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Central apnea questions
#1
Q. If 99% of my apneas are the central type meaning my airway is open, what is the need for ANY cpap air pressure in that situation?

Q. What if anything can be done about central apneas? Is it normal for older people like me (age 82) to be more prone to experience central vs obstructive apneas?

Q. I'd really be interested in seeing what my oxygen levels are during these central apneas...does the DME need a Rx under Medicare coverage to supply me with A oxygen sensor for my machine?

A. If my resmed air sense 10 auto sense machine is capable of both a static pressure setting and a variable pressure setting why would I not always want it to be set in its auto set mode rather than a 5 month old sleep study titration recommended setting of,say cpap 7? And what would a reasonable variable setting be for a 7 if I chose to try a variable setting?

Sorry for all the questions...just trying to get educated about my new situation.

Old82

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#2
It's my understanding that CPAP or APAP is not the correct treatment for Central Apnea and that you need an ASV device that will "breathe" for you when you stop doing it for yourself. Age is certainly one risk factor for Central Apnea - it is a failure of the brain to send the "must breathe" signal. There are others who can answer in greater detail to help you with this.

http://www.[[ Auto Word Filter: links to DME-owned sites not allowed Wrote:] /medicare-reimbursement-pulse-oximetry.jsp]
Medicare will generally allow payment for pulse oximetry when accompanied by an appropriate ICD-9-CM code for a pulmonary disease(s) that is commonly associated with oxygen desaturation. Routine use of pulse oximetry is non-covered.

an auto setting allows the machine to respond in real time to the changes in breathing and react accordingly. A static setting gives you the same pressure whether or not it is therapeutic. (imo, auto is much better)
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#3
Welcome to the forum Old82!

The CA's being reported are based (usually) on the premise that you didn't breathe for 10 seconds or more. You need to analyze your sleep data to see how long your not breathing to better understand what is happening. I sometimes have many CA events during a night's sleep only to find they lasted 11 to 13 seconds. As far as oximeter readings, it will probably be easier to obtain a CMS-50D+ or CMS-50F oximeter than finding the oximeter module that fits your CPAP. These models have recording capability for overnight use. The only thing to keep in mind when using these oximeters is they only record one continuous session. This means that once you start it for the evening, don't stop the recording until the next morning. Otherwise it will overwrite any previous data once the record function is restarted.

Good Luck!
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#4
(12-30-2014, 01:16 PM)old82 Wrote: Q. If 99% of my apneas are the central type meaning my airway is open, what is the need for ANY cpap air pressure in that situation?

Q. What if anything can be done about central apneas? Is it normal for older people like me (age 82) to be more prone to experience central vs obstructive apneas?

Q. I'd really be interested in seeing what my oxygen levels are during these central apneas...does the DME need a Rx under Medicare coverage to supply me with A oxygen sensor for my machine?

A. If my resmed air sense 10 auto sense machine is capable of both a static pressure setting and a variable pressure setting why would I not always want it to be set in its auto set mode rather than a 5 month old sleep study titration recommended setting of,say cpap 7? And what would a reasonable variable setting be for a 7 if I chose to try a variable setting?

Sorry for all the questions...just trying to get educated about my new situation.

Old82


Not sure what I'm doing in the reply procedure but just wanted to say thank you to those who reply.
Old82
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#5

Welcome to the forum Old82!

The CA's being reported are based (usually) on the premise that you didn't breathe for 10 seconds or more. You need to analyze your sleep data to see how long your not breathing to better understand what is happening. I sometimes have many CA events during a night's sleep only to find they lasted 11 to 13 seconds. As far as oximeter readings, it will probably be easier to obtain a CMS-50D+ or CMS-50F oximeter than finding the oximeter module that fits your CPAP. These models have recording capability for overnight use. The only thing to keep in mind when using these oximeters is they only record one continuous session. This means that once you start it for the evening, don't stop the recording until the next morning. Otherwise it will overwrite any previous data once the record function is restarted.

Good Luck!
[/quote]

Could you briefly explain cms-50d+ And cms-50f.
Thanks
Old82
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#6
Hi old82,
WELCOME! to the forum.!
To treat Central Sleep Apnea, (CSA,) an Adapt Servo Ventilator, (ASV,) machine is used.
Hang in there for more answers (and a better explanation than I could give you,)to your questions and much success to you with your CPAP therapy.
trish6hundred
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#7
@old82 - central apneas might also be caused by past and present opiate use. Check or ask physician about the medications you are on. And, do an internet search for 'opiate induced apnea'. good luck, and also please indicate what your normal or average AHI or RDI is.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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#8
Quiescence
No, no opiates. My ahi reports run between 3 and 8 and my central ai runs between 2 to 6 which brings me to a basic question about these "i"numbers which you may be able to help with. Does the i in ahi and total ai and central ai mean average per hour slept?

If so, isn't this a very misleading number? For example if my morning report says central Ai was 5 for 8 hours of therapy for that night but virtually all of my central apneas occurred during a one hour period early in the morning like during rem sleep this could mean I'm having very damaging central events over a short period of time that isn't reflected in an "average" number..correct?


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#9
(12-30-2014, 06:07 PM)old82 Wrote: If so, isn't this a very misleading number? For example if my morning report says central Ai was 5 for 8 hours of therapy for that night but virtually all of my central apneas occurred during a one hour period early in the morning like during rem sleep this could mean I'm having very damaging central events over a short period of time that isn't reflected in an "average" number..correct?

It's not misleading. If you have 4 events in 8 hours of sleep, your AHI is 4/8= 0.5. You can multiply the AHI by hours of sleep and get a total, or if you read the AHI graph in Sleepyhead, you will see the peak AHI for each discrete hour. You are correct that the frequency of events normally fluctuates during the night, but that is a good reason to monitor your own data so you can use that peak as part of your discussion with the doctor, or decision on therapy. A large part of that is to observe the conditions under which the peak events happen (pressure, time, flow, type).
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#10
(12-30-2014, 06:27 PM)Sleeprider Wrote:
(12-30-2014, 06:07 PM)old82 Wrote: If so, isn't this a very misleading number? For example if my morning report says central Ai was 5 for 8 hours of therapy for that night but virtually all of my central apneas occurred during a one hour period early in the morning like during rem sleep this could mean I'm having very damaging central events over a short period of time that isn't reflected in an "average" number..correct?

It's not misleading. If you have 4 events in 8 hours of sleep, your AHI is 4/8= 0.5. You can multiply the AHI by hours of sleep and get a total, or if you read the AHI graph in Sleepyhead, you will see the peak AHI for each discrete hour. You are correct that the frequency of events normally fluctuates during the night, but that is a good reason to monitor your own data so you can use that peak as part of your discussion with the doctor, or decision on therapy. A large part of that is to observe the conditions under which the peak events happen (pressure, time, flow, type).

I agree that it is "misleading" if you look at AHI as the only way of calculating damaging sleep patterns. AHI and CAI show that something is amiss. Having them all cluster during REM means your total AI for that period of time is much higher and therefore deleterious to the quality of your REM. Since REM problems cause health issues, and a complete lack of REM will kill you in about 5 weeks according to the folk that use sleep deprivation as a torure tool, This needs to be evaluated and treated appropriately. That is my opinion.
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