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Problem with Autosense 10 central apnea detection
#1
I am new to the whole APAP thing, first week. Just got a AutoSense 10 and sleepyhead. The problem is whenever I doze off and transition from awake to asleep, I unvoluntarily stop breathing for more than 10 secs and the machine flags an apnea event. It then proceeds to pulse the pressure and then categorizes it as a clear airway event. Whenever it does that, the sudden change in pressure arouses me and prevents me from falling asleep so I stay awake like that for a few hours till I give up and remove the mask. My sleepy head reports only show multiple clear airway events, whenever I try to unsuccessfully fall asleep.

I understand from other posts here that being still conscious, these apnea events are not significant but the problem is the AutoSense doesn't know that and doesn't allow me to even fall asleep. I am now torn between trying to tough it out and try to accustom my brain to this unwanted waking stimulus or return the machine and try to use one that doesn't have any central apnea detection but from what I read, most new comfortable machines seem to have this pulse technology and I really feel comfortable with all the other features (APAP, EPR etc...). Has anybody ever solved this problem or have any suggestions?
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#2
(05-12-2016, 07:50 PM)johnthesleeper Wrote: I am new to the whole APAP thing, first week. Just got a AutoSense 10 and sleepyhead. The problem is whenever I doze off and transition from awake to asleep, I unvoluntarily stop breathing for more than 10 secs and the machine flags an apnea event. It then proceeds to pulse the pressure and then categorizes it as a clear airway event. Whenever it does that, the sudden change in pressure arouses me and prevents me from falling asleep so I stay awake like that for a few hours till I give up and remove the mask. My sleepy head reports only show multiple clear airway events, whenever I try to unsuccessfully fall asleep.

I understand from other posts here that being still conscious, these apnea events are not significant but the problem is the AutoSense doesn't know that and doesn't allow me to even fall asleep. I am now torn between trying to tough it out and try to accustom my brain to this unwanted waking stimulus or return the machine and try to use one that doesn't have any central apnea detection but from what I read, most new comfortable machines seem to have this pulse technology and I really feel comfortable with all the other features (APAP, EPR etc...). Has anybody ever solved this problem or have any suggestions?


Hi johnthesleeper,

It looks like you don't have any ramp time set. During ramp time your machine will deliver lower pressures and in some cases won't respond to to Apnea events. I'm not sure which AirSense 10 machine you actually have. Check your machine for a better description. Also give us an idea as to your diagnosis eg. Obstructive Apnea, Complex Apnea.

I don't think you are being awakened by the high frequency pulses that detect an open airway. It appears that your machine is raising pressures in response to the detected apnea. That can be disturbing especially when trying to get used to a new machine. Try setting your ramp time to a fixed setting such as 25 minutes. See if that helps. You can go all the way up to 45 minutes if you need it. I was able to cut my ramp time down and eventually eliminate it over time. The ResMed machine I have Airsense 10 ASV was quite disturbing when I first got it. Ramp time helped me get used to it.

By the way, you will be able to get lots of ideas about your treatment from people with similar situations on this Forum. Keep us informed about your problems and any successes that you have.

Rich

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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#3
You have a rather large pressure range setting for my comfort. Try adjusting the max down 1 cm and maybe that won't wake you when it raises the pressure. Be aware of your data and make sure lowering the pressure doesn't increase your AHI to the point you feel worse in the AM.
Coffee

Happy Pappin'
Never Give In, Never Give Up


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. 
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#4
When you start there are many things to get used to, one of the big ones is just trusting the machine. Then you have to learn what is a problem and what is normal. And then you need to get all the comfort settings adjusted so you can tolerate therapy and sleep. When it's all said and done you will most likely forget you even have the mask on.

The ramp is a great idea, mine is still at 45 minutes and I like it that way.

I am assuming that you have a humidifier, don't assume that you like high humidity, play with the settings and find what you like. Same goes for temperature. I put a little water and then fill with ice cubes. others fill with water, humidity set to max, and high temperature.

Comfort settings are there for a reason, find your settings.

Eventually you may find that 6 is a little too low, or not. Make sure you get and install sleephead

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#5
thanks for your time richb,

(05-12-2016, 08:21 PM)richb Wrote: Hi johnthesleeper,
It looks like you don't have any ramp time set. During ramp time your machine will deliver lower pressures and in some cases won't respond to to Apnea events. I'm not sure which AirSense 10 machine you actually have. Check your machine for a better description. Also give us an idea as to your diagnosis eg. Obstructive Apnea, Complex Apnea.
No I do not have any ramp set and I will try that tonight but i think i read somewhere that does not disable the pulsing. My machine is a Resmed Airsense 10 AutoSet, my bad. My sleep test only showed Obstructive Apneas, with an AHI of 25.

(05-12-2016, 08:21 PM)richb Wrote: I don't think you are being awakened by the high frequency pulses that detect an open airway.
But that's really what it feels like; I actually feel pretty conscious of what is going on. Imagine being on a flight and you are very tired but still conscious and trying to sleep but everytime your head starts to fall, it suddenly arouses you. When the pulse starts, it jerks my brain the same way and I then consciously realize that I haven't been breathing for a few secs.

(05-12-2016, 08:21 PM)richb Wrote: It appears that your machine is raising pressures in response to the detected apnea.
No, it's not raising the pressure as it doesn't detect the event as obstructive, the pressure remains near the minimum of my range. I am now at a range of 6-12. I think I will also try raising the minimum, maybe the pulses won't be as noticeable...
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#6
Hi johnthesleeper,
WELCOME! to the forum.!
Hang in there for more suggestions and much success to you with your CPAP therapy.
trish6hundred
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#7
After your post count gets to 8 you can post some Sleepyhead data. There are Board members with a lot of experience interpreting their own data which might be helpful to you.

Rich
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
Post from Imgur


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#8
Yesterday I tried to use the ramp but it doesn't disable the pulse and I found the low pressure to be quite uncomfortable. I do play with my temp and humidity and feel relatively comfortable with them. I also raised my min pressure from 6 to 7 but the pulse still wakes me up. It is so strong that the mask starts moving on my face. If only there could be a chest detector linked to the machine for detecting CAs then I'm sure I could get to sleep with the mask on. Does anybody know of a good comfortable machine that does not pulse?

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#9
I also have a severely deviated septum and enlarged turbinate. I refused the septoplasty and turbinectomy based on the volume of crappy comments on the possibly debilitating effects of turbinectomy and because I was prescribed a steroid spray that really helps me breathe better. I said to myself I would try to treat the apnea without the operation and if I fail then I could always get it. But now, I realize that my apnea is pretty high and if I can't treat it first, then the anasthesia would be dangerous so I'm caught in a chicken/egg type situation. Yesterday my nose was more blocked than usual and I was unable to tolerate the mask. Didn't even get to the pulse arousal stage. richb I know you've had the turbinectomy do u have any suggestions for me?
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#10
Here is an image of ramp time where I am falling asleep and developing Central Apnea. This machine (an Airsense 10 Auto) did not use the FOT pulse algorithm to identify Clear Airway during ramp time. It then introduced the FOT (high frequency pulses) when ramp time was over. The high frequency pulses are essentially a sound that probes my airway to see if it resonates the way an open airway does (longer tube) vs a closed airway (short tube). The high frequency pulses are pretty much undetectable. What you are experiencing is the resumption of breathing with the added pressure of CPAP. This can easily surprise you and wake you up. There are adjustments that you can make and there are machines with different algorithms. You will get lots of suggestions when you post some screenshots of Sleepyhead data.

Rich


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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
Post from Imgur


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