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First Nights of APAP...All Centrals!
#11
RE: First Nights of APAP...All Centrals!
Keep an eye on your Centrals, they might go down, but if they start getting worse come back to this thread (you might want to bookmark it) for some advice.  It might take a while for the fatigue to start to go, as long as you do not have long CAs I wouldn't panic at this point in time.  If you get a lot all clustered together or they get worse post more data, it really needs to be over quite a few days.

I am no expert in reading Sleephead, so others might come along with advice.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#12
RE: First Nights of APAP...All Centrals!
Your CSR looks a lot like what I see (not every night) and the doc feels it is not true Cheyne-Stokes, otherwise I'd have more often.  The central apnea can be related to the new onset of CPAP simply by the washout of CO2 and as said, the body needs to learn to adjust or the pressure and EPR needs to be fine tuned.  Or finally, a more aggressive machine may be indicated.
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#13
RE: First Nights of APAP...All Centrals!
(11-30-2017, 06:01 PM)Hojo Wrote: Your CSR looks a lot like what I see (not every night) and the doc feels it is not true Cheyne-Stokes, otherwise I'd have more often.  The central apnea  can be related to the new onset of CPAP simply by the washout of CO2 and as said, the body needs to learn to adjust or the pressure and EPR needs to be fine tuned.  Or finally, a more aggressive machine may be indicated.

My concern is....that in my original PSG a lot of these centrals showed up (73) in a cluster at the end of the study. Cheynes Stoke was observed. The doc was going to prescribe an ASV until she saw that I took this test at a relatively high altitude (7200 ft) and I live at 3500 ft...she wanted to see if these persisted at 3500ft, and instead of yet another study she seems to feel that the readings of the ResMed can confirm or deny the original result. 

Her office just called me back and told me to watch it for another couple of weeks. I was talking to a medical assistant and not the doctor. She said she would inform the doc of my concern--I hope she does!
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#14
RE: First Nights of APAP...All Centrals!
Here is a link to Beginners Guide to SleepyHead. http://www.apneaboard.com/wiki/index.php...SleepyHead

In it you'll find a section on Periodic Breathing that explains it well.

Right now your API is under 5 which as far as most Doctors are concern is considered treated. You really don't have that many CA events going on. I still think you'll see those CA events disappear in a couple of weeks.
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#15
RE: First Nights of APAP...All Centrals!
My longest run of "CSA" breathing was for 74 minutes, boy did I wake up feeling exhausted.  I've had them here and there and any time I have them, I'm concerned and rightfully so.  Again, I don't get them every night so we are yet to figure out a reason why, no history of stroke, heart trouble, or any thing else.  I'm in perfect else except for idopathic central apnea.

As previously stated, starting CPAP can cause central apnea and it may smooth out with lowered pressure (as long as obstruction isn't a problem), lowered EPR, and if that doesn't help, more studies for possible ASV machine...which I have one next week.
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#16
RE: First Nights of APAP...All Centrals!
(11-30-2017, 08:52 PM)Hojo Wrote: My longest run of "CSA" breathing was for 74 minutes, boy did I wake up feeling exhausted.  I've had them here and there and any time I have them, I'm concerned and rightfully so.  Again, I don't get them every night so we are yet to figure out a reason why, no history of stroke, heart trouble, or any thing else.  I'm in perfect else except for idopathic central apnea.

As previously stated, starting CPAP can cause central apnea and it may smooth out with lowered pressure (as long as obstruction isn't a problem), lowered EPR, and if that doesn't help, more studies for possible ASV machine...which I have one next week.

74 minutes is quite long! Let me know how your study goes for the ASV...I think I am in the same boat as you. Doc looked at my heart tests and they were OK...but I did the Stokes thing in my original study and now i have 3 nights of APAP in and 2 night of Stokes! (Last night was 17 minutes). The machine prevents almost all the obstructive apneas so I have left of the CA's  My 90% pressure is only about 8.

I think I am on my way to an ASV also.
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#17
RE: First Nights of APAP...All Centrals!
FWIW: I had to produce almost a month's worth of use on BiPAP before the doc's office took my concern for Centrals seriously. At the 2 week mark, I requested strongly getting an appointment. I was given a next day appointment as an urgent need. The pulmonary lead nurse was discussing my PSG and my description of the ongoing complaint. She stated "Why are you on BiPAP and not on an ASV?". Me: "That's what I'd like an answer to also. Let's start the process to change to the ASV."

I do think the doc is going to expect a certain amount of TIME on the current machine to PROVE in a yes/no fashion this is or is not getting better before you change devices again.

