Resmed Aircurve 10 ASV: Central Apnea Not Relieved

[RVSleeper]

OK, thanks. Yes, the rate briefly touches zero at about 12:32. That's the only such point. There are many more such points on my worst nights though. Thanks for pointing it out. I think this is what other users have called, "Positional apnea," although I don't know what makes it different from obstructive apnea, except the BIPAP device doesn't seem to prevent it.

[RVSleeper]

Now that I'm aware that respiration rate is dropping to zero, I'm posting the OSCAR screenshots for the last two nights. Both nights used identical settings and masks, but Saturday night was nearly perfect, and Sunday night collapsed, with many points where respiration stopped. I've sent all this to my doctor. I have no idea why one night is peaceful, and the next night is terrible. I'm guessing that something aggravates obstructive apnea the second night, but I don't know what. Both nights include a cervical collar to keep my head straight.


I don't even know what changes to pressures will help stop the obstructive sleep apnea. Advice is welcome!

[SarcasticDave94]

Chart 2 has the Positional Apnea pattern most of the session. It's got both UA and Hypopnea flags from the beginning. There's only a small section near the end that was clear of this pattern.

That's what I'm seeing anyway. So your collar might not be helping as well as needed.

[RVSleeper]

Thanks! I'm on an inclined wedge with no pillows, a cervical collar to prevent chin collapse onto the chest, and no real freedom to turn onto either side. I'm at a loss to see where I could be positioning to cut off air flow. I can try two things, either rising higher up the wedge, or removing it completely, and putting in a pillow or two instead.

Somehow I avoided the problem Saturday night. That's also a puzzle.


Whatever it is, this is the main problem I've been having for over a year!

[RVSleeper]

I've looked for, "Positional apnea," using Duck Duck Go, and all the writeups speak of it obstructive sleep apnea aggravated by a choice of body position. If that's true, why can't it be treated by raising the average pressure in an Aircurve 10 ASV?

[SarcasticDave94]

What you found is true regarding actual body position, as in supine or side sleeping, this shows on the sleep study. Doctors recognize and understand this one.

Positional Apnea as mentioned on Apnea Board is a head and neck alignment position separate from the other. CPAP users recognize and understand this one.

[Jay51]

• 5.3Positional Apnea
  

From our wiki.

[RVSleeper]

Thanks!

[RVSleeper]

After several more nights of sleep, it appears that my Aircurve 10 ASV only functions well if I'm almost flat, all pillows and other support removed except for one regular pillow which is fairly thin. However, I'm getting bad backaches most nights. I've tried a pillow under my knees, and that only helped for one night for some reason. I always use a cervical collar to keep my neck straight.

If I sleep propped up on a wedge instead, the AHI soars. I do not understand why sleeping on a wedge would cause much more disturbance, and a high AHI. The wedge does stop the backaches, and reduces chances for acid reflux during the night, but it stimulates obstructive apneas somehow, which is the opposite of what I'd expect. I'd expect them to be worse when I'm flat with no wedge.

I've tried sleeping on my left side, and that solves most of the problems. However, I wake up after an hour, uncomfortable, and then I go over onto my back, and the problems start.

Screenshot of last night (on my back, no wedge, one pillow), attached. You can see the AHI soar in the middle of the night, and then drop back down.

[RVSleeper]

These two screenshots are for identical machine and mask configurations, and for roughly the same amount of time after machine startup leading into sleep. The only difference is that in the second case, I'm elevated about 30 degrees on a wedge, while in the first case, I'm flat with just a normal pillow, not a very big one. I'm flat on my back in both cases. I have a snug cervical collar on in both cases. As you can see, the wedge case produces ragged breathing, and high AHI, while the flat case is much better. This is the opposite of what is expected according to the respiratory therapists I've spoken to.

I'd stop worrying about this and just sleep flat except that gives me backaches, even with a pillow under my knees. I need some elevation.

Beyond that, it's just so counterintuitive according to most therapists, that I worry the Aircurve 10 is defective. Even the doctor seems puzzled.

People on this board have suggested positional apnea is the problem. That's why I have the cervical collar, and no additional pillows on the wedge.