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Noob with Central Sleep Apnea, AHI 145
#11
Once you hit 50 everything falls apart...
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#12
(12-13-2015, 06:07 AM)player Wrote: Once you hit 50 everything falls apart...

OMG that is soooo true!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#13
(12-13-2015, 06:51 AM)cate1898 Wrote:
(12-13-2015, 06:07 AM)player Wrote: Once you hit 50 everything falls apart...

OMG that is soooo true!

I thought that it was just me.....

Another vote here for using Sleepyhead. That software is a wonderful creation. I download my data regularly and it definitely helps. I can speak with my doctor and we both have an understanding of my condition and treatment.

By the way, if you are experiencing large leaks at 22cmH2O, it may help significantly to drop the pressure a bit. Talk to your doctor first, but it worked very well for me.
In my humble experience, many masks tend to leak a lot above 20cmH2O.

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#14
MichaelWD64, check the side effects of your medicines. My husband's doctor put him on an ACE Inhibitor for his high blood pressure and within a day or so, he couldn't walk across the room without running out of air. This went on for over a week and I began checking known side effects of all his medications and found that while it wasn't a common side effect of that particular medicine, it was a known one. He stopped taking it and was fine within two days, back to his old self. The doctor didn't want to believe that it was caused by the medicine and he had to absolutely refuse to take it again before the doctor would change him to something else. He no longer sees that doctor because this guy thought he knew everything and was unwilling to listen to any input from the patient, my husband. All I'm saying is, and this is for everyone, always check side effects for your meds. Your doctor isn't God and all-seeing, you need to be aware if something goes wrong where it's coming from. If you use the same pharmacy for all your meds, they can help watch for things that shouldn't be taken together. But we use two different pharmacies because of the price differences, so I always check everything he or I are prescribed, and if anything changes after starting a new med, that's where I start my search for the cause.
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#15
Blood pressure meds can really sap ones strength.
However, we are all different; and there are BP meds with different mechanism for action.
Off hand, Calcium Channel Blockers, ACE inhibitors, diuretics, beta blockers and alpha blockers are major categories.

In the long term, BP should be controlled to prevent adverse effects on the heart and vasculature.
There's a right BP med or combination of BP meds that will fit most people.
A little like finding the right CPAP mask; the doc just has to find the right one(s).

Some years back, my doc told me that he heard a speaker at a medical conference say, "we can control anyone's blood pressure; but they may not be able to get out of bed."
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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#16
Hi, MWD. Just read through this thread. Seems like your initial pressure is high for treating CAs. In my experience having lower initial settings decreases the number of CAs triggered by the machine. Your ASV machine will deal with Hypopneas better than with CAs so having lower initial pressures will reduce the CAs in favor of Hypopneas. My machine is set at IPAP 8 EPAP 6 giving a pressure support of 2. At those pressures without ASV I experience mostly Hypopneas. On ASV the machine automatically treats the Hypopneas with appropriate higher pressures. Sleepyhead reports no CAs and only a few Hypopneas all night for me. It seems to me that your initial pressures are set high as if you have Obstructive Apnea. If you do have Obstructive Apnea you will see Obstructive events coded at the lower pressures. If you do not have Obstructive Apnea you should see improvement at the lower initial pressures. There is the possibility hat you have Complex Apnea which is a combination of both OA and CA. Then somewhat higher pressures are indicated. Keep us posted.

Rich B
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
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#17
(02-06-2016, 08:51 AM)richb Wrote: at the lower initial pressures. There is the possibility hat you have Complex Apnea which is a combination of both OA and CA. Then somewhat higher pressures are indicated. Keep us posted.

Rich B

Thank you rich.

I absolutely do have both OA and CA.

I'm doing very well now with the pressures I have. It just took some getting used to having to mask up every night.

It's helping a lot.

MWD
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#18
(02-06-2016, 08:51 AM)richb Wrote: Hi, MWD. Just read through this thread. Seems like your initial pressure is high for treating CAs. In my experience having lower initial settings decreases the number of CAs triggered by the machine. Your ASV machine will deal with Hypopneas better than with CAs so having lower initial pressures will reduce the CAs in favor of Hypopneas.

