my report I think

[Sleeprider]

 ASV is what he want the new study for but I thought with  adjustment my numbers would get better.

Did you read what Walla Walla wrote on here?

I am on a number of medications for various reason but nothing new within the last 6 months. Two of the medications are for afib and two more are for seizures.

First, we only have 2 data points so far on your Airsense 10.  It is premature to conclude anything at this point, Walla Walla's expression of optimism notwithstanding.  With an AHI near 20, a significant number of centrals, and your doctor confirming that CA is a concern, I would not rule out ASV, any more than I would rule out the possibility you will succeed with your current machine. 

We have no data from the CPAP machine you used over 12 years prior to getting the Airsense 10, therefore we don't know when this problem began.  The potential for central apnea and hypopnea as a side-effect of your anti-seizure medications should be investigated.  We have seen it before on the forum, but we don't know what those medications are, and your doctor would be the best resource to direct that question to.  As you know, something has changed your problem from simple obstructive apnea that, as far as we know, was adequately treated by CPAP.  Now that you have data and a new sleep study the results from your new machine, and the concerns of your sleep doctor suggest there may be a more complex issue. 

With CPAP, there are limited options for treating CA and hypopnea.  We typically see people respond to simple fixed CPAP pressure with no exhale pressure relief with fewer central and hypopnea evenrts.  Those same people generally show more central apnea when pressure support is increased in bilevel therapy, however pressure support is the best tool for resolving hypopnea in those with obstructive apnea.  The number of centrals you are showing makes me doubt that bilevel without a backup rate like S/T or ASV is your answer.   Only time and usage will show whether your CPAP can provide effective therapy, or if you perhaps need to look at a medication change or different PAP technology.  I think it is best to consider all three approaches and see what falls out.

[jerry1967]

I have been on cpap for 10 years at lever 12 but it was one of the old machines so I don't know  which type of sleep problems I had.

[Walla Walla]

oops! Sorry. I need to learn how to keep my mouth shut.

[Sleeprider]

Walla, you were just trying to encourage, and nothing wrong with that.  

[jerry1967]