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RE: Worried about periodic breathing / CA patterns - jcp519 - 03-19-2024
ASV can get a little disruptive especially if you're just starting to fall asleep and the PS kicks up hard. The first few nights were rough for me, but you get used to it pretty quickly. Your body kind of learns to work with the machine rather than fight it.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-19-2024
Thanks for the replies all! Looking at my Oscar data are there any general observations around how I'm going, what I should look out for or what I should be doing differently?
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-19-2024
And secondly, any downsides (apart from cost) of going with an ASV? I know people with specific heart issues shouldn't use it but I've just had an ECG done and it came back fine.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-19-2024
The last thing I want to do is throw more money at getting an ASV only to find that in aggregate terms I've taken a backwards step...
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-20-2024
OK I had (hopefully) a couple of final questions. Specifically:
- Is the ResMed AirCurve 10 CS PaceWave ASV the gold standard for ASVs?
- Assuming yes, can that do everything that my current Resmed Airsense 11 Autoset do? I.e. is there an equivalent Airsense Autoset algorithm on that machine as well as a separate ASV algorithm?
- I understand there is a new AirCurve 11 ASV that has come out (although not yet available in Australia) - should I wait for that or go for the AirCurve 10 ASV given it will, presumably, be cheaper (using the cost increase from the Airsense 10 AutoSet to Airsense 11 AutoSet as a guide)?
Thanks for your ongoing support!
RE: Worried about periodic breathing / CA patterns - SarcasticDave94 - 03-20-2024
1. Yes, I'd rank the ResMed ASV the best
2. ASV can treat obstructive Apnea, mostly with EPAP, PS helps similar to how it does with a BPAP, the CPAP mode in ASV will be straight CPAP no range like AutoSet, example in ASV CPAP mode say you need 10 cmH2O you'll set 10 AND that's it you get 10
3. Get the 10 series, proven, likely decent cost still
RE: Worried about periodic breathing / CA patterns - Sleeprider - 03-20-2024
I agree. For most people the ASV works brilliantly preventing both obstructive and central apnea, as well as any periodic breathing. It works as a standard spontaneous bilevel between EPAP and PS min to provide comfortable BPAP therapy during spontaneous breathing, and can recruit any pressure support between the minimum and maximum setting to maintain respiratory volume and rate. If you need ASV, there is simply no substitute. If you have not read the Resmed Sleep Lab Titration Guide to learn how this device works, it is worth your time, starting at page 28. https://www.resmed.com/us/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-20-2024
Thank you so much both for your ongoing support. I've shot off a letter to my sleep physician requesting a prescription so we shall see.
Based on what my charts are showing, am I over-reacting by asking to go on an ASV? My doctor thinks so and my obsessive personality doesn't exactly help me make a balanced choice but if it will improve my therapy at all I would be extremely keen to go down this path.
RE: Worried about periodic breathing / CA patterns - SarcasticDave94 - 03-20-2024
About 50% of Apnea treatment is realistically based on how you feel. I get the idea the Centrals hinder your therapy and ability to get the well rested state. OSCAR charts, sleep studies, etc. would be the other 50%.
If you're not satisfied with the current treatment, and with a sensitivity to the negative aspects of CA, then the ASV will be the best bet. However, a VAuto may be able to get some of the same results. It's not treating CA like ASV, but more like avoiding by the high trigger method.
So maybe grade the situation with CA. If you feel they're terrible, and you want to treat, then ASV is it. It does come with the slight downside to delivery of the air. It will blow pretty hard if you give it a CA to deal with. It's not impossible to get used to, but it'll be different than what you're on now.
RE: Worried about periodic breathing / CA patterns - Jorgo - 03-20-2024
Thanks for that insight. Honestly it's been so long since I've had good sleep it's difficult to know what "good" feels like. It's therefore hard for me to work out if this is as good as it gets, or if further tweaking can be done or if it will just improve in time. My doctor thinks that the central's will decrease over time but I guess only time will tell.
I should also keep in mind that I've objectively made incredible progress, at least looking at the AHI scores - having gone from from about 80 to, typically, something in the 1-2.5 range.
My philosophy however is that if I'm going through this treatment anyway I should do everything I can to get the best possible outcome, as I'm in the extremely fortunate position to be able to afford the more complex / costly therapy machines.
As an aside, you guys are legends. I feel somewhat marginalised and abandoned by the medical professionals and I'm not sure what I would be doing without this forum and the wealth of knowledge and experience you lovely people are willing to share!