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I finally have an resmed auto vpap machine. I have an ahi of 17-27 each night which are 99% centrals. I've only been on it 8 days. I can only seem to usually sleep on my side, with a full face mask. "the resmed f10" I often wake up with a very dry mouth (I assume breathing with my mouth a lot). I am happy because the obstructive and hypopnea are now very low or gone, but the centrals are high. Also, I still can only sleep about 1-2 hours at a time. Sometimes 3 hours, but rarely.
Should I be concerned about the centrals? Looks like I'm not breathing on average 15-45 seconds. Any suggestions?
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Unfortunately, central apnea is going to probably be worse with bilevel and higher pressure support. When central apnea events are persistent like this, the course of action is to either use bilevel with a backup rate (ASV or ST), simplify therapy to CPAP which may reduce the event rate, or possibly use EERS to increase rebreathing of CO2 as described in this thread. http://www.apneaboard.com/forums/Thread-...eep?page=2
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.
Thank you for the reply's. Looks like I'm kind of between a rock and a hard place. I have used cpap (regular), in the past, but I was never able to get obstructive and hypopnea down. I also had an auto cpap, before. Both were around 35-45 AHI with the old machines. Now with the new vpap, they are down to less than 1, but the centrals are the majority and very high. Attached sleephead:
Thank you for your help, recommendations...
The flow rate seems funny to me. I would expect to see a narrow or no flow rate during CA's. But yours look like they widen out like your awake or maybe recovery breaths from obstructive events. I'll be interested to see what sleeprider has to say.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
The graph that is swinging around wildly is tidal volume, and it seems to range from zero to 1300 in very short intervals. The flow rate graph is nearly obscured by event flags during the apnea sequences, but I clearly see the lower flow amplitude. This is most likely a combination of alternating apnea and recovery breathing. Not much doubt that ASV is the answer here.
If you could provide a close-up graph of and event sequence, it would be interesting to zoom in on a segment no more than 2-minutes long. Include Events, Flow Rate, Tidal Volume and mask pressure.
Your settings of 8.0 EPAP min, 25 IPAP max and PS 4.0 are not doing you any favors at all. If you want to use Vauto mode. please consider reducing EPAP min to 6.0, IPAP max to 12.0 and PS 2.0.
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.
I tried before with a Remstar Auto with Aflex 550p APAP, 11-15 pressure range. AHI never could get regularly below 15, had about even levels obstructive, hypopnea, rera, centrals. Could never sleep more than 3-4 hours a night... gave up until new machine.
With new machine, Resmed, acurve 10 vauto, I can sleep more, but only 1-2 hours at a time, adding up to about 8 hours a night. All seem to be eliminated except for a lot of centrals.
I have to get the doctor to lower the ps because they do it remotely.
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.
