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+--- Thread: Treatment-Emergent Central Sleep Apnea (/Thread-Treatment-Emergent-Central-Sleep-Apnea)
RE: Treatment-Emergent Central Sleep Apnea - GiantCat - 09-06-2019
I'm waiting for a call back from the sleep center office. My message from yesterday was passed on, but I guess they are busy. Before I can get any information from them, I may be forced to deal with the weekend without any changes. Here's a screenshot of last night's data. I set my PS back to 3 and it certainly didn't help. Wondering how I can set this for the weekend and minimize my apneas. Based on my last sleep study I'm thinking IPAP 10 and EPAP 6 with a PS of 1 or 0. Any advice?
RE: Treatment-Emergent Central Sleep Apnea - GiantCat - 09-06-2019
more screenshots. sorry, i'm new.
RE: Treatment-Emergent Central Sleep Apnea - Gideon - 09-06-2019
What is your goal?
Path #1 The best we can get with this machine?
Path #2 Get an ASV
Path #2, Yell louder with more data showing it's crap on Monday
Path #1, See how awesome I'm doing without you
RE: Treatment-Emergent Central Sleep Apnea - GiantCat - 09-06-2019
Well, my short term goal is to lower my apneas with this BPAP machine until I can get an ASV machine, which could take several weeks. I'll be printing out all this hard data and setting an appointment and going in hard with a list of questions and demands. I'd like to work with a doctor on this, but if they aren't gonna play nicely, I'll have to go it alone.
If I have to suffer through many nights of terrible sleep to justify an ASV, that doesn't seem fair.
RE: Treatment-Emergent Central Sleep Apnea - Sleeprider - 09-06-2019
(09-06-2019, 06:27 PM)GiantCat Wrote: Well, my short term goal is to lower my apneas with this BPAP machine until I can get an ASV machine, which could take several weeks. I'll be printing out all this hard data and setting an appointment and going in hard with a list of questions and demands. I'd like to work with a doctor on this, but if they aren't gonna play nicely, I'll have to go it alone.
If I have to suffer through many nights of terrible sleep to justify an ASV, that doesn't seem fair.
CPAP mode at 9.0, EPR 1, or Vauto mode max pressure 9.0, EPAP 8.0, PS 1.0.
RE: Treatment-Emergent Central Sleep Apnea - GiantCat - 09-06-2019
(09-06-2019, 06:40 PM)Sleeprider Wrote: CPAP mode at 9.0, EPR 1, or Vauto mode max pressure 9.0, EPAP 8.0, PS 1.0.
Thank you kind sir!
I talked to the respiratory tech today at my sleep clinic. He gets it. I'm meeting with the MD on Monday to discuss getting ASV. Will need to jump through the hoops to get there, but I think we will make it happen. Hopefully new settings will do me right in the meantime.
~GiantCat
RE: Treatment-Emergent Central Sleep Apnea - Sleeprider - 09-07-2019
Let us know, but I suspect the results will be inconsistent. For "treatment emergent" central apnea, read about End Expiratory Rebreathing Space EERS in our wiki http://www.apneaboard.com/wiki/index.php?title=Enhanced_Expiratory_Rebreathing_Space_(EERS)
RE: Treatment-Emergent Central Sleep Apnea - Howtosleep - 09-07-2019
Dont despair....When I first got my bipap, it was short cycling on me. Inhale when I was still exhaling and vice versa. I got it on a Friday so nobody was going to be able to help until monday. That made me figure out what was going on and try to get it working right or my sleep was going to be horrible. The lesson is, the medical support isn't going to be right away, day or night 7 days a week. You should be your own advocate and take charge of things. I have a great doctor but the sleep test is only one snapshot. I graphed all my data and showed him what was going on over time. The more you know and understand the less like black magic it all is.
He said by his experience nasal based is always a better result than full face. I see that too. I only use full face when nose is stopped up. I use gel pillow dreamwear as I'm a stomach sleeper. I've got my bipap set in such a way that it's like natural breathing to me. Dreamstation uses different terminology than respironics. So I have to translate because there is no PS on the auto bipap I have. If you had some good results on cpap, that's where I started, just the exhale is an added bonus. Also for me it seems my dreamstation sensors are interpreting data and influenced by the tidal volume setting. If it was too low, my ahi was higher. Look on the Web and you'll find a formula for suggested tidal volume if that's a setting on your machine. A way I also verify what's going on is to wear an o2 sensor all night and see if the results mirror the machines data. If you have a bunch of centrals you should see your o2 drop. In the 80s isn't good and pap setting are way off. You'll feel like crap the next day too.
My 2ND study wanted me at over 17 for inhale. Well, for me anything over about 13 and I get air in my stomach and that wakes me up. First one was cpap at about 13. I had auto cpap and it hovered at 12-13 with low of around 9. My cpap created centrals. I'm "one of those people" that gets centrals from therapy. But I've slowly tweaked my settings that I have 0 obstructive and 0 centrals on my bipap. Just all hypopneas under about 25 or so per night. Ahi is under 5. Someday I'll post my plots and see if there is any further tweaking to be done. I have had under 1 ahi for the night occasionally. I'm starting to think new nose pillows are when my ahi is lowest. Haven't bothered to note that yet or not.
So all my blabbering just comes down to give it some time, read up on what to do if one number is high. You will get fairly quick idea if something works or not if your numbers are bad enough. You'll see a sweet spot. I know I did. My centrals seemed to go away when my tidal volume was at least the calculated, the dme set it around 500, calculated was around 750. I'm set at 800 now. I changed my settings nightly at first to narrow down to get closer to the sweet spot I have now. Think of it as a science experiment on yourself. Im an engineer so its natural for me to tinker, and doing it to my biipap should be no surprise. Good luck and if your on this board, your going to get it all figured out. These folks really know these machines. Doctors don't have this depth of practical knowledge. A good doctor will listen and help guide you.my doc had me do some settings and they were crap in the end but my plots showed him that and he is now happy with what I'm doing. I've only had my machine (s) sine Jun '18 but the board knowledge has given me a lot of info in a short amount of time that helped me tweak my settings to good results pretty quick.
RE: Treatment-Emergent Central Sleep Apnea - AshSF - 09-09-2019
Any PS (or EPR) May cause central events due to excessive co2 washout. My first suggestion would be to set PS to 0 and try a constant pressure of 10cm. If your centrals settle down then you know it’s due to co2 washout. If obstructive show up, you can just raise the constant pressure in 0.5cm increments and evaluate along the way.
RE: Treatment-Emergent Central Sleep Apnea - GiantCat - 09-09-2019
So on Friday late in the day, my sleep doctor remotely set the pressure on my BPAP to 12 IPAP 5 EPAP and PS level at 2. I tried it Friday, Saturday and Sunday nights and saw a massive improvement with AHIs at 5 for the first two nights and up to 7 on the third night. Centrals still take up the bulk of these. Inconsistency was the word tossed out, so I am not shocked that the third night had different (and worse) readings. I am meeting with him this afternoon to have a serious conversation about moving to ASV and going over my history.
Tonight I am going to try out the recommended settings put here by Sleeprider (Vauto mode max pressure 9.0, EPAP 8.0, PS 1.0.) and see what that does.
I'll post Oscar data from the past three nights before I go to sleep tonight. Onward!