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Do I have Cheyne-Stokes?
#11
RE: Do I have Cheyne-Stokes?
Agree with above comments, starting CPAP tends to blow off too much carbon dioxide and your body will stop breathing to build the CO2 back up, and this becomes an on going cycle until your body can compensate for the added air being blown in your lungs.

If you don't have a history of head trauma, neurological issues, or CSR during the day time while awake, then it is highly unlikely you have CSR.  I had the same breathing patterns with CPAP and my sleep apnea was due to CA events and now currently on ASV.  In order to minimize CA events on CPAP, lower EPR and CPAP pressure helps, but if you have OA events, you will need the pressure support.
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#12
RE: Do I have Cheyne-Stokes?
Thank you sleeprider for all of this very informative information. Also thanks to others responding with more assurance that this is not cheyne-stokes. I have an appointment with my doctor tomorrow where hopefully we can discuss all of this information. I will ask about the ASV and see if I can be moved to that. Will see how quickly that can happen. I hope my insurance doesn't become a pain.

I am confused how the in-home sleep study can score with with severe obstructive apnea (65 AHI), but not be able to say anything about central apnea? I asked to see more detailed results and the doctor claimed they only had the average number generated by the software -- no charts etc. I pushed to see if I could do the in-lab test at that time, but insurance refused. Hopefully with more data from the machine the insurance will cover these new things.

I hope this doesn't get too expensive. If I need a new machine, what happens to the old one? I am on a 6 mo rent-to-own right now. Any way, I think my insurance is decent and I have met my deductible already this year so hopefully it won't get too crazy on me. It looks like the hoses, masks, and such are the same?

Again, thank you everyone!
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#13
RE: Do I have Cheyne-Stokes?
Home sleep studies have problems determining what is going on, and it depends on what was being measures. Normally the criteria for OA is a lack of flow (detected by a nasal canula) together with respiratory effort as measured by a chest strap. In other words, you are trying to breath, but airflow is blocked, and an apnea occurs.

A CA can be scored if there is no flow and no chest effort. You have to see the details of the study to see if it was correctly interpreted. In addition, many people get a diagnosis of severe obstructive apnea, even if the only thing seen was central apnea. Don't ask me why, but we even see this from clinics using full polysomnograph recorders.
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#14
RE: Do I have Cheyne-Stokes?
(05-14-2018, 02:58 PM)cisbrane Wrote: Thank you sleeprider for all of this very informative information. Also thanks to others responding with more assurance that this is not cheyne-stokes. I have an appointment with my doctor tomorrow where hopefully we can discuss all of this information. I will ask about the ASV and see if I can be moved to that. Will see how quickly that can happen. I hope my insurance doesn't become a pain.

I am confused how the in-home sleep study can score with with severe obstructive apnea (65 AHI), but not be able to say anything about central apnea? I asked to see more detailed results and the doctor claimed they only had the average number generated by the software -- no charts etc. I pushed to see if I could do the in-lab test at that time, but insurance refused. Hopefully with more data from the machine the insurance will cover these new things.

I hope this doesn't get too expensive. If I need a new machine, what happens to the old one? I am on a 6 mo rent-to-own right now. Any way, I think my insurance is decent and I have met my deductible already this year so hopefully it won't get too crazy on me. It looks like the hoses, masks, and such are the same?

Again, thank you everyone!

The DME list price for a ResMed AirCurve 10 ASV is about $5,000. Not cheap. They can be had for far less.

But for treating Central/Complex Sleep Apnea they are world class devices. My ASV was life-changing in terms of providing effective therapy.

Good luck with the appointment. 

Bill
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#15
RE: Do I have Cheyne-Stokes?
You can find good prices on them if you search around online ... There is one for $2149 over here: <link removed: Search for CPAP Liquidators>
Also check SecondWindCPAP sometimes one will come up at a great price...

I am very lucky to have insurance covering mine, well soon, on the last week of compliance for this machine..

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#16
RE: Do I have Cheyne-Stokes?
And here is a refurb for $1795

<link removed: Search for CPAP Liquidators>
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#17
RE: Do I have Cheyne-Stokes?
You can buy a used Resmed S9 auto asv from dotmed $150 I cannot post a link so you will need to search it will need a PSU $20 clone from Amazon so an ASV for under $200 with postage. I now have 3 I am sorted for the next 15 yrs
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#18
RE: Do I have Cheyne-Stokes?
Thanks for the responses to finding my own machine. Hopefully my insurance will cover at a reasonable rate, but that is a great backup.

Here is data from last night with EPR off. It didn't really seem to matter.


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#19
RE: Do I have Cheyne-Stokes?
Yep, still looks like my results and that ASV is in your future.
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#20
RE: Do I have Cheyne-Stokes?
I talked with my doctor, and the whole conversation had me questioning how much they know about these graphs.... He had the compliance only data from ResMed, and did not have access to the graphs. I brought my SD Card, but they don't have ResScan to read it... So I showed him my graphs and he saw the Flow Rate graph and was like " I don't understand what this graph is showing". I asked if it was Cheyne-Stokes and he said that we need to do an in-lab sleep study to determine that (true, but I don't think he understood what he saw).

He did agree, however, that my results so far are odd, and that he only sees things like this in 1 patient a year. He was surprised to see such low pressure averages for what appeared to be severe OSA in the original test. Also that he usually sees this in older patients, but that I'm young (30) and so he is surprised. He says that I have his attention, but wants more data. He did suggest that ASV is in my future if I really am having central apneas. The current plan, similar to sleeprider's post, is to get more data through the end of the month to see what it looks like. He is going to talk to my insurance to try and convince them that a sleep lab study is required.

So, I will see what happens in a month. Hopefully my insurance can approve the study before the end of the month so that things can move quicker. While 15-18 AHI isn't great, it's much better than the 65 AHI originally reported. I do feel more rested than previous, so I will continue my current machine for the moment.
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