Post Reply 
[Equipment] CSA #'s that require BPAP or BPAP-SV?
Author Message
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #11
RE: CSA #'s that require BPAP or BPAP-SV?
(03-12-2014 07:03 PM)WakeUpTime Wrote:  It's another night of the persistent Central Sleep Apnea events (5/hour) on a regular CPAP machine.
Just wondering if they're part of "getting used to the new CPAP machine" or perhaps I really
do need an AutoSV machine to get rid of them altogether.

I wouldn't be overly concerned. They are part of the adaptation to CPAP therapy for many of us.

If you'd like, you can use SleepyHead to see how long these CA events last. They have to last at least 10 seconds to count as a CA. If they last significantly longer, or if you are concerned for any other reason, you can ask your doctor about it.

If I were you I would NOT adjust your pressure. Your CA index is very low and will likely drop as you adapt to CPAP therapy. If it doesn't your doctor might want to lower your pressure temporarily, but I doubt it's necessary, and it will likely raise your OA and H indices, so it's a dodgy business.

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.
03-12-2014 08:00 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
igdoc Offline

Members

Posts: 13
Joined: Feb 2014

Machine: PR S1 Bipap ASV Advanced 961
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: Built in
CPAP Pressure: EPAP 7.5. PS 0 to 7
CPAP Software: SleepyHead EncoreViewer EncorePro

Other Comments:

Sex: Male
Location: England

Post: #12
RE: CSA #'s that require BPAP or BPAP-SV?
Looks like you are on the cusp of an abnormal amount of central events which is usually accepted as 5 central events an hour when asleep and not in wake/sleep transition when central events are regarded as normal. You may well end up needing an ASV machine to completely stabilise your breathing. However I would recommend trying switching off the CFLEX/AFLEX if it is not too uncomfortable or at least substantially lowering the level. This has been shown to reduce central events in certain individuals (such as myself with full Complex sleep apnea). In my opinion it is certainly worth a try.
Ian
03-13-2014 07:30 AM
Find all posts by this user Post Reply Quote this message in a reply
WakeUpTime Offline

Advisory Members

Posts: 156
Joined: Jan 2014

Machine: PR System One BiPAP S60 Auto 760
Mask Type: Nasal pillows
Mask Make & Model: P10 pillows
Humidifier: PR S1 w Heated Tube+Hose
CPAP Pressure: Auto / Inhale 11-12.5 / Exh 9
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location:

Post: #13
RE: CSA #'s that require BPAP or BPAP-SV?
(03-13-2014 07:30 AM)igdoc Wrote:  Looks like you are on the cusp of an abnormal amount of central events which is usually accepted as 5 central events an hour when asleep and not in wake/sleep transition when central events are regarded as normal. You may well end up needing an ASV machine to completely stabilise your breathing. However I would recommend trying switching off the CFLEX/AFLEX if it is not too uncomfortable or at least substantially lowering the level. This has been shown to reduce central events in certain individuals (such as myself with full Complex sleep apnea). In my opinion it is certainly worth a try.
Ian

You understand my situation very well. I'll try exactly that. (Much appreciated.) It's either a transitional thing (only 2 mo. of CPAP) or the "Complex" part of CSA (CSA during CPAP). [No significant CSA was detected during the sleep study; only with CPAP.]

I'm just curious how much time to give it before being convinced it's CSA. Perhaps somewhere in a 6-12 month window I suppose. I really seem to be stuck on that 5 CA events/hour number. I don't know if that's the cause of the ongoing crummy sleepless nights on CPAP. (It's not a tolerating thing.) The OSA is down to a low 2, but sleeplessness continues (awake every 1.5 hours last night).

The machine's set at a constant 12 at the moment rather than variable, which seems to be the number that almost ends the OSA. The pressure doesn't really bother me, but my stomach each morning is sure ballooned/bloated/cramped.

Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
03-13-2014 07:55 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #14
RE: CSA #'s that require BPAP or BPAP-SV?
(03-13-2014 07:55 AM)WakeUpTime Wrote:  The pressure doesn't really bother me, but my stomach each morning is sure ballooned/bloated/cramped.

Turning off or lowering the EPR will likely make that problem worse.

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.
03-13-2014 03:49 PM
Find all posts by this user Post Reply Quote this message in a reply
igdoc Offline

Members

Posts: 13
Joined: Feb 2014

Machine: PR S1 Bipap ASV Advanced 961
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: Built in
CPAP Pressure: EPAP 7.5. PS 0 to 7
CPAP Software: SleepyHead EncoreViewer EncorePro

Other Comments:

Sex: Male
Location: England

Post: #15
RE: CSA #'s that require BPAP or BPAP-SV?
The papers I have read suggest that 80% of people who initially have large numbers of CPAP induced central events will improve by 2 months. That is not to say that after 2 months no one will see improvement but it may be less likely to happen. The improvement is due to the body potentially readjusting the Carbon Dioxide apnea threshold level.

