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Is Resmed S9 Autoset mode suitable for central sleep apnea?
#1
I have been on CPAP for 1 year but I am continuing to decline. I am using the Resmed S9 Autoset with a pressure setting of 9 in CPAP mode. I personally believe I have central sleep apnoea as well as obstructive but my respiratory doctor disagrees, I have decided to change my settings myself.

Is the AutoSet mode an APAP mode?

Is the AutoSet mode suitable for central sleep apnoea?

Is AutoSet alone enough for central sleep apnoea or do I need medication?
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#2
(12-05-2015, 12:30 PM)napnaptime Wrote: I have been on CPAP for 1 year but I am continuing to decline. I am using the Resmed S9 Autoset with a pressure setting of 9 in CPAP mode. I personally believe I have central sleep apnoea as well as obstructive but my respiratory doctor disagrees, I have decided to change my settings myself.

Is the AutoSet mode an APAP mode?
Autoset is the ResMed name for their model of an APAP.
In the menu, the auto mode will say auto.


Is the AutoSet auto mode suitable for central sleep apnoea?
Not really. The Autoset in auto mode will not raise pressure when it detects a Central Apnea. Which is good. The Auto Servo Ventilator (ASV) machine is the machine intended to treat central and mixed apnea.

Is AutoSet alone enough for central sleep apnoea or do I need medication?
I am unaware of any medication intended to treat central sleep apnea. There are medications that can cause or worsen central apnea: such as opioid pain meds.

Why don't you use the software to analyze the type of apnea being scored by your present machine.?

[Image: pBt22Od.jpg]
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#3
The S9 Autoset is an auto CPAP or APAP. CPAP (even an automatic adjusting one) does not treat central apnea because it does not respond on a breath by breath basis to detect and provide the pressure required to overcome a central event.

The gold standard for central apnea is an Adaptive Servo Ventilator. Examples are the Resmed Aircurve 10 ASV, or Philips Respironics BiPAP Auto SV.

You can use the sleepyhead software with your S9 to evaluate the frequency and type of apnea you are having and use that information to make a positive change in your therapy. Just download Sleepyhead from the link above this thread, and install it on a computer that can download the SD data card in your S9 machine. There won't be any guessing then as the data will show the breakdown of OA H and CA events and lots of other information.
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#4
Quote:Why don't you use the software to analyze the type of apnea being scored by your present machine.?

I found some central apnoea events on sleepyhead but my respiratory doctor says that the machine is not very accurate and the only way to correctly diagnose sleep events is in a sleep lab which gathers from multiple data sources.
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#5
(12-05-2015, 01:36 PM)napnaptime Wrote:
Quote:Why don't you use the software to analyze the type of apnea being scored by your present machine.?

I found some central apnoea events on sleepyhead but my respiratory doctor says that the machine is not very accurate and the only way to correctly diagnose sleep events is in a sleep lab which gathers from multiple data sources.

Well, the doc is the doc; and I am not a doc.
I would rephrase what he said as the best way to diagnose CA is in a sleep lab where you are wired up with all sorts of sensors such as: EEG, respiratory effort band, et cetera.

If you do indeed have central or mixed apnea, then ultimately you end up in a sleep lab with an ASV titration study. There are some complex settings on an ASV such as rate and pulse pressure that are best determined under controlled conditions.

You may find that if you switch your Autoset from CPAP mode to Auto mode that you will have more CA's scored by the machine.
[Image: pBt22Od.jpg]
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#6
I am 30 years old, average weight, non smoker, non drinker, I have been on CPAP for over a year now for OSA (Dx 7 AHI),MSLT negative, prior to this I was on Sertraline for apparent Bipolar which it turns out was actually sleep apnoea. CPAP is helping only a tiny bit I am still flat out exhausted and my memory is extremely bad and getting worse. I never feel refreshed.

Here is the catch, when I am on Sertraline after only 4 days I wake up refreshed, my memory improves but the drug has bad side effects so I am reluctant to take it again.

Now the obvious is depression but I was refereed to a specialist team of psychiatrists/psychologists and they all agree I don't have depression or any other mental illness but I do score very badly in my cognitive tests and they see how tired I am. I am like this when I am happy or Sad and they see I am getting worse.

The only thing I notice with the Sertraline is that it keeps me up very late yet I wake up feeling great, now my theory is that it is disrupting my REM sleep and 4 days of good sleep sounds about right. This brings me to the question do I also have central sleep apnoea?
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#7
(12-05-2015, 01:53 PM)justMongo Wrote:
(12-05-2015, 01:36 PM)napnaptime Wrote:
Quote:Why don't you use the software to analyze the type of apnea being scored by your present machine.?

I found some central apnoea events on sleepyhead but my respiratory doctor says that the machine is not very accurate and the only way to correctly diagnose sleep events is in a sleep lab which gathers from multiple data sources.

Well, the doc is the doc; and I am not a doc.
I would rephrase what he said as the best way to diagnose CA is in a sleep lab where you are wired up with all sorts of sensors such as: EEG, respiratory effort band, et cetera.

If you do indeed have central or mixed apnea, then ultimately you end up in a sleep lab with an ASV titration study. There are some complex settings on an ASV such as rate and pulse pressure that are best determined under controlled conditions.

You may find that if you switch your Autoset from CPAP mode to Auto mode that you will have more CA's scored by the machine.

In my sleep study I only got 2 hours sleep which the doctor says is enough, I do not agree, I think that to detect central sleep apnoea I need another test but I am being denied that, I am so tired and my memory is so bad I am like a corpse.
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#8
This is essentially a duplicate thread. You are asking the same question about: Do I have CA?
Well, no one can answer that without data. In the other thread, your doctor said it needed to be dx'ed in the sleep lab.

Why not request that the doc test for CA in the lab?
[Image: pBt22Od.jpg]
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#9
Agree with JM. Another possibility - I have found that RERAs and flow restrictions which do not quite qualify as apneas (usually because they are less than 10 seconds) can effect even a very low AHI night. If your machine allows RERA and detailed data tracking go to SH software and enable UF1 and UF2 to see whether your sleep is being disrupted for reasons not reflected with a simple AHI number. If so, you can try adjusting your therapy to decrease these events. A refreshed person may appear in the AM.
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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. 
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#10
(12-05-2015, 02:20 PM)sonicboom Wrote: Agree with JM. Another possibility - I have found that RERAs and flow restrictions which do not quite qualify as apneas (usually because they are less than 10 seconds) can effect even a very low AHI night. If your machine allows RERA and detailed data tracking go to SH software and enable UF1 and UF2 to see whether your sleep is being disrupted for reasons not reflected with a simple AHI number. If so, you can try adjusting your therapy to decrease these events. A refreshed person may appear in the AM.

Yes I have done this and it did show interruptions but there is not way to tell what from, I have moved rooms in my house and even on holidays in a tropical climate I felt the same. Another sleep study would cost me 5K and it is being denied to me anyway. I think I will try something else.
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