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Central Apneas after Turbinate Surgery
#1
Central Apneas after Turbinate Surgery
Hello to all!

I have been using a Bilevel for years and my current machine is an Aircurve 10 VAuto.

I had turbinate surgery on Jan 11th and I am breathing much better except some nights when I am congested. I never had significant central apneas before and my stats were always good, but after surgery I am getting a lot of central apneas. I hope you can offer me advice on what to try. I have installed OSCAR and ResScan and have data from both.

Thanks in advance,
u4ea
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#2
RE: Central Apneas after Turbinate Surgery
Let's start with a daily details chart from Oscar. Since you are only 2-3 weeks out of surgery, you are still in some transition. Let us know what you'd like to improve in your therapy. Your profile shows a 12-25 pressure span, but without pressure support, it's not very useful. You seem to be using a F20 mask, and that has certainly had mixed success. Are you interested in changing up? Have you ever tried nasal therapy?
Sleeprider
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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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#3
RE: Central Apneas after Turbinate Surgery
(01-31-2021, 08:35 PM)Sleeprider Wrote: Let's start with a daily details chart from Oscar. Since you are only 2-3 weeks out of surgery, you are still in some transition. Let us know what you'd like to improve in your therapy.  Your profile shows a 12-25 pressure span, but without pressure support, it's not very useful.  You seem to be using a F20 mask, and that has certainly had mixed success. Are you interested in changing up? Have you ever tried nasal therapy?

Hi Sleeprider,

I will send the chart from Oscar and then I hope you will have enough info about my sleep problems. I have the F20 mask and I love it. I have tried nasal therapy but I had a UPPP throat surgery and the air just goes right out of my mouth. I would like to get rid of the central apneas, I never had them before the surgery so I thought maybe the pressure needs to be lowered?

Thank you!
u4ea


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#4
RE: Central Apneas after Turbinate Surgery
Events are mainly CA, and the EPR can reduce your CO2 enough to drop your respiratory drive. To learn more about your apnea, I'm going to ask you to reduce pressure and EPR. Let's try some changes:
Minimum pressure 11.0
Maximum pressure 14.0
EPR Full-time at setting of 1
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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#5
RE: Central Apneas after Turbinate Surgery
SR, it looks like you might have your replies mixed up? u4ea does have more ca but is using a vauto at 4 over 11-25.
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#6
RE: Central Apneas after Turbinate Surgery
Sorry about that. Vauto settings:
Mode Vauto
EPAP min 9.0
Max Pressure 20
PS 2
Trigger Sensitivity: High

Our objective is to reduce CA and it looks like your turbinate surgery may have changed up your requirements.
Try to expand the left column by moving the dividing pane to the right so text is not wrapped, or use your computer's zoom funciton to make the text smaller (touchpad pinch move, mouse Ctrl + scroll wheel). I'd like to fit a bit more information in there.
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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#7
RE: Central Apneas after Turbinate Surgery
(01-31-2021, 09:58 PM)Sleeprider Wrote: Events are mainly CA, and the EPR can reduce your CO2 enough to drop your respiratory drive.  To learn more about your apnea, I'm going to ask you to reduce pressure and EPR.  Let's try some changes:
Minimum pressure 11.0
Maximum pressure 14.0
EPR Full-time at setting of 1

Hi Sleeprider,

I changed my settings last night before I saw this post.

I changed max IPAP to 15.4 and I only had 3.4 events per hour and slept 7:32 hours last night with one bathroom trip.

Thank you for your quick reply!  and I will leave it set as is and see how I sleep tonight.

Thanks again!
u4ea
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#8
RE: Central Apneas after Turbinate Surgery
(02-01-2021, 02:46 PM)u4ea Wrote:
(01-31-2021, 09:58 PM)Sleeprider Wrote: Events are mainly CA, and the EPR can reduce your CO2 enough to drop your respiratory drive.  To learn more about your apnea, I'm going to ask you to reduce pressure and EPR.  Let's try some changes:
Minimum pressure 11.0
Maximum pressure 14.0
EPR Full-time at setting of 1

Hi Sleeprider,

I am changing my Bipap to your suggested settings.
Minimum pressure 11.0
Maximum pressure 14.0
But I don't see a setting for EPR on my Aircurve 10 Auto
Is it called something else on this machine?
Thanks,
u4ea
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#9
RE: Central Apneas after Turbinate Surgery
An AirCurve Vauto doesn't have an EPR. Instead, it uses the term PS (pressure support). EPR subtracts its pressure value from your IPAP setting to determine the EPAP pressure value. The PS adds its pressure value to your EPAP setting for an IPAP pressure setting. Thus, you will set your EPAP to a starting value then set the PS value to a pressure difference you wish for your IPAP. You then set the IPAP value to the maximum that you will allow your AirCurve to obtain. An example would be setting the EPAP to 10, a PS of 4, and an IPAP of 18. This would start your AC10 off at an EPAP of 10, an IPAP of 14, but would allow your unit to climb to a maximum of EPAP of 14 and the IPAP to 18, the programmed limit. The PS will be a constant difference between the two.
Crimson Nape
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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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#10
RE: Central Apneas after Turbinate Surgery
I was mistaken when I recommended Airsense 10 settings for your Aircurve 10 Vauto. i did catch the error of post #4, and posted revised settings in post #6. Please accept my embarrassed apologies, and some changed settings.

Mode Vauto
EPAP min 9.0
PS 3.0
Max Pressure 20.0
Trigger sensitivity: High

This reduces the pressure and pressure support, and uses a sensitivity setting for trigger (the switch from EPAP to IPAP) that has worked for many of us to reduce CA events.
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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