use for ASV (page 27) with the intended use for iVAPS or ST. You need a more intelligent device designed to treat central sleep apnea. https://document.resmed.com/en-us/docume...er_eng.pdf

We get too many members on this forum that are prescribed the ST machine when they need ASV. They are not the same. The ASV works on each breath to correct respiratory rate and volume. The ST-A works in fixed pressure mode the way yours is setup, or in ST-A mode it works over the course of several breaths to correct respiratory volume. Start by reading the titration guide so you understand better what you have and what you need, then let's talk some more about getting your doctor and you onto the right path.

[Bobblan]

The problem is  you are using a Lumis ST-A instead of what you need which is an ASV device.  Adaptive servo ventilation would provide pressure support to normalize respiration volume and rate as needed and when needed.  The ST-A is simply a fixed bilevel with a timed backup rate that is normally used for people with pulmonary diseases and airway resistance like COPD.  There is no doubt in my mind, you have primarily central sleep apnea and are using the wrong device. Compare the intended use for ASV (page 27) with the intended use for iVAPS or ST.  You need a more intelligent device designed to treat central sleep apnea. https://document.resmed.com/en-us/docume...er_eng.pdf

We get too many members on this forum that are prescribed the ST machine when they need ASV. They are not the same. The ASV works on each breath to correct respiratory rate and volume. The ST-A works in fixed pressure mode the way yours is setup, or in ST-A mode it works over the course of several breaths to correct respiratory volume.  Start by reading the titration guide so you understand better what you have and what  you need, then let's talk some more about getting your doctor and you onto the right path.

I get what you're saying, and I absolutley agree that I should need an ASV.

However my Ahi average monthly is around 4.2 ~ which imo is good enough, obviously this could be way improved with an ASV.

I am currently under a certain clinic that doesnt have the funds or outright refuses my attempt at getting an ASV. "absolutley not, those are for very rare cases" is what I got told when I asked about it, however, there is hope, there are certain other clinics in my town that specialises in Sleep apnea, that I've been thinking of trying. The only issue is that currently i'm so tired and need so many hours of sleep that i tend to forget/dismiss doing important stuff and putting it off onto later, which doesnt help.

I'm trying to understand my condition better, but Oscar seems intimidating to learn and i just get frustrated
But I'm going to read what you linked, and try to get a better idea of my condition.

Thank you very much for the reply,

---

The "UA's" are most likely central apneas (this is how your machine report them - I have an s9 adapt asv and it does the same thing).  

The only way to get central apneas with either ST or ASV is if the pressure support is too low to trigger a breath.  This may be your case. 

I had the same scenario happen to me.  By using positional apnea techniques, it stopped both the Hypopneas (H's) and UA's.  

Lower pillow height, possibly side sleeping instead of back sleeping (with anything between your chin and chest to stop chin tucking), or using a soft cervical collar.  

• Positional apnea
  

Ah okay, I was worried that this machine didnt even recognize them, but if thats the case, thats good news.

Then I dont have to think about centrals being missed.

I usually sleep with a very high pillow and to the right side of the bed.

Going to test using a lower pillow height for the night, thank you for the suggestions