+- 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: Worried about periodic breathing / CA patterns (/Thread-Worried-about-periodic-breathing-CA-patterns)
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-06-2024
Thank you both for your ongoing support! Just to clarify however, are you saying that ASV might actually increase my central events? I thought (maybe overly simplistically) that ASV would have zero downside and could only help my central events and lead to a better overall outcome. Is that not necessarily true?
I've got a follow-up discussion with my specialist today where I was going to push for ASV under the assumption that there was zero downsides, but if that's not the case then I'd be keen to understand the trade-offs to determine the most optimised treatment.
As context, insurance works a bit differently in Oz, so I'm not sure I necessarily have to prove that my treatment is failing on more simplistic / inexpensive types of PAP machines before moving on to something like ASV (but again, something I will be discussing with my doctor today!).
Thanks again for your help, I've been feeling a bit overwhelmed and alone in all of this so it's really helpful to know there's a great and active community that is helping people like me through this.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-06-2024
Going off on a bit of a tangent, does anyone have an explanations for why I have such fewer events (both central and obstructive) sleeping on the right side vs left?
RE: Worried about periodic breathing / CA patterns - jcp519 - 03-06-2024
Could be a difference in your throat anatomy that causes more OA's. Central apneas are weird though. Before my ASV, I would still have nights of under 3 AHI, but other nights would be almost 8. Like they said, consistently inconsistent.
Also, don't panic about the periodic breathing, its more than likely not true CSR.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-06-2024
Thanks for the reply! I've managed to calm myself down a bit now. I should have also mentioned that I had an ECG to check heart health and a brain MRI to make sure there was nothing sinister driving my central / mixed events, and both were clear.
What was your experience with central apneas before / after ASV, if you don't mind me asking?
RE: Worried about periodic breathing / CA patterns - jcp519 - 03-06-2024
On CPAP my AHI hovered around 5-6 on average, with pretty much all of those events being central in nature. I felt better with CPAP, but still had some persistent daytime sleepiness due to the CAs. I also had similar periodic breathing episodes and also freaked myself out reading about CSR. My best advice for that, is don't read too much into it or you'll just end up worrying yourself.
I got my ASV about 2 weeks ago and the very first night all of my CAs were gone and my AHI dropped to less than half. Once I got the settings dialed in the first few days, my AHI is regularly below 1. I also feel much better with most days having almost no sleepiness. My worst days on ASV are like my best days on CPAP.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-06-2024
Oh wow that's incredible, congrats on the awesome outcome! And unfortunately too late, I've already been reading plenty of stuff to properly freak myself out
RE: Worried about periodic breathing / CA patterns - Sleeprider - 03-06-2024
(03-06-2024, 05:17 PM)Jorgo Wrote: Thank you both for your ongoing support! Just to clarify however, are you saying that ASV might actually increase my central events? I thought (maybe overly simplistically) that ASV would have zero downside and could only help my central events and lead to a better overall outcome. Is that not necessarily true?
With ASV, central apnea are nearly impossible. I have never seen central apnea on ASV, and any residual events on a properly set ASV are obstructive UA or H events.
RE: Worried about periodic breathing / CA patterns - SarcasticDave94 - 03-06-2024
As Sleeprider mentions, a well tuned ASV will take care of the Central Apnea. It can however get most of the other Apnea events treated too. An exception would be flow limits, the ASV algorithm specifically doesn't treat those. As I recall, they're in opposition, treating CA and FL that is.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-06-2024
Thanks all! I just spoke to my specialist who strongly thinks I should stay on the APAP machine. I'm inclined to go with his approach and then evaluate again in 6-12 months time. He seems convinced that the central events will likely largely disappear over time.
I'm also hoping that the last 4-5 nights where I got scores between 0.5 and 2.5 is going to be the new normal and not just a blip.
I'm also going to a titration sleep study to further refine the settings which should hopefully continue to further reduce my events.
Finally, for now I will increase minimum pressure a bit and turn off ramp.
Thoughts?
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-18-2024
Just reviving my thread from a couple of weeks back. Still agonising over whether I should buy an ASV. I spoke at length with my sleep physician and he is strongly encouraging me to continue with my APAP machine and I was originally convinced, but the clear airway events are stubbornly holding at about 1.5-2 on a good night and subjectively I'm not feeling as rested as I had hoped, so now I'm torn.
He said it will take time and the clear airway events will reduce as my body gets used to therapy but I'm still not fully convinced.
Looking at my sleep study (posted earlier), my events were all over the place, with 77 hyops, 174 obstructive, 99 centrals and 117 mixed. I guess my fundamental question is, will moving to an ASV have any detrimental impact to the other types of apnea?
And secondly, is it worth getting a second opinion? Or is that just throwing away more money?
For context, I'm in Australia so it's a different arrangement from an insurance perspective and I will be buying the machine outright. I still have a 30 day return on my current machine but that window is rapidly closing.
Thanks!