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Centrals not part of sleep study
#1
Hello All,

I have 7 central apneas an hour during sleep but the sleep study machine that I was texted on, did not have the capability to register centrals. Now my DME will not give me a resmed machine designed for centrals. When I found this out by accident, I called my insurance to see if I could have another sleep study, they said no.

I believe this is another case of the medical mafia sticking together!!!!Angry

Kate
:Using cpap then vpap since Feb.2013,
Kate
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#2
If the machine that you have is really the ResMed S9 Bilevel Adapt, I believe that it is a machine for centrals. It may not be the most agressive but it may just need some adjustments made. How long have you been having 7 centrals per hour? I do not remember if you have said what kind of a sleep study you had. Could you refresh my memory. If you had a full fledged Lab sleep study, they do not need the machine to tell them that you are having centrals.

Best Regards,

PaytonA
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#3
Payton's right. The S9 VPAP Adapt is a true ASV machine. Basically the big gun for central apnea problems.

http://www.resmed.com/us/en/consumer/pro...adapt.html

What exactly does it say next to the power button on your unit?

Take out the water tank so you don't spill water into the unit, and look on the back of the blower unit to find the model number on the label. (Maybe 36037)

I'm not sure there actually is an S9 Bilevel SV Adapt. There's an S9 VPAP Adapt and an S8 VPAP Adapt SV.

Is there such a thing as an S5i humidifier? I'm familiar with the H5i humidifier.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#4
My machine is model number 36006A. Next to the button, it says VPAP AUTO.

My sleep study was done in a motel with a technician.

Kate
:Using cpap then vpap since Feb.2013,
Kate
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#5
For your sleep study, did you have bands around your chest?
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#6
(08-10-2014, 06:38 AM)Kate Wrote: My machine is model number 36006A. Next to the button, it says VPAP AUTO.

My sleep study was done in a motel with a technician.

Kate

Thanks. That's a "ResMed S9 VPAP Auto," not the "4ResMed S9 Bilevel SV AUTO" you have listed in your profile. Please change your profile to avoid confusion in the future.

The DME doesn't decide if you get a machine that treats central apnea. That decision would have to be made by your doctor.

What's your total AHI? What was your AHI in the sleep study?

As for another sleep study, it might be possible if you need another study if your current machine isn't treating your apnea, but it will need preauthorization. In particular, you may be able to get insurance to pay for a "titration," which is a study that doesn't diagnose your apnea, it is used to find the right pressure for your machine. In particular if you get moved up to an ASV machine, you are more likely to get a titration study approved.

While the VPAP Auto isn't "the big gun" machine for central apnea, you may be able to make it work with some adjustment. While people with bad central apnea may really need an ASV machine, there are some drawbacks to an ASV machine.

Look at your centrals on the air flow waveform in your data. See how long they last. If they don't last very long, it's not as worrisome as if they last a long time. I find SleepyHead is easier for me to work with.

Remember that "central apnea" isn't necessarily any more harmful than obstructive apnea. They may just be harder to eliminate.

By the way, your sleep test probably would register central apneas as apneas, it just didn't distinguish between central and obstructive. If the sleep study was done without you wearing a mask and getting CPAP pressure during part of the test, you may not have had any central apneas. Many people don't have central apnea until they get CPAP pressure.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#7
I've noticed that I can create centrals by merely swallowing while fully awake. Is that normal? Incidentally, I use a small digital audio recorder to record my sleep sounds and it seems that all of my centrals are occurring when I'm awake. I mean as best I can determine I'm awake since I breathe much differently when awake and do things like clear my throat. I also mention things like "I'm turning over to my side now" so it sorta proves that I'm awake. I'm just ready to bet my centrals are all phony alerts created by my swallowing spit to keep from drowning.

Edit: I have also noticed that a farting mask can be mistaken for a snore event. Makes sense, so it pays to review the leak reading when you see a snore event. I think it pays to check all readings in reference to any event markers just to help understand how these machines work.

As for my swallowing incidents, I see that I can score a reading in the Flow Limitation graph with a single swallow whereas I can score a central incident with a double swallow. That seems reasonable and proves the machine is listening even if not able to distinguish my conscious acts from my autonomic ones.

I think I'll just deduct my centrals from the AHI score in order to get a more meaningful score.
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#8
(08-10-2014, 06:38 AM)Kate Wrote: My machine is model number 36006A. Next to the button, it says VPAP AUTO.

My sleep study was done in a motel with a technician.

Kate
You need a sleep study in sleep lab for proper diagnosis of central sleep apnea and other sleep disorder

Pain relief medications contain opiates can causes central sleep apnea

Stand to be corrected, machine designed to treat central apnea does not score central apnea
imo, near impossible to setup an ASV machine without proper diagnosis and sleep doctor supervision

I can tinker with my machine but my machine is not an advanced ASV machine



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#9
(08-08-2014, 05:51 PM)Kate Wrote: I have 7 central apneas an hour during sleep but the sleep study machine that I was texted on, did not have the capability to register centrals

If the machines used during your sleep study had no way of registering central apneas, then how do you know you have them?

Are you using your ResMed S9 VPAP Auto to determine that you're having 7 centrals per hour?

If so, there are two things you should know.

1. No CPAP machine can determine if you're have a central apnea. They can make an educated guess, but not a determination.

2. Even if the central apneas detected by your CPAP machine are real, they could be caused by the CPAP therapy itself. The course of action now is to see if they go away. Talk to your doctor about temporarily lowering your pressure to see if they can be reduced. If they persist for several months then that will be something the doctors will need to take much more seriously.

Use software to see how long these central events last, and you can also get an oximeter to see if they are causing oxygen desats.

Just because there's a medical mafia doesn't mean that every doctor is a member. There are lots of competent well-intentioned doctors out there, you just have to look for them.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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
(08-10-2014, 09:22 PM)Sleepster Wrote: 1. No CPAP machine can determine if you're have a central apnea. They can make an educated guess, but not a determination.

I disagree with this statement.

Other than the fact that it records apneas when you are still awake, I think we can be reasonably confident anything an S9 or PRS1 calls a central apnea or clear airway apnea is in fact a central apnea.

I do think the machines will sometimes score a central apnea as obstructive, but I don't think they tend to call obstructive apneas central.

The question of recording apneas when you're not asleep applies to both central and obstructive apneas.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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