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New user with central apnea, screen shots included, what changes should I make?
#1
New user with central apnea, screen shots included, what changes should I make?
Hello there. i am a new cpap user, started using Resmed 11 Auto back in June that I got from my DME that got the machine before everyone else so pretty lucky to have it.  I feel like i am getting better over time, but seems like every 3-5 days I spike with some high apnea numbers. my doc says I have central apnea and says i need a servo machine and a in hospital sleep study (not just the at home ones thus far).  Any changes I can make to settings to improve? Running 6-10 Pressure.
Male Mid fifties
-Nonsmoker, non-drinker
-Good sleep hygiene
-Take no medication

Thanks 


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#2
RE: New user with central apnea, screen shots included, what changes should I make?
If applicable, turn off Ramp and EPR. This may help reduce the CA. If your doctor actually recognizes the Centrals as an issue, and that he's going to get you in for a sleep study involving ASV, then you're on the right track. Just hold him to that.
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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#3
RE: New user with central apnea, screen shots included, what changes should I make?
Dave is excellent with advice having to do with centrals but I would like to see how you would do on a straight Cpap.

In other words
Turn off ramp
Turn off epr
min 8.5
Max 8.5

I think that would be the best setting to minimize your centrals.
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 user with central apnea, screen shots included, what changes should I make?
While Dave's actions are correct, call your doc ASAP and say the AutoSet isn't working because of high centrals. And be persistent about it.
Ask your doc how quickly he can get in for the ASV titration study. Note this needs to occur often. Also ask if there are any additional tests you need before ASV.

There are, the LVEF test, an ultrasound you will easily pass. Get the barriers put of the way asap.

Your doc appears to be on the fail and get new machine path.

I want the doc to make the therapeutic changes to empathasize failure to control Centrals.
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#5
RE: New user with central apnea, screen shots included, what changes should I make?
Please post a copy of your sleep test and a 10 minute segment of the centrals.
Let's see what they look like, see if they happen to be Treatment Emergent Central Apnea or CO2 induced.
What is the basis for the central apnea diagnosis? What type of central apnea does your doc think it is?

It sounds like your doc has the right idea, and we so seldom see this, let's encourage him, the doc, to take the faster action. And we will look closer at the data.
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#6
RE: New user with central apnea, screen shots included, what changes should I make?
Yes that info above is sound.

Myself, just to get ASV was an uphill climb. I had to call the doctor, DME, and insurance; one of these 3 got a call daily until I had an ASV. I cannot stress this enough, do not let your pursuit of the ASV go cold. Call them a lot. They will forget you if you don't.

Echocardiogram was and is still required last I heard. LVEF percentage is needed to be measured, 45% and above typically means the cardiac doc reviewing this signs off as ASV being OK.
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 user with central apnea, screen shots included, what changes should I make?
It has been an uphill battle to get insurance to approve new study and ASV machine, in appeal process now. thank you for the setting recommendations in the meantime.
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#8
RE: New user with central apnea, screen shots included, what changes should I make?
If I might suggest, as I've done in the past, create a stack of notes on your personal account of PAP symptoms and complaints, chronic fatigue, disruptions due to CA, discomfort in current PAP therapy, settings you've tried and the results, and so on. I would encourage focus on the negative aspects about your therapy, and then go on to include internet searches about ASV success on Central treatment.

Afterwards, bring this stack of info to your doctor's attention, because this will go into your patient file. You're adding ammunition to attaining the ASV.
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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