[Diagnosis] Alarming results, help needed

[Crimson Nape]

Your study was 5 years ago and up until 6 months ago, your data seemed acceptable. At this 6 month point, things started to change and you started having significant CAs. A CA is when your brain doesn't signal your body to breathe. You will probably need another sleep/titration study to determine the best device for your therapy. I recommend printing out this daily screen and present it to your doctor, to help support your claim.

Also, you may wish to delete the sleep study results you posted, then block out your name and particulars and repost it.

- Red

[pholynyk]

Regarding your AirCurve vAuto; it is not an ASV. There are at lease five models in the AirCurve 10 lineup. They are the vAuto, S, ST, ST-A, and ASV.
The S is a fixed bi-level; the ST adds a timed backup breath rate. The vAuto is an auto-adjusting bi-level.
The ST-A is a bi-level with assured minute ventilation, and the ASV is the Auto Servo Ventilator.

I am not familiar with the ST-A and the ASV.

[Sleeprider]

CasualBribery, you are now presenting with severe central apnea that may be induced by the bilevel therapy. I suspect that, although your sleep study diangostic called out mild obstructive sleep apnea with an AHI of only 8.0 with frequent awakenings, you may actually have a tendency to idiopathic central sleep apnea and issues with respiratory drive hat appeared to the technician to be obstructive or flow resistant. This severe central sleep apnea with your current settings on your Vauto of pressure 5.8 to 7.8 with zero pressure support shows that even without pressure support your apnea is far higher than the test condition. I have a proposal for one more night to attempt therapy before I refer you back to your doctor to find a pathway to ASV. Set your Vauto to Vauto mode, EPAP min 4.0, Max pressure 6.0, PS 2.0 and trigger sensitivity Very-High. Please show those results tomorrow.

If these results continue, I will recommend discontinuing therapy and discussing the matter of ASV titration with your doctor. Based on the diagnostic test, you are better-off without PAP therapy until the right therapy can be prescribed. You actually don't need a titration to start ASV as the default settings for treating central apnea are fully automatic and all you need is the machine. Try to move your appointment time forward as you have failed CPAP and bilevel unless something remarkable happens.

The answer to your question regarding the Aircurve 10 is there are four models of Aircurve bilevel machines. The VPAP-S, Vauto, ST / /ST-A and ASV. Each has its own purpose and intended therapy application. Only the ASV is intended for central and complex apnea which is your apparent issue. ASV works by using a backup pressure support to provide additional pressure to your airway to cause a breath when you don't spontaneously breath at the rate or volume that is targeted. Your Vauto requires spontaneous respiration or it will not switch to IPAP (inhale pressures) and it does not have adaptive pressure support capability. You will require ASV or supplemental oxygen and no PAP therapy.

Sorry I didn't see this thread until now. Please feel free to ask any questions, and you might want to read the Resmed Clinical Titration Guide to understand better how titrations are performed and how the CPAP, Aircurve VPAP and Aircurve ASV work differently. https://document.resmed.com/en-us/docume...er_eng.pdf

[Sleeprider]

Just a quick addition. Request a copy of your detailed diagnostic and titration study. With a titrated CPAP pressure of 4.0 I suspect you immediately displayed CA when pressure was increased. I don't think your results will be a surprise to your medical team other than they are quite severe. In my opinion, they prescribed the Vauto instead of CPAP in anticipation you would be back with this problem; however your Vauto will not resolve this.