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+--- Thread: Suddenly my Centrals got a lot more disruptive (/Thread-Suddenly-my-Centrals-got-a-lot-more-disruptive)
RE: Suddenly my Centrals got a lot more disruptive - RLRoth - 03-16-2024
Going back about 3 years ago, prior to a diagnosis of Central Apnea, I would suddenly awake with adrenaline rushes and my heart pounding. I became fearful of sleeping.
A lab study showed an average of 57 incidents per hour. I was exhausted every day, and felt dizzy from lack of sleep.
My pulmonologist recommended an ASV machine- the AirCurve 10, which I’ve been using since diagnosis. It has been a life changer. I rigorously use it and am 100 percent compliant. I’m down to about 0.4 incidents an hour now. My doc is ecstatic, as am I. I’ve asked him about using a portable CPAP machine when traveling, and he has explained that those of us with central apnea must have the ASV machine that acts like a ventilator.
Have a competent pulmonologist get you properly configured on the ASV.
RE: Suddenly my Centrals got a lot more disruptive - tcinoz - 03-19-2024
(03-16-2024, 11:31 PM)RLRoth Wrote: Going back about 3 years ago, prior to a diagnosis of Central Apnea, I would suddenly awake with adrenaline rushes and my heart pounding. I became fearful of sleeping.
A lab study showed an average of 57 incidents per hour. I was exhausted every day, and felt dizzy from lack of sleep.
My pulmonologist recommended an ASV machine- the AirCurve 10, which I’ve been using since diagnosis. It has been a life changer. I rigorously use it and am 100 percent compliant. I’m down to about 0.4 incidents an hour now. My doc is ecstatic, as am I. I’ve asked him about using a portable CPAP machine when traveling, and he has explained that those of us with central apnea must have the ASV machine that acts like a ventilator.
Have a competent pulmonologist get you properly configured on the ASV.
Thank you for your story and suggestion based on your experience. It's great to hear that you have resolved your situation with the right equipment for you.
I had my review with the sleep doc yesterday, and then today I saw another sleep doctor at a hospital where I'd made an enquiry four months ago before I was properly diagnosed. I kept the appointment open even though I'd found another doctor more readily available further afield, and used that appointment today to get a second opinion.
There was a lot of talk that at least some of my CAs may be 'treatment emergent' ones - even though I had quite a few (and hypopneas) in my original sleep study. Also both doctors agreed that given my low AHIs (averaging about 4 to 5 p/h overall) and the relatively early stage of my CPAP treatment (about ten weeks) to give it another month or two at least to see if they settle down further.
The other factor is that for someone with a heart condition one study showed that ASV machines could be dangerous, and my heart is problematic. I see a cardio for a check-up in June, and my sleep doctor has made an appointment for me to coincide with that, so I've been advised to carry on with the present treatment at least until then, so I guess that's what I'll do.
Meanwhile I've had three nights of wild variations since I last posted! One was the best night yet followed by two with the usual clusters of CAs late in my sleep cycle. I'm also working on eliminating leaks. Thanks everybody for your contributions - all very instructive and much appreciated. I'll update the thread if anything out of the ordinary happens. Meanwhile, I wish everyone plenty of good, uninterrupted sleep!
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RE: Suddenly my Centrals got a lot more disruptive - SarcasticDave94 - 03-19-2024
You've been on AutoSet for some weeks, at the start of the thread you said 6. I'm skeptical of the treatment emergent CA thoughts at this time.
ASV and heart conditions: the concern is based on a flawed SERV-HF test. At least here in the US, to get ASV an echocardiogram is required to pass. I had to do this, with the info of LVEF being the highlighted area. 45% and less is the cutoff. Mine was 55% the first time involving ASV. Other heart tests had mine up to 63% after using ASV for 2 years. Don't let the concern over this stop you.
My heart is OK but not great. ASV didn't cause the problem. I have a timing issue called PVC, premature ventricular contractions.
RE: Suddenly my Centrals got a lot more disruptive - tcinoz - 03-19-2024
(03-19-2024, 08:44 AM)SarcasticDave94 Wrote: You've been on AutoSet for some weeks, at the start of the thread you said 6. I'm skeptical of the treatment emergent CA thoughts at this time.
