Very high events per hour

[Ron Poelstra]

Thank you!

I have reset the machine settings and contacted my doc and requested a new study.

[Sleeprider]

These new settings will reduce your CA event rate, but I'm certain you will ultimately require the stimulus of an ASV to achieve normal sleep. Getting a titration with ASV is your ticket. You are normal healthy weight and have all the characteristics of someone with idiopathic central apnea. Simply put, there is no good explanation for why you stop breathing at night. Fortunately the Resmed Aircurve 10 ASV is amazingly effective at treating this problem resulting in AHI less than 1 for most users. What you need to know is that insurance doesn't like to pay for higher level therapy, and your doctor was doing what they require, by starting you on CPAP or bilevel without a backup rate. The next step will get you where you need to be.

[Ron Poelstra]

Thanks again, I will keep the thread updated as appointments and tests progress.

[Sleeprider]

I have a question for you. Your profile shows your are in Colorado. What elevation do you live at and use your equipment? Is that a significantly higher elevation than the sleep lab? Elevation can significantly affect central apnea events. 8000' is a key for increased CA, but it can occur lower.

[Ron Poelstra]

Our elevation is about 7400 feet.  The sleep lab is about 6400.  Very interesting observation.  I have a question now, you jogged my memory.  We went to California recently for about 3 days.  Of course at or near sea level.  I slept perfectly while there, all tree nights.  I had assumed it was because of more O2 in the air, but could it have been elevation as well?

[Gideon]

Much of the Central Apnea we see is CO2 induced. When we flush out CO2 to below our apneic threshold a central apnea occurs. We stop breathing and CO2 rises and we resume breathing and the cycle repeats.

[SarcasticDave94]

Elevation certainly can play into your CA. Make sure you create notes that detail your very high CA in both PAP/OSCAR results and the diagnostic test results. You need to list all your negative feedback, there's nothing positive you have to comment on about your PAP therapy to doc. You'll want to request specifically the ResMed AirCurve 10 ASV, nothing acceptable except this one.

[Sleeprider]

Elevation has a strong impact on CA events, and we have several members from Colorado that have experienced the same issues. My best guess is your doctor is already aware that you need more advanced therapy because she went straight to bilevel. She probably won't be surprised to hear from you that the cure is worse than the disease it seeks to cure. Obviously that is not the desired outcome and I'm sure she will be prepared to discuss ASV and a logical path for you to get there. If not, I'll be surprised, but it's a common problem, but somehow I think you might be working with one of the good doctors. Let's hope. Meanwhile, let's see where the new settings take you tonight.

[Ron Poelstra]

   

The new settings did make a difference last night, but I have experienced the one off good night before.  We will see how the next few night go.  But, again, last night was a major improvement.  Thank you to all for the great advice.  I have not yet heard back form the doc.

[ICEMAN]

Huh What the, How good is that! Is that true, going from near on 100 to 2.53AHI  do these blokes know  BOAT's,  the best, I cant believe that transformation ?