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CSA. Cheyne Stokes? ASV or CPAP?
#11
RE: CSA. Cheyne Stokes? ASV or CPAP?
(07-18-2022, 09:01 AM)Sleeprider Wrote: Jonno, welcome to Apnea Board.  Your results with the Autoset are interesting with all events being central.  Your pattern of sleep disorder is fairly common. Shortly after going to sleep your pressure rises from your ramp of 5.0 to a higher pressure. You seem to have 6.4 as a maximum pressure and EPR that keeps your exhale pressure at 4.0.  It will help if you minimize the monthly calendar so we can see more respiratory statistics and settings.  While the event rate is low, you find it disruptive to sleep. Your previous sleep results do not indicate a problem that would normally qualify for medical intervention or insurance reimbursement.  

We need to get a better look at normal respiration where you are sleeping but not experiencing events so we can evaluate what the flow looks like, and we may want to evaluate what your therapy looks like without EPR to see if that helps.  Let's consider this an evaluation period of your response to some different CPAP variables, that we hope will lend some insights to your problem/needs.   I would like to see you try a night of fixed pressure with EPR and ramp off, and a fixed pressure of 6.0.  You can still use Autoset mode with a minimum pressure of 6 and maximum pressure of 6 and the device will record flow limitation. If you change to CPAP mode it will disable flow limitation scoring.  This should provide a look at your baseline respiration without the influence of bilevel (IPAP/EPAP) pressures.   Your respiratory flow seems to vary from breath to breath and in addition to seeing the full night, I'd like to sample some zoomed screenshots of 3-4 minute duration where we can clearly see the flow wave shape. Remember to swichoff the calendar by clicking the triangle or F9.

I managed to stick it out on these settings. Was difficult initially but managed to get through the night and it got more comfortable as the night went on. I have attached 2 screen shots. AHI is low but still getting the centrals.


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#12
RE: CSA. Cheyne Stokes? ASV or CPAP?
It Seems the fixed pressure was causing more hypopneas and disturbed sleep. I set it back to EPR with Ramp Auto half way through he night. I struggle to fall asleep with ramp off and fixed pressure. Im not sure what to try next for the centrals.


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#13
RE: CSA. Cheyne Stokes? ASV or CPAP?
If we were working with the Vauto or VPAP S we could use some pressure support and set the trigger sensitivity on high. This seems to help queue your spontaneous respiration to create a breath, when a CA might normally be recorded. We're kind of out of options on CPAP.
Sleeprider
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#14
RE: CSA. Cheyne Stokes? ASV or CPAP?
Thanks for the help sleep rider. I’ll see if I could trial a different machine. The only other option I could get hold of is an AirCurve 10 CS pacewave. Might only be in a few weeks though.

One additional question I have is, prior to quite a number of the CA events I notice an arousal, does this mean I’m awake. 

And on others there seems to be a build up of a waxing and waning pattern where it looks like I’m asleep.
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