[Treatment] struggling to breath

[Robo64]

Thanks again for all your help and replies, its good to be able to talk about this condition here as no one around me realy understands anything about apnea.

I tried to add 2 jpg's not sure if they will display. The waveform graph is my first our of sleep. Clock is out should be 12pm not 1.

Thanks

[attachment=2274]
[attachment=2275]

[Robo64]

Well it appears the attachments worked. The first hour of sleep looks pretty bad to me, but realy not sure, I would be interested to hear your comments. Like I said I have a titration study next week, shoud I be taking any of these graphs with me.

Thanks
Rob64

[DeepBreathing]

That's pretty ugly. It's a bit hard to tell from these charts but it looks like some of those apneas are well over a minute long, which is worrisome. The number of central apneas is also a possible concern - was your home sleep test able to distinguish central from obstructive apneas? It's possible that they have been brought on by the therapy (in which case they will hopefully go away again) but if they were there in your initial study then you might need to think about a different therapy approach. The other possibility is that if you weren't sleeping properly, dozing in and out of sleep, that these could just be spurious artefacts called "sleep / wake junk".

I'd definitely take those charts to your titration study. In fact I'd call the clinic before the study, explain that you are seeing a lot of central apneas and ask them to ensure you are titrated for bilevel and ASV therapy at the same time. ASV (adaptive servo ventilation) is the only way to totally eliminate central apnea. The good news is that they work really really well. The bad news is that they cost more than twice as much as a regular machine.

Given the ASV are so expensive you'll want to work through the other options first. You might be lucky and the centrals will just go away as your system adjusts to therapy. Or a lot of them might be sleep / wake junk, which should also settle down as you get used to the machine. But don't get yourself locked into purchasing a machine until you're confident it's the right one for you.

[richb]

Well it appears the attachments worked. The first hour of sleep looks pretty bad to me, but realy not sure, I would be interested to hear your comments. Like I said I have a titration study next week, shoud I be taking any of these graphs with me.

Thanks
Rob64

The sleep study tech most likely will not be allowed to discuss your sleep study with you. It is going to be important to get a titration on an ASV machine at some point during your sleep study. As I mentioned previously, you need to be sure that your sleep Doc has specified that ASV settings are used during a portion of your sleep study. Your graphs show that your current machine is not working for you. In fact it is probably making things worse. Show the graphs to your sleep Doc.

Rich

[vsheline]

In fact I'd call the clinic before the study, explain that you are seeing a lot of central apneas and ask them to ensure you are titrated for bilevel and ASV therapy at the same time. ASV (adaptive servo ventilation) is the only way to totally eliminate central apnea.

It is going to be important to get a titration on an ASV machine at some point during your sleep study. As I mentioned previously, you need to be sure that your sleep Doc has specified that ASV settings are used during a portion of your sleep study. Your graphs show that your current machine is not working for you.

I agree with DB and Rich. Waiting until the titration to ask that the titration include ASV would be a mistake.

I think the titration will likely only follow doctor's instructions, and you would likely need to insist that the doctor give expanded instructions to the sleep test clinic ahead of time. And you would need to call the sleep clinic ahead of time to verify they have received the expanded instructions and will include ASV in the titration as needed.

[Robo64]

was your home sleep test able to distinguish central from obstructive apneas? It's possible that they have been brought on by the therapy (in which case they will hopefully go away again) but if they were there in your initial study then you might need to think about a different therapy approach. The other possibility is that if you weren't sleeping properly, dozing in and out of sleep, that these could just be spurious artefacts called "sleep / wake junk"

My home sleep study Did show centrals, they were in majority, but not as many as I am having now. You mentioned sleep/wake junk, that is a definite possibility as I toss and turn a lot, it takes ages to g to sleep as I am concentrated on my breathing.

I read in other posts here that most people hold their breath when turning over, causing false clear airway apenia, this coud be the case with me, I often find myself holding my breath, even during the day.

I agree with DB and Rich. Waiting until the titration to ask that the titration include ASV would be a mistake.

I'm hearing ya, I will contact the doctors office tomorrow, will probably only get the secretary, but I will push the issue.

Thanks for all for your advice
Robo64

[vsheline]

My home sleep study Did show centrals, they were in majority, but not as many as I am having now.

Hi Robo64,

I think perhaps a third of new CPAP users initially have 5 or more centrals per hour of sleep, and for about half of these new users the centrals will gradually reduce in number and become insignificant, less than 1 or 2 per hour, over the course of the initial weeks or few months of regular use, as our systems become accustomed to breathing under pressure.

But if centrals were in the majority during your diagnostic sleep study (without CPAP) then your centrals are not going to go away on their own as you become accustomed to PAP therapy.

If the number of centrals you are having continues to be in excess of 5 per hour of sleep and continues to outnumber the obstructive apneas per hour of sleep, then you need ASV therapy.

Good luck,
--- Vaughn

[kwhenrykerr]

Robo64 how are you doing ?