Apnaes: difference between Central / Obstructive ?

[Camera Obscura]

Hello SR.
Before issuing a new machine everything seems to depend on the OK of my cardiologist.
Some check on a left ventricle seems necessary.
I will have more info tomorrow from the experts, keeping fingers crossed.
The thread of Nicole and her 9-year-old is heart touching, thanx for the link.
Have a good night!

[SarcasticDave94]

It sounds like cardiologist wants you checked for LVEF, the left ventricle efficiency fraction. This I did in '17 before ASV would be issued due to flawed tests that mistakenly concluded ASV would be bad for hearts that are in CHF/congestive heart failure status. I'm not CHF but do have heart PVC/premature ventricular contractions that gives me palpitations and sometimes low oxygen levels.

The LVEF is found by a test called echocardiogram, basically an ultrasound of the heart that records audio/video info and a cardio doc interprets the test, giving a summary including a LVEF number%. If it is at 45% or less, you might not get ASV, but if you were even close to the 45% you'd know the heart is in bad shape. My LVEF in '17 was 55% and in '20 during a full blown heart chemical stress and echo test, I scored 63% LVEF.

I was issued an ASV in 8 or 9/17 and it's caused no negative heart issues.

[Camera Obscura]

Thanx you for the explantion Dave.
I know I have a slight irregularity in my ECC. I guess it nothing spectacular as my cardiologist
did not sound an alarm bell.
The sleep.doctor seemd amazed to find out that people arrive at creating a forum on his speciality .... I promised to send a link.
Speedy guy, nice but dependent on the details from the technician. Surprisingly he had no direct acces to my data...
Let's wait and see , hope this discussion thread attracts his attention when I send him the link. It may help awareness patient/ technician/doctor and help doctors give the forum as a reference for more info. He seemed surprised and interested.
The fact that we had found a better pressure for my case should be convincing .

[SarcasticDave94]

If you feel you need more details on the echo test I can explain what I had to deal with. It's not a big deal test as I have had easy tests and very hard tests regarding health.

Sounds like you're about like everyone else apnea wise though, so no unique status. But that is good actually, being unique in pulmonary needs is quite lonely and frustration building. But I didn't get any T-shirts. Coffee? Well OK yep lots of that.

[Dormeo]

Camera Obscura, your doctor sounds great! If he does visit the site, I'd be interested to hear his reactions. Best of luck in your progress toward an ASV.

[Camera Obscura]

The specialist is going to change my machine for a RESMED S10; That is not an. ASV as far as I understand it but it seems to be better adapted to what he suspects to be hyperapnaes.
I guess I should accept his opinion...?

[Sleeprider]

We will get to see the events on our preferred software. That is going to help us, but if the centrals showing on the Loewenstein are real, you need the Aircurve 10 ASV. If it doesn't cost you anything to switch, and you tell the specialist you believe that your history of central apnea from your diagnostic test, and continued with your CPAP data strongly indicate the Aircurve 10 ASV, then it's just a matter of time. As I recall, your results improved when we took away pressure relief and variable pressure. That does not predict a good outcome with any CPAP or bilevel without backup rate.

By S10, do you mean the Airsense 10 Autoset or the Aircurve 10 Vauto? One more time, neither of those machines treat central apnea or hypopnea. There is no such thing as hyperapnea. What cereal box did your "specialist" pull his credentials from?

[Camera Obscura]

I think that the specialist means mixed apnea. I find it a bit unpolite to tell him that the apnea board knows better than he does. I do tend to agree with you though.
Price is not a real issue I guess. It is not me who pays for the machine. I get the impression that, although the machines seem new, they originate from a rental stock of the distributing technical company (Bastide in France). My social security should not be the victim of choice revisions of the doctor!
Anyway, I will continue to analyze and fight for the best possible solution.
There is apparently also an issue of heart failure risk in ASV usage ...
I will go through the S10 experience and see what it gives.
Interesting for others here maybe?
I will be back with my first result end of the week, and also will start using OSCAR at once!
Take care, stay healthy...

PS for those interested:

A camera obscura is a darkened box with a convex lens or aperture for projecting the image of an external object onto a screen inside, a forerunner of the modern camera.

[Sleeprider]

As I said, I'm all in for using a Resmed machine as long as expectations are realistic. At least we will finally get a good look at what is going on. I assume that if this fails, you will eventually be able to persuade the specialist that he doesn't get to guess at this indefinitely and it's time to move to a known good solution?

[Camera Obscura]

Right Sleeprider.
I expect better but not perfect. I will need to argue my case again in some time and with your much-appreciated help!