ASV and heart conditions: the concern is based on a flawed SERV-HF test. At least here in the US, to get ASV an echocardiogram is required to pass. I had to do this, with the info of LVEF being the highlighted area. 45% and less is the cutoff. Mine was 55% the first time involving ASV. Other heart tests had mine up to 63% after using ASV for 2 years. Don't let the concern over this stop you.
My heart is OK but not great. ASV didn't cause the problem. I have a timing issue called PVC, premature ventricular contractions.
Yep, your point about the need for an echocardiogram I think is the same here, hence my sleep doc wanting to synch my next appointment with the one lined up with my cardiologist. I was told also that if my CAs are heart-related, it's my heart that needs treatment more than my sleep.
After a bad night last night I'm again thinking I may end up on an ASV eventually. An additional problem is pain in my right knee - probably arthritic - which makes lying on either side for long intolerable. Last night I tossed and turned, got up many times, changed positions, settings and and masks and spent some time on the recliner, but nothing worked for long. I just have to write this one off and hope for a better night tonight. Unbelievable how much it can vary.
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RE: Suddenly my Centrals got a lot more disruptive - SarcasticDave94 - 03-19-2024
I've not looked over the thread lately. Have you tried static pressure? This means a single pressure, no variables. The goal is to see if maybe the Central component will diminish.
Static pressure might help the CA, but the obstructive events and feel are probably going to be worse.
RE: Suddenly my Centrals got a lot more disruptive - tcinoz - 03-20-2024
(03-19-2024, 07:01 PM)SarcasticDave94 Wrote: I've not looked over the thread lately. Have you tried static pressure? This means a single pressure, no variables. The goal is to see if maybe the Central component will diminish.
Static pressure might help the CA, but the obstructive events and feel are probably going to be worse.
Thanks - good idea... worth a try. I tried static pressure when it was low (around 7) but reverted to variable to get used to higher pressures.
I've set it at 10.4 fixed for tonight, with EPR back at 3. I'll see how I go with that.
I'm not too fussed about obstructive events. They seem relatively few and far between and probably nearly all are positional.
RE: Suddenly my Centrals got a lot more disruptive - SarcasticDave94 - 03-20-2024
OK copy that. Note that Centrals might be sensitive to variable pressure from Ramp, EPR, then also pressure ranges. Not any or all the above is guaranteed, but CA are nasty little things that have a mind of their own, a will bent on disrupting your sleep, they're consistently inconsistent too.
RE: Suddenly my Centrals got a lot more disruptive - tcinoz - 03-20-2024
(03-20-2024, 09:26 AM)SarcasticDave94 Wrote: OK copy that. Note that Centrals might be sensitive to variable pressure from Ramp, EPR, then also pressure ranges. Not any or all the above is guaranteed, but CA are nasty little things that have a mind of their own, a will bent on disrupting your sleep, they're consistently inconsistent too.
That's a good way of putting it! And the concept of "might be sensitive to" those variables gives me a better understanding of the hows and whys of this CPAP journey.
I experimented with settings during the night based on how I was feeling at the time of waking (which I continue to do often) but from the chart it looks like the steady 10.4 with EPR at 2 gave the best results.
By the morning I was suffering from morning hypertension, as I do (160/110 on rising today) hence the lowering of pressure for the last part to try and calm the metabolism down a bit but as usual I copped a spike of centrals during that period. I intend to stick with 10.4 going forward for now, but those erratic flow limitations and leak rate bother me.
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RE: Suddenly my Centrals got a lot more disruptive - SarcasticDave94 - 03-20-2024
OK it looks fair on the charts, not great but maybe not terrible.
What do you think? Is it headed towards acceptable?
RE: Suddenly my Centrals got a lot more disruptive - tcinoz - 03-20-2024
Hard to say. I'm thankful that it looks a lot better than the previous night, but I didn't feel great during the night or on waking up. The morning hypertension is a worry and wasn't something I was ever aware of previous to five or six months ago when the first signs of sleep apnea emerged. That said, I feel heaps better than I did in the weeks before I was properly disgnosed and started CPAP. As long as it keeps me breathing and the AHI doesn't climb much above 5 I guess I need to be grateful, but it's a work in progress and I'll strive for further improvement - whatever it takes.