Hi MichaelWD64,

An ASV machine will very quickly raise Pressure Support if our breathing suddenly slows down or stops. During a central apnea, if the Max PS setting allows the ASV machine to raise the pressure support as high as 10, this is usually high enough to do for us all the work of breathing if we have normal healthy lungs. COPD or other lung conditions may require a higher PS Max setting in order to be able to keep us ventilated during times we would have had central apneas.

I am of the opinion that it is usually best to use a Min PS setting of at least 2.

During obstructive apneas, however, even very high Pressure Support like 15 or higher may be insufficient and annoying and cause problems. Best way to treat obstructive apneas is with higher EPAP, not higher PS.

However, Obstructive Sleep Apnea is usually strongly positional, and sleeping flat on our back "supine" usually requires higher pressures to treat, which can aggravate complex/central sleep apnea.

If we take measures to prevent the possibility of rolling onto our back while asleep, this will usually lower our pressure needs, which often lowers the number of CA events we get, too.

Some 'PAP users have found marvelous improvement by making sure they won't roll onto their back while asleep. Some sleep wearing a light knapsack with something light but bulky in it. Others sew a sock or pockets onto a teeshirt with a couple tennis balls inside, between the shoulder blades along the spine. Others use long body pillows under the sheet to help remain on their side. Others sleep in comfortable recliner chair so the head and neck are elevated but stay aligned. Whatever it takes.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#19
Hi,

I never ever sleep on my back. Always on my side. Never even end up on my back.

thank you,
MWD


(02-06-2016, 01:59 PM)vsheline Wrote:
(02-06-2016, 08:51 AM)richb Wrote: Hi, MWD. Just read through this thread. Seems like your initial pressure is high for treating CAs. In my experience having lower initial settings decreases the number of CAs triggered by the machine. Your ASV machine will deal with Hypopneas better than with CAs so having lower initial pressures will reduce the CAs in favor of Hypopneas.

Hi MichaelWD64,

An ASV machine will very quickly raise Pressure Support if our breathing suddenly slows down or stops. During a central apnea, if the Max PS setting allows the ASV machine to raise the pressure support as high as 10, this is usually high enough to do for us all the work of breathing if we have normal healthy lungs. COPD or other lung conditions may require a higher PS Max setting in order to be able to keep us ventilated during times we would have had central apneas.

I am of the opinion that it is usually best to use a Min PS setting of at least 2.

During obstructive apneas, however, even very high Pressure Support like 15 or higher may be insufficient and annoying and cause problems. Best way to treat obstructive apneas is with higher EPAP, not higher PS.

However, Obstructive Sleep Apnea is usually strongly positional, and sleeping flat on our back "supine" usually requires higher pressures to treat, which can aggravate complex/central sleep apnea.

If we take measures to prevent the possibility of rolling onto our back while asleep, this will usually lower our pressure needs, which often lowers the number of CA events we get, too.

Some 'PAP users have found marvelous improvement by making sure they won't roll onto their back while asleep. Some sleep wearing a light knapsack with something light but bulky in it. Others sew a sock or pockets onto a teeshirt with a couple tennis balls inside, between the shoulder blades along the spine. Others use long body pillows under the sheet to help remain on their side. Others sleep in comfortable recliner chair so the head and neck are elevated but stay aligned. Whatever it takes.

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#20
Michael, on the topic of BP meds, I know there are several categories, as justMONGO mentioned. While it's true that each of us reacts differently, I can share my experience. When diet and exercise alone wasn't doing the BP control job, I went to daily BP meds. At first, my doc at that time put me on a beta blocker. They made me feel terrible; side effects made me non-functional. That was a med he was used to prescribing. Then, a cardiologist who heard about what I was on suggested I give a sartan a try. That's when this family of meds was still pretty new. So, I got a script for Cozaar. Result, absolutely no side effects and BP was definitely down to normal. I have been continuing on this med (generic form is Losartan). The only potential problem, according to my current doc, is that my BP is watched to make sure it doesn't go too low. Over time, I've been able to cut down from 100mg/day to half that dose and BP steady as she goes with nice numbers; still absolutely no side effects.

David
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