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New User [adjusting pressure on AirSense 10 Autoset]
#11
RE: New User [adjusting pressure on AirSense 10 Autoset]
At 255 and 355 you had some kind of disturbance that set off what looks like an imbalance in your CO2 levels that triggered periodic breathing around you apneic threshold.
CO2 levels are the main factor in our basic drive to breathe, not low oxygen that many believe.

You posted a 1 hr and 42-minute interval, see the posted duration above the flow rate chart.  Now I'd like to see a 15-minute shot that includes the disturbance that precedes the "CSR"/PB event.  I need to closer view to validate the type of periodic breathing.
Another view, a 2-minute view, of the disturbance ahead of the CSR/PB so we can see if we can determine the cause.  2-minute views show us the breath by breath detail of what is happening.

CSR, if it is CSR, is associated with CHF, and if it is CSR your cardiac doctor and GP should be aware of it.  Regarding AFIB, I honestly don't know. If you have a pulse oximeter that may provide some input, or if you have a pacemaker you could call and see if you and an afib event near those times (255, 355).  The amount of space the heart takes in the thoracic cavity varies with its beat, which can vary the amount of space available to breathe.  We can, at times, see the pulse in the flow rate so it is possible.

From what I can tell, you are not using EPR, correct?

Thanks
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#12
RE: New User [adjusting pressure on AirSense 10 Autoset]
We have not seen the settings on your machine, but they seem to be 6-20 EPR 2. and last night you turned off EPR and had pressure ranging from 7 to 12. You have to many central events to be ignored. The "politically correct" advise is to advise your doctor of these unacceptable results and lack of satisfying sleep. The Apnea Board question is, do you have good insurance, or are you on your own? You probably need adaptive servo ventilation, but the path to that therapy is designed to extract as much cash from your insurance or you as possible, so we really need to know if you are going to do this on your own (self-funded), or if you can afford the tests, delays and costs to go through medical channels.
Sleeprider
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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.
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#13
RE: New User [adjusting pressure on AirSense 10 Autoset]
Sorry delay in replying.  I am attaching the screen shots, I hope this is want you wanted.  On 6/24 my AHI was 2.16 with 0 CSR  with EPR set to 2, on 6/25 AHI was 21.03 (CA 18.69 and CSR 35.46% with EPR set to 1.
I am going to try a few more days but I am feeling it is not helping.


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#14
RE: New User [adjusting pressure on AirSense 10 Autoset]
Thanks for reply.  setting are 7-20 with EPR of 2 or 1, My doctor doesn't seem to know too much about Centrals and my cardiologist knows even less.,
I have Medicare and AARP Secondary insurance. While ASV may benefit me, I would want to try it before making a commitment  as I understand they are rather expensive.
Possible, once my stress decreases, my AFib will quiet down.
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#15
RE: New User [adjusting pressure on AirSense 10 Autoset]
Mike, the way to do that is to get an ASV "Titration" at a sleep lab to prove efficacy. Titration is in quotes because all they typically do is set it up in auto mode and let it go.
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#16
RE: New User [adjusting pressure on AirSense 10 Autoset]
I'll admit I've not gone through the whole thread, but if bonjour and Sleeprider are talking ASV and with this recent chart, I'm of the thought that is already a FAIL. Build a list of all complaints and symptoms that the CPAP is not addressing. Include this OSCAR data on X number of CA. Tell the docs respectfully and firmly it's a fail and you request an ASV titration ASAP. And once your foot is on the gas pedal on this, do not let it up at all.

Best to your success. And I can get into detail on making it happen if needed, because I had to make it happen for me. Self advocacy or bust.

PS The CA will be up and down, different each night. We call this consistently inconsistent. To self advocate for the ASV, rely very heavy on How You Feel.
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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#17
RE: New User [adjusting pressure on AirSense 10 Autoset]
Thanks, I will look into it.
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#18
RE: New User [adjusting pressure on AirSense 10 Autoset]
Thanks so much for your info. I will start the process with the doctor.
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#19
RE: New User [adjusting pressure on AirSense 10 Autoset]
The Resmed titration protocol for CPAP clearly shows that the appropriate response to your central apnea is the ASV.  The protocol is below, and it comes from the Resmed Sleep Lab Titration Guide https://www.resmed.com/us/dam/documents/...er_eng.pdf  That document can tell you all about the different machines, and you should develop an understanding of how ASV works. You can consider sharing this resource with your doctors.  Requesting a clinical titration for ASV will mean a sleep lab technician will test bilevel (which will fail) and ASV to see if it is effective in reducing or eliminating your central or complex apnea. From this you can obtain both a prescription for ASV and justification sufficient for insurance coverage.  The more you learn about this, the better you can advocate for the best therapy for your needs.

[Image: attachment.php?aid=4115]
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.
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#20
RE: New User [adjusting pressure on AirSense 10 Autoset]
Thanks so much for all the information on ASV and how to proceed.
I have a lot going on so it might take awhile meanwhile, is it safe to continue using CPAP?
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