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CO2 Retention - ASV (ComSAS)
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niammus Offline

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Posts: 10
Joined: Dec 2015

Machine: Resmed S9 VPAP Adapt ASV
Mask Type: Full face mask
Mask Make & Model: Resmed airfit10
Humidifier: HI5
CPAP Pressure: none
CPAP Software: ResScan SleepyHead

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Sex: Male
Location:

Post: #1
CO2 Retention - ASV (ComSAS)
Hello Every one,


I've been using the ASV for couple of nights and I had a perfect AHI. The problem is I feel more fatigue and dizziness. I'm have a CO2 retention so I'm not exhaling the co2 and absorbing it.

I'm thinking by reducing EPAP and Increasing pressure support to make larger difference to help to exhale.

I'm using full face mask I'm asking if I use nasal mask would help to more CO2 washout. Any other ideas ?

Thanks
12-22-2015 04:03 PM
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AshSF Online

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Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #2
RE: CO2 Retention - ASV (ComSAS)
Having higher pressure support will lead to more co2 washout but reducing epap may increase obstructive apneas and lead to lower O2. So it's not that simple. I suggest you consult your physician. There could be multiple cpap related reasons for feeling dizzy in the morning.

You could go to a nasal pillow mask. It has the least amount of dead space so it will help in increasing co2 washout. Also, you can use the slim tube (15mm diameter instead of 22mm). This too reduces dead space in the breathing circuit.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
12-23-2015 12:53 PM
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PaytonA Offline
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Posts: 3,013
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Orange County,California

Post: #3
RE: CO2 Retention - ASV (ComSAS)
(12-22-2015 04:03 PM)niammus Wrote:  Hello Every one,


I've been using the ASV for couple of nights and I had a perfect AHI. The problem is I feel more fatigue and dizziness. I'm have a CO2 retention so I'm not exhaling the co2 and absorbing it.

I'm thinking by reducing EPAP and Increasing pressure support to make larger difference to help to exhale.

I'm using full face mask I'm asking if I use nasal mask would help to more CO2 washout. Any other ideas ?

Thanks

What makes you think that you are having CO2 retention caused by CPAP? CO2 retention can be from other causes. You should see your doc as soon as possible.

Increasing the EPAP will increase the air flow through your mask to increase replacement of air with fresh.

Best Regards,

PaytonA
12-23-2015 04:59 PM
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vsheline Online

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Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: CO2 Retention - ASV (ComSAS)
(12-23-2015 04:59 PM)PaytonA Wrote:  
(12-22-2015 04:03 PM)niammus Wrote:  I've been using the ASV for couple of nights and I had a perfect AHI. The problem is I feel more fatigue and dizziness. I'm have a CO2 retention so I'm not exhaling the co2 and absorbing it.

I'm thinking by reducing EPAP and Increasing pressure support to make larger difference to help to exhale.

Increasing the EPAP will increase the air flow through your mask to increase replacement of air with fresh.

Yes, raising EPAP will increase CO2 washout because it will increase airflow through the mask vent holes during exhalation.

I recommend buying a recording pulse oximeter if feasible, so you can track your blood O2 levels. Raising the Pressure Support will tend to raise the average SpO2 (Oxygen saturation in the blood, as measured "percutaneously" through the skin). The kind worn on the wrist with separate finger sensor cup is more comfortable, especially if worn several days in a row.

Supplier 19 is a reputable supplier of pulse oximeters. (A link to Supplier List is at the head of Apnea Board web pages.)

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-24-2015 04:51 PM by vsheline.)
12-24-2015 04:48 PM
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archangle Offline
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Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #5
RE: CO2 Retention - ASV (ComSAS)
Unless you're really badly dizzy or fatigued, don't do anything based on a few nights sleep with any change in CPAP.

If you've been having apnea during the night, your body adjusts. When you start or change CPAP, even if completely eliminates your apnea, your body may be out of balance until it readjusts to not being strangled all night long. You might even be feeling dizzy because you're not accumulating CO2.

Also, check your minute vent rates. That will probably give you some clue as to whether you should be retaining CO2.


(12-22-2015 04:03 PM)niammus Wrote:  Hello Every one,


I've been using the ASV for couple of nights and I had a perfect AHI. The problem is I feel more fatigue and dizziness. I'm have a CO2 retention so I'm not exhaling the co2 and absorbing it.

I'm thinking by reducing EPAP and Increasing pressure support to make larger difference to help to exhale.

I'm using full face mask I'm asking if I use nasal mask would help to more CO2 washout. Any other ideas ?

Thanks

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
12-24-2015 08:27 PM
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