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New to Sleep Apnea (central Apnea)
#1
New to Sleep Apnea (central Apnea)
Let me say thank you for all the help before hand.

After having my sleep study done I've been diagnosed with severe central sleep apnea, from what I gather most people suffer from the obstructive type and there isn't a ton of info out there for what I have. I'm looking into machines before going to my DME appointment tomorrow since I'm seeing a lot of machines online that are significantly less then what they're quoting me. Any suggestions on machines? I know Resmed seems to be the most common brand but I'm unsure if the AVS is needed or if a better machine is out there for my apnea.

Thanks,
Kyle

   
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#2
RE: New to Sleep Apnea (central Apnea)
Hi cyipher!  -  Welcome

There are several subcategories with in the CPAP moniker.  For brevity there are 4 basic groups, CPAP and Auto CPAP, Bi-Level and Auto Bi-Level, Auto Servo Ventilator (ASV), and Special timed units and IVAPS.  Each of the above addresses a particular need or therapy that the previous unit can not.  Also, as you move up in the list, you go up in unit price.

Be forewarned, there are VERY basic CPAP models that do not provide detailed sleep information.  These are referred to as, "Bricks".  Since they fall under the same insurance codes, many DMEs will try to stick you with one because they receive the same amount of money for a less expensive unit.

Here is a Wiki article that should provide some insights: http://www.apneaboard.com/wiki/index.php...ne_choices

Additionally, most of us here prefer the Resmed brand as opposed to others for the base unit.  Their algorithms are more advanced and faster to respond to events than the others.  For most apnea patients, the Resmed AirSense 10 Autoset is the go-to unit.  It can provide either static or variable pressure and act as a very limited bi-level unit if needed.

As far as a mask;  One great thing is that all manufacturers standardized on the hose to mask connection size.  This means that you are able to use any brand of mask with any CPAP, you don't have to stay within the same manufacturer.

Good luck on your journey.  Keep us updated on your adventure.

- Red
Crimson Nape
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.
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#3
Cool 
RE: New to Sleep Apnea (central Apnea)
Asv is used for centrals. If that is what you are give n make sure it is a ResMed not a Phillips dreamstation. Most DME give out the dreamstation because it is cheaper for them

Please take a look at supplier 2 link at top of the site. They sell new, open box and slightly used. They may be MUCH lower price than the DME. 

Once you get the machine you are basically on your own. The only thing they will check is for compliance. 

See the link for DME on the bottom of the post.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: New to Sleep Apnea (central Apnea)
Welcome to Apnea Board. If what you're displaying is a split study, Centrals at 94 to 10 Obstructive, then yes you're dealing with pre-existing CA. Actually it's complex Apnea as you have both OA and CA, but much more Central. So yes ASV is the right machine. Best answer is the ResMed AirCurve 10 ASV.

A few questions. Where is the full sleep study? Do you have it? No, then get it. After you have your full certified copy, post the redacted version here. HIPAA law permits you to get the detailed report. "No you can't get it" from the doc is the wrong answer. What exactly is your doctor's diagnosis and stated actions? Is ASV being discussed? Have you already done a titration involving ASV? No, then it likely need to be done.

If insurance is involved and insurance paying is your direction to get ASV, you may need to try and fail CPAP/APAP, then BPAP, and maybe ST as well. And failing these will be very likely.
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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#5
RE: New to Sleep Apnea (central Apnea)
Dave,

sent pm as i cannot send a link
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#6
RE: New to Sleep Apnea (central Apnea)
As mentioned in PM, the details show the diagnosic 0 line with 94 Central and then supposedly treated well on 8 cmH2O but still having CA at 17. That's not treated as it hadn't gotten down to 5 AHI but is at 6.6 at pressure of 7, and 15.7 AHI at 8. You're not passing the medical treated aspect of AHI down to 5 or less.

So ask these things: Why do you think I'm treated with 15.7 AHI on pressure of 8? How are we addressing the diagnosic info of 94 Central events? Are we going to pursue treating my Central Apnea with ASV? And will there be ASV titration? Then you also need to give a list of symptoms and complaints of not being treated, well rested state elusive, and similar if applicable.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#7
RE: New to Sleep Apnea (central Apnea)
(05-17-2021, 11:15 AM)SarcasticDave94 Wrote: If insurance is involved and insurance paying is your direction to get ASV, you may need to try and fail CPAP/APAP, then BPAP, and maybe ST as well. And failing these will be very likely.

That is exactly what happened with me.  Diagnosed with Central Sleep Apnea, had to try each different machine -- and after each failure, had to wait for  another in-lab sleep study, and then wait for another doctors appointment.  I finally got the ASV machine 9 months after starting the whole process.  Also, had to wait for the DME to order in each machine -- they don't seem to keep anything in stock.
I used the Phillips Respironics one, and have switched to the ResMed AirCurve 10 ASV and think the latter is the better machine.  Also, getting a proper mask is a challenge.  You have to try them and make adjustments as needed -- which is to say, you may have to try different brands and/or different styles.  I'm 3 years into this process and just figuring out that I may have to try a Full Face Mask next. 
It seems everything about this apnea stuff happens slowly -- and don't expect any help from your doctor or the DME.  In my case, they like me believing they were monitoring me, but in fact, they were not.  As previously stated, check the links for dealing with your DME --- it has a lot of good information in it.
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#8
RE: New to Sleep Apnea (central Apnea)
Mine was similar to get the ASV. Shame on the insurance.

FWIW my Fisher and Paykel Vitera full face mask works well with an ASV. I could hit Max pressure with minimal leaks. If adjusted right and there's a correct fit, any mask should work with ASV.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#9
RE: New to Sleep Apnea (central Apnea)
If I've not mentioned, get pad and pen and write your ongoing Apnea treatment symptoms and complaints. You're going to need this plus your diagnosic/titration report and address this with the doc, highlighting the CA events. Also get a free copy of OSCAR and upload your data here so we can see how therapy is going.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#10
RE: New to Sleep Apnea (central Apnea)
Why is 6 and 8 bad and 7 good? Answer - Because Central Apnea is consistently inconsistent.

They found nothing that will work.

All the shown values are CPAP, where are the BiLevel.
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