Dave Coffee my 2 cents
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#18
RE: First Nights of APAP...All Centrals!
If you don't mind, what was your situation when you tried to get an appointment? Similar to mine? Worse?

I have only 5 nights on the APAP, but two of those had 12-18 min CSR but all 4 nights had an average of 25 CA's and only 1 OA's. My AHI is averaging about 4.1 so far. My original PSH had 73 CA's and Cheyne Stokes.

I don't know how serious this is but I doubt the doc will see me before my January appointment--unless I throw a fit maybe!!
Began APAP 11/28/17
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#19
RE: First Nights of APAP...All Centrals!
(12-02-2017, 12:46 PM)Allessio77 Wrote: If you don't mind, what was your situation when you tried to get an appointment? Similar to mine? Worse?

I have only 5 nights on the APAP, but two of those had 12-18 min CSR but all 4 nights had an average of 25 CA's and only 1 OA's. My AHI is averaging about 4.1 so far. My original PSH had 73 CA's and Cheyne Stokes.

I don't know how serious this is but I doubt the doc will see me before my January appointment--unless I throw a fit maybe!!

I'm guessing these were directed to me. OK, so my BiPAP was causing Central/Mixed Apneas that were recorded on the PSG and the Central/mixed apnea issue was continuing at home. Through the Apnea Board guru advice, I made adjustments to the pressure settings, but I couldn't get any good results. (This was due to having the wrong tool to fix what I was dealing with. BiPAP was NEVER going to fix my situation.)

By this, I mean that I FELT terrible. I was getting more tired each use/sleep session. I was not getting better by using the BiPAP. Every night produced a day where I felt more tired than the previous day. It was a vicious cycle that the only way to end was to stop using the BiPAP. Oxygen deprived headaches were increasing in intensity and frequency as well. FWIW my BiPAP PSG showed 124 Centrals to 24 Obstructive, yet I was given a BiPAP.

Stated simply, tell your sleep doctor what your sleep results are, and by that I mean how you feel, what you're experiencing, etc., and what your concerns are. "X is worse, Y is worse, etc. and this is why I am concerned."

"I don't know how serious this is but I doubt the doc will see me before my January appointment--unless I throw a fit maybe!!" Remember the saying: Squeaky wheels get the grease. If you are seriously in need of attention sooner than January, squeak loud and clear. Get me in ASAP, if that applies.

Best wishes to ya,
Dave  Coffee
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#20
RE: First Nights of APAP...All Centrals!
(12-02-2017, 01:10 PM)SarcasticDave94 Wrote:
(12-02-2017, 12:46 PM)Allessio77 Wrote: If you don't mind, what was your situation when you tried to get an appointment? Similar to mine? Worse?

I have only 5 nights on the APAP, but two of those had 12-18 min CSR but all 4 nights had an average of 25 CA's and only 1 OA's. My AHI is averaging about 4.1 so far. My original PSH had 73 CA's and Cheyne Stokes.

I don't know how serious this is but I doubt the doc will see me before my January appointment--unless I throw a fit maybe!!

I'm guessing these were directed to me. OK, so my BiPAP was causing Central/Mixed Apneas that were recorded on the PSG and the Central/mixed apnea issue was continuing at home. Through the Apnea Board guru advice, I made adjustments to the pressure settings, but I couldn't get any good results. (This was due to having the wrong tool to fix what I was dealing with. BiPAP was NEVER going to fix my situation.)

By this, I mean that I FELT terrible. I was getting more tired each use/sleep session. I was not getting better by using the BiPAP. Every night produced a day where I felt more tired than the previous day. It was a vicious cycle that the only way to end was to stop using the BiPAP. Oxygen deprived headaches were increasing in intensity and frequency as well. FWIW my BiPAP PSG showed 124 Centrals to 24 Obstructive, yet I was given a BiPAP.

Stated simply, tell your sleep doctor what your sleep results are, and by that I mean how you feel, what you're experiencing, etc., and what your concerns are. "X is worse, Y is worse, etc. and this is why I am concerned."

"I don't know how serious this is but I doubt the doc will see me before my January appointment--unless I throw a fit maybe!!" Remember the saying: Squeaky wheels get the grease. If you are seriously in need of attention sooner than January, squeak loud and clear. Get me in ASAP, if that applies.

Best wishes to ya,
Dave  Coffee

  thanks Dave....one more thing...has the ASV did its job? How long have you been on it and How do you feel now??
Began APAP 11/28/17
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