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Obstructive and Central Sleep Apnea
Hello all,

I am new to the forum. I had my first sleep study done approximately 5 months ago. I was told at that time I had severe obstructive sleep apnea and I had to have oxygen bled into my cpap maching. I did not comply with my insurance requirements so lost my equipment. I had to go through another sleep study approximately 3-4 weeks ago. Then they called me and said I had so many hypoxic events they wanted to do another sleep study with a more sophisticated machine. I had that test about 10 days ago. I got a call today saying I have both Obstructive and central sleep apnea and would need a home ventilation machine or something like that. Does anyone know anything about this type of machine? I've searched the internet and cannot find anything. I don't know if the equipment has another name or what. I know the machine I used on the second sleep study was much larger than the first machine. It was the same machine I used on my first sleep study. I asked the nurse that called me today to tell me the results and asked her several questions and got an I don't know on all my questions. I am probably not posting this in the correct area and if not I am sorry. I have shingles right now and don't too hot. If anyone can help me I would so appreciate it. I am so confused about why this was not diagnosed on my first sleep apnea test.
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Adaptive servo ventilators (ASV) machines are fairly common among member. They can overcome obstructive apnea like most of us have, by providing positive pressure, but they also can initiate a breath when you don't. Many patients have underlying cardio-pulmonary conditions, and others have complex apnea. I'm sure you've reviewed your medical history and prescription drug use with your doctor.

The equipment has a number of models and names, but basically you are being qualified for "BiPAP ST" or bilevel adaptive servo ventilator with timed respiration. Lots to read, nothing to fear. If it is what you need, you'll feel like a million bucks after you start.

Sorry to hear about your additional pain with shingles.
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Hi jh7221,
WELCOME! to the forum.!
I hope you get to feeling better from your shingles, soon, I know that can be very painful.
Hang in there for more answers to your questions and much success to you as you start CPAP therapy.
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Thanks to both of you who responded. I had a massive heart attack at 56 so perhaps that is contributing but I am relieved to know there are members who have this type of machine and to know that it is called ASV. My pulmonologist has diagnosed me with early cor pulmonale due to years of undiagnosed sleep apnea. He says I am in very early stages and once I get on my sleep apnea therapy and USE IT he thinks that will stop it from getting worse. My heart doctor has not diagnosed me with that because my echocardiogram is normal. My doctors do go over all my meds but in the state I live the doctors must enter each prescription they write into a database and that database is available to all physicians. It is great for doctors to look at a patient's drug history to look for interactions or abuse of meds. Once again thanks for the response. I appreicate it so much.
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Find out the details and WRITE IT DOWN!!! this time. Your life could be at stake.

You may or may not be getting an ASV (Adaptive Servo Ventilator) machine. That's sort of the "best" choice in general, but there are some other options, such as an ST mode bilevel machine or a full ventilator machine.

There is some info in my useful links in my signature line at the bottom of this post for avoiding being screwed by the system.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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G'day jh7221, welcome to Apnea Board.

As a user of an ASV I think they are the cat's pyjamas! I messed around for quite a while with conventional machines but they just can't treat central apneas properly.

The difference is in the nature of the apnea. With the common obstructive apnea, your upper airway collapses when you are asleep - your tongue, soft palate and the tissues of your throat all close up, obstructing your airway. Your body is starved of air and you'll wake up snorting and gasping, then immediately fall back to sleep and start the cycle all over. Often you don't realise this is happening, and you don't remember it in the morning - you just feel like a total wreck.

Central apnea is very different. The muscles which control your breathing are normally stimulated by a signal from the brain stem which basically says "breathe now". For a whole range of reasons, this message isn't getting through, so you literally forget to breathe. You just lie there quietly until such time as your brain realises there's an emergency happening and sends you the wake-up call. Central apneas can be caused by going onto CPAP therapy until your system becomes accustomed to it, but it sounds like yours is idiopathic.

An ordinary CPAP machine just gives you a more or less constant air pressure to hold your airway open. The ASV machine (adaptive servo ventilator) does that, but will also detect when you stop breathing because of a central apnea and give you an extra pulse of pressure to get you breathing again. They react very quickly, and can reduce the occurrence of apneas to nearly zero.

The two main brands are Resmed and Philips Respironics. Resmed make the Aircurve 10 ASV and the (recently superseded) S9 VPAP Adapt, which is what I have. Philips make the BiPAP autoSV Advanced. These both look just like the ordinary CPAPs from the same manufacturer but have much more sophisticated internal software and tend to be very expensive in comparison. I had the Philips for a while but could never get comfortable with it. On the other hand I found the Resmed very gentle and easy to live with. Most importantly, I hardly get any apneas at all. If you can, try out both machines (for at least a few weeks each) and see which one suits you best.
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Thanks Deep Breathing that was very useful info. I just got a call from Apria to schedule an appointment for me and then they realized they needed to get authorization from my insurance. I am not thrilled with using them but I guess there aren't many DME suppliers that have what I need that my doctor likes using and are also a participating provider in my insurance. The information you gave me was very helpful. My pulmonary doctor just called and I will be getting ASV. I am thankful that I was able to find out what it was I will be using. This board has been very helpful. Thanks so much.

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