(01-31-2015 09:23 PM)Lambsydoats Wrote: One thing I don't understand is why my healthcare provider (the PA--I am not allowed to schedule an appointment with the MD) isn't as concerned about centrals as he is about obstructives. As you know if you've read many of my posts, I'm more concerned about the CAs, considering it's unknown what's causing them. Could be nothing, but unless someone helps figure that out, how will we know?
On Thursday, the medical assistant said the PA reluctantly agreed to lower the pressure to 8 (from 9) to see if it helps the CAs without wreaking havoc on the OAs.
An average of 2 or 3 Central Apneas per hour of sleep is not considered anything to worry about. (However, if I were taking medications which depress respiration like opiates, I would definitely want to have an ASV machine capable of keeping me ventilated if I were to stop breathing, even if my normal CAI when on pain meds was only 2 or 3, in case I might ever mistakenly take too much.)
More than 5 CA events per hour of sleep is usually considered as warranting treatment. However, I may be more concerned about having 2 or 3 Obstructive Apneas per hour of sleep if the obstructive apneas were lasting a long time, such as 45 seconds or a minute each.
Some patients have no CA events during their "diagnostic" sleep study (when they are not being treated with CPAP) but exhibit more than 5 CA events per hour of sleep after starting treatment. Usually, within a few weeks or months the number of CA events reduces as we become adjusted to sleeping under pressure, dropping below 5 per hour during sleep. This is one reason why doctors are sometimes not overly concerned about more than 5 CAs per hour with new patients.
But if the patient had a significant amount of CA events per hour in their diagnostic study (with no CPAP treatment) or if after a few weeks or months of CPAP therapy the patient is still having more than 5 CA events per hour, then, in my view, the doctor should prescribe an ASV titration and an ASV machine.