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New diagnosis of mixed sleep apnea
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ruach Offline

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Posts: 33
Joined: Feb 2016

Machine: DS960T BiPAP autoSV ADV 60 series, 30cm DOM
Mask Type: Nasal mask
Mask Make & Model: DreamWave
Humidifier: PR1 60 Series Heated Tube Humidifier
CPAP Pressure: EPAPmin 8, EPAPmax 15, etc.
CPAP Software: SleepyHead

Other Comments: Max Pres 25.0, EPAP min 8.0, EPAP max 15.0, BPM Auto, PS min 0.0, PS max 17.0

Sex: Female
Location:

Post: #1
New diagnosis of mixed sleep apnea
About 3 years ago, I was diagnosed with obstructive sleep apnea. It took quite some time to find a mask that worked well for me and also i was able to get a bipap auto after using the auto cpap for about 7 months.

A few months ago, I started a discussion with my respiratory therapist that I still fall asleep during small group meetings, or basically when I am sitting and am inactive. Also during this time, the AHI on my bipap was unusually high, averaging between 10 to 15 AHI.

So, a couple of weeks ago I had another night time sleep study, that was supposed to be followed up by a daytime multi-latency sleep study. Since I didn't get any N3 (deep restorative sleep) during the night, they canceled the day study because they felt there was no reason to have a day study since my tiredness was because of not having any N3 sleep. They also said that I had 50 Periodic limb movements during the night (my first study only had 5 PLMs during the night). Oh yes, my AHI index during this study, using a bilevel pap, was 24.9. The technician eluded that it seemed that the bipap was not helping me.

This week the Sleep doctor called and said that there were central apneas as well as obstructive apneas, and they have changed my diagnosis to Mixed Sleep Apnea, and also that I would be scheduled for another overnight sleep study titration using an ASV. Surprisingly, I was able to get my next study scheduled for this coming Sunday night. Someone must have canceled, because normally the wait period is a couple of months to get an appointment.

I was very uncomfortable at the Regional Overnight Sleep Center for the most recent sleep study- the bed was a little harder than I am used to, and the blankets were a bit rough to the touch for me. For this upcoming overnight titration, I am thinking of bringing my own blanket to make it more comfortable- and definitely bring my own pillow.
02-05-2016 10:37 PM
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DeepBreathing Offline
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Posts: 2,294
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #2
RE: New diagnosis of mixed sleep apnea
G'day ruach. Welcome to Apnea Board.

ASV machines feel quite different compared with ordinary CPAP or bilevel machines, and can take a little bit of getting used to. But once over the initial hump, they are absolutely marvellous. The main issue is that as you drop off to sleep, your breathing naturally gets a bit ragged during the transition - an ASV might interpret this as an incipient apnea and start "helping" you to breathe more regularly - this can be disturbing and prevent you getting to sleep properly. Once you are asleep the ASV reacts very quickly to any changes in the airflow and will give you an extra pulse of pressure to stabilise your breathing - this is the process which prevents the occurrence of central apneas.

Depending on which machine you use, there are various techniques to optimise the experience. Resmed ASV machines are easy - they will generally follow your breathing rather than try to force you. Just relax, breathe slowly and evenly and the machine will match your rhythm. If you feel the pressure going up too much during that transition phase, just blow back strongly - the machine will get the message and reduce pressure for a period.

With Respironics machines, you can make adjustments to the backup rate (ie how many breaths per minute the machine will impose), as well as the inspiration time etc (which you're probably familiar with from your bipap). Unless these are set for your comfort, you might find the Respironics ASV feels too aggressive, so be aware that they can be tweaked.

Good luck with your titration - ASV machines are wonderful high tech instruments which give most people a really comfortable sleep and a dramatic improvement in their apnea.

DeepBreathing
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.
02-05-2016 11:22 PM
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DariaVader Offline
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Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #3
RE: New diagnosis of mixed sleep apnea
Welcome

It will be good to have that under control.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
02-05-2016 11:26 PM
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trish6hundred Offline

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Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: New diagnosis of mixed sleep apnea
Hi ruach,
WELCOME! to the forum.!
When I went in for my sleep studies, they told me that I could bring my pillow if I wanted to, so I don’t blame you for bringing your own blanketand pillow, whatever makes you more comfortable.
Good luck to you at your ASV titration and, hang in there for more suggestions.

trish6hundred
02-05-2016 11:28 PM
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ruach Offline

Preferred Members

Posts: 33
Joined: Feb 2016

Machine: DS960T BiPAP autoSV ADV 60 series, 30cm DOM
Mask Type: Nasal mask
Mask Make & Model: DreamWave
Humidifier: PR1 60 Series Heated Tube Humidifier
CPAP Pressure: EPAPmin 8, EPAPmax 15, etc.
CPAP Software: SleepyHead

Other Comments: Max Pres 25.0, EPAP min 8.0, EPAP max 15.0, BPM Auto, PS min 0.0, PS max 17.0

Sex: Female
Location:

Post: #5
RE: New diagnosis of mixed sleep apnea
Thanks trish6hundred and DariaVader-
Also, thanks DeepBreathing for the details on the ASV machines- I have a feeling I won't be able to choose, since the DME for Kaiser typically has a specific list of authorized equipment . . .
02-06-2016 11:56 AM
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