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APAP Prescribed for Central Sleep Apnea?
(02-20-2017, 10:24 PM)NeverRested Wrote: I should mention, this is from a day where I took off my mask while sleeping, which I did a lot at first, so the data for the night is incomplete.  This also shows my settings before they were changed by my sleep dr from 6-16 to 4-16.

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The CSR pattern that you see is just a more extreme form of your Central Apnea. The machine escalates the "Periodic Breathing" that is evident in the chart you posted to CSR from time to time. If you, as I do, have Central Apnea NOT associated with Congestive Heart Failure you are going to see Periodic Breathing and Central Hypopneas during your sleep study. These will escalate to include many periods of CSR when you are on a traditional CPAP or APAP machine. Your data will show that your CPAP machine has failed to treat your Central Apnea. The next step might be to have a titration on an ASV machine to show that ASV is an effective treatment. You are on the right track.

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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I agree with Rich and just want to contrast your example with the one I posted earlier. True Cheyne Stokes is a gradual waxing and wainng of the respiratory effort usually including a central apnea at the nadir of the cycle. In congestive heart failure, this may be associated with fluid in the lungs that make the central apnea appear to be obstructive as in the closeup of the example I posted before; however this is still a central event. Just as the machines don't always get it right, Sleepyhead doesn't either, but you can fix it. You can change the label for CSR to PB and Periodic Breathing, which is what it is. Just go to the Sleepyhead Menu File/Preferences/Events, and double click on Cheyne Stokes Respiration and change to Periodic Breathing, and change the abbreviation from CSR to PB. Your graphs will look a lot less alarming and what you show above is periodic breathing. This is Cheyne Stokes, but the graph is labeled PB. Note the duration of these apnea (over 40 seconds) and the very gradual transitions in and out of apnea. It is the gradual transition that is the hallmark of this disease.

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This is both helpful and reassuring. Thank you. I've had a little trouble with the VA, it was a challenge to even get a smaller mask when the one I started with was much too big, so I imagine an uphill battle to get the right therapy, but at least I'm on the right track. Thank you again for all your help, I really appreciate it.
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The new administration seems intent on improving the treatment our service men and women get from the VA, so hopefully they will become more responsive soon. Your case is pretty straight-forward in that you have already had a positive diagnosis for central apnea. The procedure to trial CPAP is a formality that few people understand, but it is written policy and procedure for the approval of the more expensive ASV device. I think your doctor should be supportive and transparent about this process. Let him know what you know now.
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