The important thing is why you are sleeping badly as a few central events are not likely to be the cause unless they are prolonged. Lowering the EPR/CFLEX/AFLEX will certainly not help aerophagia causing your bloating but it will probably not make it significantly worse.
Ian
03-13-2014 04:11 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #16
RE: CSA #'s that require BPAP or BPAP-SV?
(03-11-2014 03:29 PM)WakeUpTime Wrote:  I get a good sleep until about 3am with CPAP but the rest of the night is just awake but somewhat paralyzed.
Can you think of any reason, why you cannot go back to sleep?
03-13-2014 04:15 PM
Find all posts by this user Post Reply Quote this message in a reply
WakeUpTime Offline

Advisory Members

Posts: 156
Joined: Jan 2014

Machine: PR System One BiPAP S60 Auto 760
Mask Type: Nasal pillows
Mask Make & Model: P10 pillows
Humidifier: PR S1 w Heated Tube+Hose
CPAP Pressure: Auto / Inhale 11-12.5 / Exh 9
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location:

Post: #17
RE: CSA #'s that require BPAP or BPAP-SV?
(03-13-2014 03:49 PM)Sleepster Wrote:  Turning off or lowering the EPR will likely make that problem worse.

I'm still relatively new at this, so please pardon my ignorance... Turning off the Exhaust Pressure is the same as making the Exhaust Pressure the same as Inhale Pressure yes? Therefore, turning it off would make the bloating (from air) worse. That part I think I get. It would make the BPAP behave like a CPAP.

However, "lowering the EPR" in BPAP makes it easier for the Exhaled air to escape, and therefore would reduce air in the stomach wouldn't it?

(03-13-2014 04:15 PM)zonk Wrote:  Can you think of any reason, why you cannot go back to sleep?

I do stay in bed, but don't go into anything that I would describe as a comfortable deep sleep. It's a "surface resting state" with an exhausted body. No, there's no big worries, or high stress, or heavy alcohol use (everybody eventually asks). I suppose there could be some subconscious frustration of "here we go again, day number 212 of 4 hours of sleep".

Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
(This post was last modified: 03-13-2014 04:25 PM by WakeUpTime.)
03-13-2014 04:15 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #18
RE: CSA #'s that require BPAP or BPAP-SV?
(03-13-2014 04:15 PM)WakeUpTime Wrote:  
(03-13-2014 04:15 PM)zonk Wrote:  Can you think of any reason, why you cannot go back to sleep?

I do stay in bed, but don't go into anything that I would describe as a comfortable deep sleep. It's a "surface resting state" with an exhausted body. No, there's no big worries, or high stress, or heavy alcohol use (everybody eventually asks). I suppose there could be some subconscious frustration of "here we go again, day number 212 of 4 hours of sleep".
Check Robysue profile, she have blog titled "adventure in hose land" which include chapter about insomnia among other useful stuff
03-13-2014 04:40 PM
Find all posts by this user Post Reply Quote this message in a reply
igdoc Offline

Members

Posts: 13
Joined: Feb 2014

Machine: PR S1 Bipap ASV Advanced 961
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: Built in
CPAP Pressure: EPAP 7.5. PS 0 to 7
CPAP Software: SleepyHead EncoreViewer EncorePro

Other Comments:

Sex: Male
Location: England

Post: #19
RE: CSA #'s that require BPAP or BPAP-SV?
Don't worry we have all been new to this at some stage. EPR is Resmed's CPAP/APAP version of exhalation pressure relief and CFLEX/AFLEX is Phillips Respironics version. There are technical differences but essentially they both reduce the pressure during exhalation compared with inspiration to increase the ease of breathing. Switching them off could potentially increase the aerophagia but the pressure change is relatively small compared with your inspiratory CPAP pressure of 12 and therefore any effect on this should be small. Hope I have understood and that this helps.
Ian
03-13-2014 05:00 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
WakeUpTime Offline

Advisory Members

Posts: 156
Joined: Jan 2014

Machine: PR System One BiPAP S60 Auto 760
Mask Type: Nasal pillows
Mask Make & Model: P10 pillows
Humidifier: PR S1 w Heated Tube+Hose
CPAP Pressure: Auto / Inhale 11-12.5 / Exh 9
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location:

Post: #20
RE: CSA #'s that require BPAP or BPAP-SV?
(03-13-2014 04:40 PM)zonk Wrote:  Check Robysue profile, she have blog titled "adventure in hose land" which include chapter about insomnia among other useful stuff
You're right. Robysue is an amazing resource with great help. I'll follow some of these ideas.
(If she offered a course, I'D TAKE IT!)

Insomnia is an interesting subject. For me, it's hard to just get up and do something else. Why? The brain is wide awake (the heart too sometimes) but the rest of the body is in a near-paralyzed tired state. My eyes are burning, etc. To do something else is sometimes even harder. I have to experiment with an audio book sometime to see how that might work out.

Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
(This post was last modified: 03-15-2014 02:32 PM by WakeUpTime.)
03-15-2014 02:32 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Differnce between BPAP and A-FLex?? MrEGuy 5 507 04-12-2016 03:35 AM
Last Post: MrEGuy
  [CPAP] New to CPAP/BPAP, New to forum Tmaul 3 625 09-30-2015 06:02 PM
Last Post: Tmaul
  VPAP S - BPAP to CPAP? nesteve 4 1,129 04-28-2014 03:13 PM
Last Post: zonk
  [Diagnosis] Reasons to BPAP, over CPAP WakeUpTime 38 6,825 03-17-2014 08:59 AM
Last Post: me50
  Medicare: Switching from CPAP to BPAP sir_sleeps_alot 7 2,965 03-09-2014 07:38 PM
Last Post: trish6hundred
  Talking about BPAP Chuck 10 3,951 09-19-2012 12:10 PM
Last Post: Chuck
Question [Equipment] CPAP vs BPAP ITShortBus 6 3,052 04-23-2012 10:25 PM
Last Post: greatunclebill

Forum Jump:

Who's Online (Complete List)