Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Pressure] Rem Sleep Issue
#1

Have been on CPAP treatment for 1 1/2 years. Having problem with early AM rem sleep cycle awakenings. Have 40% central; 46% obstructive;14% hypopneas. Did 2nd sleep study last night. Tech did titration from 10 up to 25. tried 5 different masks. All leaked profusely at higher pressures. My normal on my S9 Resmed Auto is 14-20. Tech is baffled and I will do another session tonight. Anyone have ideas on adequate mask to handle high pressure settings oe other suggestions? VPAP? Thanks.
Post Reply Post Reply
#2
Welcome to the forum, jimmyfreddy.

There are two things that stand out in your post:
(06-24-2014, 01:23 PM)jimmyfreddy Wrote: Have been on CPAP treatment for 1 1/2 years. Having problem with early AM rem sleep cycle awakenings. Have 40% central; 46% obstructive;14% hypopneas.
and
Quote: Did 2nd sleep study last night. Tech did titration from 10 up to 25. tried 5 different masks. All leaked profusely at higher pressures. My normal on my S9 Resmed Auto is 14-20.

Both of those facts point to the question: Is an APAP really the right machine to treat your problem?

First, it's becoming pretty routine to start switching people to bi-level during a titration study once the pressure has reached about 15cm. Mostly it's for patient comfort: The fact that the IPAP and EPAP can be more than 3cm apart on a bi-level does make it much easier to exhale against the required positive air pressure. And if, for some reason, the doctor who reviews and signs the sleep study report recommends using a pressure over 20, you'll have to get a bi-level since APAPs only go up to 20cm. Bi-levels can go up to 25cm of pressure.

Second, did your original diagnostic study say anything about central apneas? Or have the CAs emerged since you started on APAP therapy? And if they emerged, what is the treated AHI? And the treated CAI? The answers to these questions are very important for you and your medical team to be looking at. Approximately 15% of PAPers wind up developing clinically significant problems with central apneas after starting PAP therapy; when this happens, the PAP winds up with a diagnosis of Complex Sleep Apnea or CompSA for short. PAPers with higher pressures may be more at risk for CompSA than PAPers with lower pressures.

Hence it's worth asking your sleep doctor to look at your APAP's data and ask whether or not the combination of 40% CAs together with pressure levels of 14-20 warrants an investigation into whether you have CompSA. If CompSA is indeed the problem, a VPAP (bi-level) may or may not make much of a difference. Some people's CompSA does resolve after a few weeks or months on a plain old bi-level, but many CompSA sufferers continue to have problems with too many CAs on a bi-level. The next step is usually either a bi-level ST or an ASV machine, both of which are capable of "triggering" inhalations when the central apneas start manifesting themselves.



Post Reply Post Reply
#3
Hi jimmyfreddy,
WELCOME! to the forum.!
Best of luck to you with your second sleep study and hopefully, you will get your CPAP difficulties straightened out.
Hang in there for more responses to your post.
trish6hundred
Post Reply Post Reply




Possibly Related Threads...
Thread Author Replies Views Last Post
  [CPAP] AirSense 10 Recall issue in Canada josephww 4 264 09-25-2017, 12:50 PM
Last Post: sonicboom
  Wireless connection issue in Canada on AirSense 10 Autoset? josephww 11 373 09-24-2017, 12:27 AM
Last Post: Mogy
Question S9 humidifier issue Bradsky 7 192 07-31-2017, 04:11 PM
Last Post: Bradsky
  URGENT issue FAA approval for international travel? NCZzzz 14 1,569 07-29-2017, 12:52 PM
Last Post: David Govan
  On/off button issue & mysterious machine resetting itself mmorans5 3 268 07-03-2017, 07:31 PM
Last Post: trish6hundred
  Full Face Mask issue Lanco 14 661 06-29-2017, 08:37 PM
Last Post: Lanco
Sad Dreamwear Issue Myearthhaven 16 797 06-09-2017, 06:34 PM
Last Post: sonicboom

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.