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Assistance with my configuration
#11
RE: Assistance with my configuration
Thank you that makes alot of sense. I am not overweight and I am very fit. Resting heart rate is around 51-53 avg, and my doctor said I have a very athletic heart supposedly. I however do have fibro, so not sure if this complicates things.

I just called the sleep doctor and he said he would look at my results in January and to continue as I am now. Guess I am stuck until January now.
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#12
RE: Assistance with my configuration
Well just avoid CA as best as you can, but it's really a balance of CA reduction or comfort. Try to balance between these if possible. On our side of the pond, I have had to abide by the SERVE-HF issue and get tested for LVEF via a echocardiogram. In 2017 to get the first ASV, I scored 55% LVEF or 10 above the cutoff of 45%. My new cardiac doc wanted me to get a chemical stress test this spring. My LVEF is now 63% and I've got a heart condition called PVC-premature ventricular contraction. I think it's fair to say ASV isn't much more risk to use than CPAP. Neither blow up party balloons in case you were curious.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: Assistance with my configuration
The CPAP shop said after the result of that study they got forced to call everyone they gave ASV to make sure they still wanted them after the results got released. They said they could just swap the AutoSet for an ASV but I just need the prescription to do so. (I am still going to ask my doc tonight if he can do it himself)

Assuming I can keep my non CA stuff around where it is and low, once and if I can convince my sleep doc to prescribe me an ASV that should clear up the central and I would start to feel better?

Here are some symptoms I had prior to starting CPAP:
-loud snoring (stopped now)
-scaring myself awake because I stopped breathing (Think this has stopped somewhat, I still become aware I am not breathing sometimes because I can feel myself completely still and not moving and I can feel the CPAP pulsing)
-really sore throat (stopped mostly)
-really dry mouth (on and off I think sometimes I mouth breath, have been testing a chin strap and waiting for a double side mouth guard to arrive to test)
-really bad headache in morning (stopped mostly)
-would wake up suddenly short of breath and I would have to sit up (stopped)

I am still really really sleepy I don't really feel any better since CPAP. I am not waking as much as I used to, it used to be really difficult to fall asleep because I would scare myself awake over and over as I stopped breathing.

I take melatonin otherwise I cannot fall asleep or stay asleep otherwise. If I accidentally forget to take it I am going to have a really bad night.

I do not drink.
I do not smoke (I used to years ago and stopped).
I do not take painkillers etc (Even though I have fibro I just attempt to deal with it somewhat).
Very active (cycling, running, hiking) x5 a week

I recall sleep issues and extreme sleepiness for as long as I can remember. Just really sick of feeling so exhausted constantly. (And also managed to irritate my wife for years by snoring and scare her by stopping breathing then gasping all night )
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#14
RE: Assistance with my configuration
I did some extra research on this and it seems like its not technically a legal requirement to have a prescription for this in Australia but it is a "nice to have" type thing, and some places just want it to cover themselves.

Supposedly any doctor can write the prescription however it said regarding ASV ideally to have this information in the request:
-Bi-level, ASV, Auto SV Machine
-Phrasing such as BiPAP Servo Ventilation or BiPAP SV or ASV
-May include a BPM setting or backup
-Contains IPAP minimum or maximum
-Contains EPAP

Does someone have some settings I could ask my normal doctor to provide in the prescription if I continue to feel exhausted and go down this path? My normal doctor would likely write the prescription for me if I asked him.
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#15
RE: Assistance with my configuration
You have very mild CA events and they can be easily treated. Resmed publishes a titration protocol, including recommended default settings for ASVauto mode, which is fully automatic.  Read the lower right side of the chart for recommended beginning settings and consider changing EPAP min from 4.0 to 5.0.  This is an authoritative source from the manufacturer, and should make your doctor feel at ease about prescribing these settings.  The source is the Resmed Clinical Titration Guidelines which you can find online in PDF format. https://www.resmed.com/us/dam/documents/...er_eng.pdf  This is an excellent source to learn about the different machines.  

You had a low level of central events during your diagnostic sleep test. CPAP cannot treat these, so it is no surprise they remain present, or worse with CPAP therapy. We typically see individuals move to ASV and experience zero AHI right from the start. There are exceptions, but it works very simply and effectively.

[Image: attachment.php?aid=4210]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
RE: Assistance with my configuration
Thank you so much, you are all really helpful Smile

I spoke to my doctor earlier and as suspected he is completely fine to write the prescription he was just waiting for the settings I can give him. He didn't know much about central sleep apnea but became really interested when I mentioned it to him and started researching it. He has OSA and is using a Resmed Airsense 10 Autoset himself.

So just to confirm I will get him to write a prescription for:
Resmed Aircurve 10 ASV
Min EPAP: 5 cmH2O
Max EPAP: 15 cmH2O
Min PS: 3 cmH2O
Max PS: 15 cmH2O
Ramp: Off

Hopefully I can get the ASV by midweek next week if all goes well (They said they need to get it moved from one of the other stores)
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#17
RE: Assistance with my configuration
That is correct!

Shoot a link to that titration protocol over to your doctor. It's a great resource.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#18
RE: Assistance with my configuration
Add
Heated Hose
Mask of Patient's choice
to the prescription.
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#19
RE: Assistance with my configuration
I agree with all this. FWIW ASV will treat all apnea you throw at it. The OSCAR you see now will be clear of all events, more or less. AHI will very likely be 3 or less consistently. Note this ResMed ASV doesn't have a setting you change for backup rate, the algorithm adjusts it to what it senses your rate is and configures that way. IPAP is the sum of EPAP and PS, all 3 roam within the min/max ranges you set.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#20
RE: Assistance with my configuration
Thanks all, doc wrote up the script for ASV so I will call the CPAP place tomorrow to get it (will probably take a few days). Will ASV be better regarding aerophagia?

Surprised today my AHI got to 2.74.. Although I got about 5 hours into the day and needed a nap because I couldn't keep my eyes open. Mostly just seem to be left with CA I think. I managed to note one time I woke up last night was about a minute after I had a central, I am unsure if it is related to the central but it took me a little bit to get back to sleep. Another time was after a lightning storm hit close by and I thought the bookcase fell over, I flew out of bed and nearly took the machine down the hallway with me.

Regarding idiopathic central apnea, is this something I should get my doctor to look into further? When I was speaking to him he said he had never heard of central sleep apnea before. Would central apnea get worse over long periods of time (years etc)? I assume it has a cause just mine is currently unknown right?

He was happy to have the titration protocol document, I had to email it to him as he couldn't download stuff on his work computer.
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