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Having Centrals but not Diagnosed with Centrals, also having CSR's
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
The huge number of hypopnea is significant, and the clinical criteria for scoring, usually requires desaturation of 3-4%. Hypopnea can be central or obstructive, but in your case, I think a great deal of it is central. As you know, we try to treat obstructive hypopnea with bilevel therapy, but this transitions your hypopnea events to full blown central apnea, thus the need for ASV. I know it feels like you want to quit, but the only problem is actually getting you to the therapy you actually need and that we have been pointing to since page 1 of this thread. You were warned that the traditional medical approach of clinical testing, and physician prescriptions would be very difficult and many have taken the fall-back position of self-funding ASV therapy. Getting your life back is worth some financial sacrifice. At this point your sleep is broken and you don't see how it can be fixed, but it can. Unfortunately you are going to have to do it yourself.

The least expensive solution would be to buy the Resmed S9 VPAP Adapt #36007 or 36037. The difference between those two models is fixed EPAP with 36007 and ASVauto on the 36037. The best way is to use Supplier #2 to acquire the Resmed Aircurve 10 ASV for $1319 USD. This vendor has an excellent history of shipping units to AU with good warranty support.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
I think I need time to process this stuff; you are very supportive and convincing - I appreciate that; I feel like your advice is sound and from the beginning ASV is what you’ve mentioned and what I have been pushing for. I just need to think.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
   

There was 4 episodes just like the above, one lasting an hour (broken into 2 parts), one 30 minutes and one 45 minutes

   

Doesn't seem healthy
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
I have seen it before and it was resolved with ASV. The periodic high repspiratory rate is a classic central apnea condition. Haven't heard from member Hojo in a long time, but he resolved this with ASV. let me know if you want to see his threads. They are long like yours.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(09-15-2020, 08:01 PM)Sleeprider Wrote: I have seen it before and it was resolved with ASV. The periodic high repspiratory rate is a classic central apnea condition. Haven't heard from member Hojo in a long time, but he resolved this with ASV.  let me know if you want to see his threads.  They are long like yours.

Well hopefully the next doctor I see knows “that” and after a few more example days, the test results and the last year of central 4x-6x dominant Results from the CPAP machine, that the next doctor I see, sees what you see - at the moment my partner won’t support a machine purchase from America (yet) but if I keep suffering and the doctors don’t help this next go around ( l2 doctors one next week; and one at the end of October) if but then I’m still “here” I might be able to convince her to finance it (unemployment/chronic illness/PTSD).
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
I have realised that at the moment; heart rate and oxygenation (not sleep quality) there is no difference using or not using the CPAP machine in regards to my ability to deal with, daytime sleepiness (I micro sleep all the time) & other symptoms.

Last night after hours of lying there with the CPAP at 9 being unable to sleep because of the pain in my throat, so modifying the settings to give a ramp EPR for 30minutes of 3 just to try and enable me to get to sleep and reduce my throat pain... I ended up giving up and just throwing the mask and hose on the bed side table - giving up on the machine.

I ended up sleeping without it, mostly on my side/stomach using a neck contoured pillow, my oxygenation saturation stayed above 93%, my average heart rate was 51 - I did have obvious heart rate spikes which match previous night's CPAP/Oximeter report when I had a 40minute flow limited sections that repeated 4x and increased my respiration rate by almost double and my heart rate my approx 40% with intermittent central apneas.

... And just like every other day, I got up at this morning at 6:45am, had a shower and then fell asleep on the couch for another 2+ hours (which again, no oxygenation drops and the same heart rate issues, and I snore more without the machine)

*************************

Basically what I am saying is that for me, at the moment, there doesn't seem to any real benefit for me using a CPAP machine over sleeping normally (managing my position as best i can). I need a different machine which based on this threads advice is an ASV.

**************************

However, I am no @SarcasticDave

I am unemployed because of illness and PTSD, I haven't worked in 5 years and as such I don't have money to buy a ASV off prescription. My partner bought me the CPAP machine I have at the moment; but she will only do things that are "following the rules" so she won't fund an ASV without a specialist prescription in Australia for an ASV - and I will have to sell my car (which I am considering) as I don't have a cent to my name ... I rely on her (which is bad enough just financially; but then add how sick I am and how limited I am because of my illnesses and then the broken sleep and sleeping during the day when she has to work.... I don't know why she is with me or at least no way way more resentful than she is letting on (she probably is)...

So yeah, I guess for now this is where this ends, my GP has send out a referral for a new specialist, we will see if that specialist even takes me as a client, after being dropped twice (I had an appointment booked for next Tuesday but I got a message today saying that they don't have the skills in house to deal with my condition - so that sucked to be dropped again) so now I have send off requests for appointments to a couple of doctors and hopefully one of them accepts me and books me an appointment... in 4-5 weeks... and can help me.

Until then, there is nothing I can do...
No money... No family... no choices...

Anyway, unless a miracle happens and changes something, now its time for the thread to die as I can't self fund and doctors are dropping me because I am too complicated... so I'm f**ked.

Thank you for your insight...
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Hi Primalyogi,

Given you appear to be in NSW, is it possible you are eligible for assistance from EnableNSW?

This page goes in to some detail on Adult Nocturnal Ventilation Funding Criteria, which appears to cover ASV.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(09-17-2020, 03:35 AM)kappa Wrote: Hi Primalyogi,

Given you appear to be in NSW, is it possible you are eligible for assistance from EnableNSW?

This page goes in to some detail on Adult Nocturnal Ventilation Funding Criteria, which appears to cover ASV.

Hi,

Thanks for the link I’ll look into it as I’ve never heard of it; I still need a doctor to actually accept me as a patient because i got dumped again - just because of my records - once they were transferred the centre cancelled my appointment ... so I’ve been pretty distressed and slept on the couch without a machine the last 2 nights which... your not interested.... thank you for the sharing - I’ll have a look.

Thank you.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
I need a doctor first, then for them to be willing to fill in that form and ... I just got told by my 4th attempt to get an appointment - that I’m to complicated and was turned down - I’m waiting on doctor number 5... which was the last one.. if that fails I’m just going to give up and try a hospital outpatient facility or something which decreases my probablity of getting the right help or being able to use that form.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Hi Primalyogi.

That sounds really tough. If you have a health care card and should generally be eligible (or potentially eligible under some other scheme that excludes you from theirs - you mentioned PTSD) it might be worth calling the EnableNSW people directly and ask them for recommendations on who to see or where to go. I imagine many sleep specialists in private practice are relatively lazy and just want to churn through simple cases (for their next yacht upgrade I'm sure Dave will suggest Wink. Finding the right doctor in the public system can be challenging but they are more likely to bounce you to a suitable expert rather than toss you on the street as seems to be happening now.


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