Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.
Login or Create an Account
09-04-2022, 04:09 PM (This post was last modified: 09-04-2022, 04:11 PM by shifttybits.)
Can I optimize my treatment?
I've been lurking around in these forums for a few months now and have finally decided to post to get some advice on my current treatment.
I was diagnosed with idiopathic non-ischemic cardiomyopathy this past April with an EF of 30%.
In addition to all the lifestyle changes and medications that go along with heart failure treatment I decided to finally address my sleep apnea which I knew I must have. I did an at home sleep study in the beginning of May. I have attached the results to this post.
The following is the doctor's interpretation of the study:
Quote:This home sleep study demonstrates severe obstructive sleep apnea, worse in the supine position. Mixed + central apnea index was elevated and there was a dense cluster of central respiratory events towards the beginning of the recording at presumed sleep onset; clinical correlation for these findings is recommended. Average oxygen saturation was low at 92%
I purchased a Resmed AirCurve 10 VAuto and began treatment toward the end of May. I use a F20 full face mask as well.
Also since my initial diagnosis I have dropped 25 pounds and my EF has gone up to 40% (measured at the beginning of August).
I managed to get my AHI to under 3 AHI from 38AHI.
09-04-2022, 04:16 PM (This post was last modified: 09-04-2022, 04:17 PM by shifttybits.)
RE: Can I optimize my treatment?
It seems I mostly have what is being reporting as CA events now. I am attaching past 3 nights as well for review. These are typical nights for me lately.
In general I'm not feeling much better. I am not sure if it is my medications, the cardiomyopathy are something still related to the apnea.
Is there anything more I can do to see if my apnea treatment can be improved?
I am NOT an expert but was curious because the Aircurve 10 is purpose-built to handle Centrals. As I understand it, your machine should be able to eliminate virtually ALL centrals. September 3rd was a much better night; did you make any changes that would account for that? An expert should come along soon to help you with this.
The AirCurve vAuto is NOT designed to handle Central Apneas. It is targeted at UARS, flow limitations, and hyponeas.
The machine for treating Centrals is the AirCurve ASV - Auto Servo Ventilator, and there is some controversy about using it for people with low ejection fraction.
There are ways the vAuto can minimise CA events, and somebody else will have to discuss that.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
As you mentioned I have a low EF so the ASV was not recommended to me at this point in time. Hopefully my EF will continue to increase, but for now I am stuck with the VAUTO.
You are "stuck" with a very good machine. And no, it is not meant to treat CA's but we can try to minimize them by using the Trigger setting. The default setting is Medium.
Set the Trigger setting to High.
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.
What is your trigger set at?
Ask your doctor if there is a problem that conflicts with your heart failure with setting Trigger higher to attempt to trigger a breath easier and thus reduce your central apnea. I have no expertise with your combination of conditions so I'm not recommending this for you. Only to have you talk about it with your doctor.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter