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[CPAP] Is My Central Apnea Hopeless?
#31
RE: Is My Central Apnea Hopeless?
(08-22-2021, 06:15 PM)CasperTBird Wrote: …. If so, hopefully it will be a fairly simple process to adjust the settings as given in the posted Titration Protocol.  Otherwise, …

ResMed’s ASV is probably one of the simplest xPAP machine’s to set up despite its complex algorithms. Just because there are so few parameters to adjust. Finding the best settings for you is also simple if you post your OSCAR screenshots and adjust your settings per the responding posts. 

I don’t want to say “recommendations”, but you will be happy with the results. 

Now if you already have a comfortable mask that does not leak, that’s the bigger hurdle to overcome.
RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.
~ Woof, woof.

I-love-Apnea-Board
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#32
RE: Is My Central Apnea Hopeless?
I have a quite complex case of needs. When I had the same ResMed AirCurve 10 ASV, I set up ASV Auto mode, edited EPAP range a bit and it tackled all Apnea, period. The only complication can be if you absolutely need manual timing controls, but I'm pretty sure you'll be fine without them.

I had a harder time fiddling with the mask straps, and adjusting it to stop leaking.

When I did my self titration, I used EPAP to work on Obstructive events and I edited PS min to 4 and had it there for a month or so, but default PS 3-15 was doing the job better.

It might take a few days to titrate, but it'll be quite straightforward.
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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#33
RE: Is My Central Apnea Hopeless?
I've had a week to try out the Resmed S9 Adapt, and the results are very encouraging.  After the first two nights of getting used to the new therapy, I have had an AHI below 1.0 every night.  It's certainly working with the autoASV setting.  My only issue is that I still wake up a few times a night because of air leaks blasting me in the face.  They always come out the top of my mask: into my eyes or forehead.  I'm using a medium AirTouch F20, but I ordered a small cushion and small headgear just to see if that will help.  The leaks are always during the highest pressure inhalations, so I'm also wondering if lowering the pressure settings on the machine might help.

By the way, I got an EKG and bloodwork done at my GP's office, and they were both fine.  So no worries about heart failure for the ASV.

The members of this board have been my saviors, and because of your helpful posts I am starting my correct treatment months ahead of schedule (and likely with thousands of dollars in savings thanks to the link to a used machine).  With the exponential increase in COVID patients in my area, getting in to the hospital to meet my sleep doctor is literally impossible right now.  I have an appointment scheduled for three months from now in the hopes that non-emergency patients can get in by then.  And who knows how long it would have taken to get an ASV through insurance....

Thank you everyone for your replies!


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#34
RE: Is My Central Apnea Hopeless?
WOW!  What a wonderful result you are having!  The change is incredible.  This list is so very helpful!  I-love-Apnea-Board
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#35
RE: Is My Central Apnea Hopeless?
Best case is work on mask and leaks directly instead of lowering pressures. Dropping pressures can hinder therapy. I had the F20 and I gave up on it after a year plus. I couldn't get it to consistently not leak. I would fiddle with the straps and get it to be OK for leaks for a few days then it's blowing in the wind again. Repeat the strap adjusting and repeat a few good days and repeat over and over. If this F20 causes you leak issues, put it out of your misery and replace it with something better. I use Fisher & Paykel's Vitera but there's others. Replace it with almost anything and you'll be happier.
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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#36
RE: Is My Central Apnea Hopeless?
I've been looking forward to seeing your ASV results for some time, and am very happy to see the results that, to be honest, were completely expected. It's also good to hear the Dotmed lead worked out, and the machine was the more advanced ASVauto version. It will be interesting to hear your doctor's reaction to this, and more important his update to your diagnosis and prescription. We are here to assist people that can't get help from the medical system that too often refuses to listen, or endlessly conducts test and trial and error costing thousands of wasted dollars. Let me give you some credit where it is due. Without your determination to seek better therapy and to put your own dollars at risk to implement our suggestions,none of this could have happened. You were your own advocate and it takes a lot of faith and determination to over-ride the recommendations of your doctor and insurance to move to advanced ASV therapy. Many people with CA drop out without ever knowing why the therapy doesn't work. But enough of my soap-box. Congratulations on the great results and finally better sleep. Mask leaks should be pretty easy to resolve. Read the mask primer link in my signature links, and give serious consideration to a nasal pillows mask like the Resmed Airfit P10. As long as you can control air escaping from your mouth it will seal well. With that said, your leak rate is very good other than occasional spikes of flow that suggest you are just briefly losing the mask seal.

Based on my review of your chart I think setting EPAP min at 5.0 is more in line with your needs.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#37
RE: Is My Central Apnea Hopeless?
After finally reading the mask primer posted on here, I'll start with its suggestion to try the least obtrusive mask and work my way up from there.  For now, that will be the Airfit P10 nasal pillows as suggested by Sleeprider.  If I end up needing a full face mask like I'm using now, I'll give the Fisher & Paykel Vitera a try - it can't be worse than my F20.  The silicone version rubs the bridge of my nose raw and I can't get a seal with the memory foam version.

I suppose I'll start a new thread if I have more questions about masks or other issues, but for anyone reading this later, I'll answer the question that started the thread:

CENTRAL APNEA IS NOT HOPELESS!  I just needed the right tool for the job, which was an adaptive-servo ventilation machine in my case.  Thank you to everyone here that helped me steer towards this device!

Thanks
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#38
RE: Is My Central Apnea Hopeless?
Ple keep ALL your inquiries, including mask issues in the same thread. It can really help to maintain that history.
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#39
RE: Is My Central Apnea Hopeless?
As a short follow up, it took a few months for me, but after months of AHI readings of 0.1 to 0.5 maximum, I have finally started to feel like a normal human again. The debilitating headaches that I used to have daily are gone, I have more energy to do things during the day, and my wife has noticed I am much less irritable. The nasal pillows worked perfectly even though I have always had trouble breathing through my nose.

Unfortunately, I now have to deal with doctors and insurance to get a prescription for an ASV. I was able to convince a used third party seller that my BiPAP prescription still applies for an ASV, but I don't want to count on that in the future. My current doctor ordered an echocardiogram, which showed no problems, but she is still unwilling to write a prescription for an ASV without a lab sleep study. I did have a home sleep study that showed CSA, but she insists that I need a lab sleep study with a chest strap measurement to be sure that I need an ASV. After submitting that to insurance, it was denied because they said my home sleep study already showed everything the doctor needed to plan treatment. So now I am going in circles trying to figure out who is wrong and get my prescription.

While I'm waiting for all that to get sorted out, I have a question for the board: Have ozone sanitizers been replaced by UV sanitizers? I have a Sleep8 sanitizer, but the original site where I bought it no longer sells it or the replacement supplies, and I don't find it on the most popular CPAP supplier websites here in the US. Instead, they all seem to be selling some variant of a UV santitizer. Before I buy more replacement bags, I just wanted to check with the board to see if I should switch my sanitizer instead.
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#40
RE: Is My Central Apnea Hopeless?
IMHO you need neither the Ozone nor the UV sanitizers.
The source air is your room air which you breathe all day anyway, the only "germs" that get placed in your mask tubing humidifier are yours, which your body is used to. Periodically cleaning with mild soap and water, which the manufacturers of the "cleaners" say is required prior to using the cleaner. Once done, the so called "cleaners" are not needed.
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