Central sleep apnea

[Ron AKA]

Anyone here with central sleep apnea? What was the fix and how are you doing with it?

Can you post some typical nights with a SleepyHead daily detail screen shot. That would be very helpful in understanding to what extent your central apnea is an issue. How long have you been using a CPAP? The reason I ask is that studies have found that central apnea can increase or emerge as an issue with the initiation of CPAP treatment in about 6% of the cases. However over the first 6-8 weeks in 75% of those cases the CA issue reduces and resolves itself. Here is a link to an article on it.

The True Pervalence of Central Apnea in CPAP Patients

I am about at the 8 week of treatment mark and I thought I was seeing a reduction in CA events, but it remains highly variable from night to night, and I am not sure it is going to resolve itself with time only. I think there are two steps which may offer some benefits over the AirSense 10 for treatment. The AirCurve VAuto in S mode, may mitigate CA events to some extent. However the AirCurve ASV offers the most positive treatment. My personal plan is to continue with the AirSense 10 to see what I can get out of it over the longer term, before I jump to another machine.

[mesenteria]

Like all these studies they never say how many patients were studied and how and where it was done.
...

"..Multiple clinical databases were queried to assess potential signal biomarkers of ASV effectiveness, including the following: (1) attended laboratory adaptive ventilation titrations: 108, of which 66 had mainstream ETCO2 measurements; (2) AirView data in 98 participants, (3) complete data, from diagnostic polysomnogram (PSG) through review and prospective analysis of on-therapy data using SleepyHead freeware in 44 participants; and (4) hemodynamic data in the form of beat-to-beat blood pressure during ASV titration, using a Finometer in five participants..."

It was the large second paragraph in the abstract, all of which I have quoted above.

[mesenteria]

Anyone here with central sleep apnea? What was the fix and how are you doing with it?

It won't be helpful to you, but five months into tmt I am left with an AHI average of 0.72.  Almost all of it is CA in my case.  They average three a night and rarely exceed 15 seconds in length.

[SarcasticDave94]

Does the ASV feel like a regular CPAP when you use it?

To me it does the more I have used it. I say that as I am well adjusted to the ASV now. I have to note the exception, as it were, because it is a different animal than CPAP. I encountered a beginner's learning curve that includes the occasional high pressure hit when I was moving to settle into another position while falling asleep. I believe the ASV thought it was a central event that it needed to give higher blow power, but it was caused by me moving and holding a breath. I would "blow back", literally, into the mask to help it get back into place as it were. I can sometimes also feel some pressure changes, seemingly more distinct than the Respironics BiPAP I had prior, as I'm transitioning to sleep. I noticed it much less after about a month. Otherwise, it operates and acts like the CPAP and BPAP.

[johndee]

Hi Guys,
Sometimes cpap can trigger centrals and a simple switch to a bpap can eliminate that. But to clarify...it's the ST portion of an ASV that actually treats centrals. I had about 1/3 centrals in my sleep study and am using a BiPap ST to treat both my OSA as well as the centrals. So if you are healthy otherwise (no copd) a bipap st may do the job.
JD

[jaswilliams]

Does the ASV feel like a regular CPAP when you use it?

Getting to sleep is different. On a resmed the breathing rate is set on a 3 minute rolling average I find that as I fall asleep the machine detects a slow down in breathing and wants to assist and starts blowing or dropping pressure support if my rate is too high. This can be remedied by blowing back against the machine and it will back off for another 3 minutes by which time I am usually asleep.


Beyond that I don’t know as I am asleep but I can see from sleepyhead mask pressures moving between 6 and 20 but I am comfortable and wake rested

[BTS1]

Anyone here with central sleep apnea? What was the fix and how are you doing with it?

I have Complex Apnea with most my events being Central.  My AHI was 95 before treatment, I am now on an ASV machine after they had me on CPAP and Auto BiPAP ... ASV is amazing and has me well under 5 .. Most nights under 1 ... Haven't been happier with this machine. .

[Hojo]

Does the ASV feel like a regular CPAP when you use it?

To me it feels so much better and it is largely due to the fact that I do not have obstructive apnea.  My pressure is set at the absolute minimum of 4 and the ASV is there only when I stop breathing.  I occasionally notice that the machine puts in air for me and I realize, hey, I'm not breathing.  It is comforting to me knowing that it is there when I need it.

The 'blow back' that Dave speaks of I will also use; the machine will kick in if it notices that I stopped breathing and when I don't want it to do so, is when I'm 'pausing' as I roll over from my back to my side.

[Shift Worker]

Hello,
I have been using my Resmed ASV for my complex apnea, I was never able to get used to a standard CPap or even a regular BiPap and therefore left myself untreated for way too long. After several bouts of Afib I decided to do myself a favor and figure this sleep thing out, I got myself a sleep Dr. played all the games, meaning four more sleep studies and an ECO to find out if my heart was in good enough shape. Then I was given my ASV and then a sharp "learning curve" or getting used to my machine waking me as I dozed off. I can not tell you the difference between the different Pap therapies but I can tell you that using my ASV allows for regular rest full sleep, better concentration and more energy during the day! I also just had a total hip replacement and have recovered from that with flying colors, I am impressed at how easy recovery from hip replacement has been, and yes I partially blame me getting restorative sleep for this!
All I can tell you is, if you are a candidate for the ASV treatment, stick to it and life will become better. It has for me.

[jerrydaw]

I would have to say that the ASV machine feels like a regular bilevel machine, not a non-bilevel machine.  The difference between the two is the treatment of the exhale relief.  Before I got the ASV, I was worried that the feeling would be different, i.e. that I would awaken when it intervened in a central event and caused me to take a breath.  That has not been the case for me.  I do not awaken and I am fully asleep when any intervention occurs. Like others, I had to navigate the insurance route of starting with a regular CPAP machine, then trying a bilevel machine, then taking another sleep test to finally obtain the ASV machine.  In my case, I had a mixed bag of about half obstructives and half centrals.  My first two machines took care of the obstructives but left me with about 20+ centrals per hour.  With the ASV, I am down to about 1.9 AHI average.  It is truly a  wonderful machine.  I wake up rested after a good night's sleep.  The only drawback is that the pressures cause a severe case of dry mouth.  I usually wake up at least once during the night and drink water to relieve the very dry tissue sensation.