+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: [Treatment] ASV settings for treatment of complex sleep apnea (/Thread-Treatment-ASV-settings-for-treatment-of-complex-sleep-apnea)
RE: ASV settings for treatment of complex sleep apnea - JoeyWallaby - 04-18-2020
I don't have any sinus symptoms, apart from blocked nose and maybe pressure behind eyes (feeling of congestion). I've been using dymista spray (fluticasone and azelastine) and saline spray which helps temporarily, nasal rinses when I'm not too lazy.
I'll see an ENT sometime. Back on bilevel and getting marked centrals and stuff, periodic breathing?
![[Image: c7pOMPa.png]](https://i.imgur.com/c7pOMPa.png)
![[Image: LvCWFmU.png]](https://i.imgur.com/LvCWFmU.png)
RE: ASV settings for treatment of complex sleep apnea - mper6794 - 04-18-2020
Hi, Joey
_ sorry for the drawbacks;
_ nice to hear you have backed to Vauto;
_ I don't see any periodic breathing,; rather typical slee-wake-junk....each central follow a package of concentrated, "vertical" flow rate (you were awoke);
_ keeping my suggestion on Resmed titration protocol.
all the best.
RE: ASV settings for treatment of complex sleep apnea - mper6794 - 04-18-2020
Hi, Joey
....sorry, reposting...
_ sorry for the drawbacks;
_ nice to hear you have backed to Vauto;
_ april 17th: I don't see any periodic breathing,; rather typical slee-wake-junk....each central follow a package of concentrated, "vertical" flow rate (you were awoke);
_april 16th: maybe REM period at the end of the night;
_ keeping my suggestion on Resmed titration protocol.
all the best.
RE: ASV settings for treatment of complex sleep apnea - mper6794 - 04-18-2020
...some time ago, while in sheepless case, I gathered and did these anayles below, trying to dismiss his "periodic breathing". It might add something on your doubts: in particular, attention to scales and existence of respiratory effort (MV) during period of lowering FR;
all the best
RE: ASV settings for treatment of complex sleep apnea - JoeyWallaby - 08-29-2020
ENT said my sinuses are fine, no more sinusitis, don't have deviated septum or anything. The main thing he noticed was the base of my tongue is large, that obviously being relative to the size of my mouth. Advised me to continue using nasal sprays if it helps.
I've wondered if a MAD would help, however I wouldn't want to use it long-term due to causing changes in teeth alignment, possible TMJ issues and more.
I think palate expansion would be ideal for me, however nobody does proper palate expansion (EASE and MSE) where I live.
RE: ASV settings for treatment of complex sleep apnea - Sleeprider - 08-29-2020
Joey, I don't think surgery is an appropriate answer to predominately central apnea. Your work with EERS looks pretty good for a while. I think if you are seeing central apnea then reduction in pressure support and EERS remains a good solution, and the ASV seems like the most appropriate theapy.
RE: ASV settings for treatment of complex sleep apnea - SarcasticDave94 - 08-29-2020
My impression of MAD is that that's what it makes you when you realize you paid a lot of money for a result you may not get AND still need PAP therapy of some flavor. Madness indeed.
RE: ASV settings for treatment of complex sleep apnea - JoeyWallaby - 11-13-2020
Like Slim Shady, I'm back, back again.
I'm 99% sure I don't have GERD, actually laryngopharyngeal reflux (LPR). Why? Well, I don't get heart burn. And looking at the symptom list...
- a bitter taste in your throat
- a sore throat or a burning sensation in your throat
- difficulty swallowing
- hoarseness
- the need to constantly throat clear
- frequently feeling the need to clear your throat
- chronic postnasal drip, or feeling like you have drainage dripping from your nose into your throat
- asthma
- the sensation of a lump in the throat (or a tickling or burning sensation)
Looking at pubmed, having sleep apnea is correlated with having LPR, just like GERD. I think a lot of the arousals and "central apneas" I was having could have been reflux
RE: ASV settings for treatment of complex sleep apnea - Geer1 - 11-13-2020
I believe I already mentioned this but look into digestive problems and food sensitivities, these are a common cause of LPR. The food sensitivity or other underlying digestive issues causes bloating which causes you to burp up pepsin/acid.
This is one of the problems I had. I tried PPI's for a couple months, they are rarely a long term solution for LPR and LPR came back when I finished. I built legs so my bed was on an angle, tried modifying diet to remove acids etc. Finding my dairy sensitivity seems to have solved my LPR (at least the majority of it). I don't have the chronic cough anymore, have been able to lower bed back down, reintroduced acidic foods etc.
Dairy removal hasn't fixed my overall health issue completely but helped with a number of symptoms including LPR. At this point I think that my dairy sensitivity is actually a symptom of a greater issue rather than the underlying issue. In my case dairy was the most obvious thing but for you it could be something completely different. If you are like I was you might not even realize how bad your digestion is, I didn't realize this until I started doing some more restrictive elimination diets and started getting some reprieve of symptoms.
RE: ASV settings for treatment of complex sleep apnea - JoeyWallaby - 11-13-2020
Yes being on PPIs long term is a bad idea. I'm going to do an elimination diet hopefully within a month or two, I'm a bit of a picky eater and struggle with low body weight so restricting my diet is difficult.