Attached are some Central Apnea closeups. I had about 13 yesterday, 18 the day before.
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Should I switch to Bi-PAP and is it worth it for me?
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09-27-2019, 10:54 AM
RE: Should I switch to Bi-PAP and is it worth it for me?
My sleep study only gave an AHI of 17.8. No mention of Central Apneas. Probably because they were not measured. It was a home sleep study.
Attached are some Central Apnea closeups. I had about 13 yesterday, 18 the day before.
09-27-2019, 11:06 AM
RE: Should I switch to Bi-PAP and is it worth it for me?
(09-27-2019, 09:39 AM)bonjour Wrote: The OP would likely benefit, in time after his body adjusted to the higher PS, to BiPAP. His CA went away without flex meaning his body needs to adjust from the additional washing of CO2 that occurs with the better breathing that occurs from the higher PS. Too much pressure support still causes my CA index to rise too high, even though I've had plenty of time to adapt. I realize I'm an exception, and that most people are able to adapt.
Sleepster
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.
RE: Should I switch to Bi-PAP and is it worth it for me?
(09-27-2019, 10:54 AM)pr560 Wrote: My sleep study only gave an AHI of 17.8. No mention of Central Apneas. Probably because they were not measured. It was a home sleep study. They can distinguish central from obstructive sleep apnea in a home sleep study. Did you have a belt around your chest while you were sleeping? I think you should ask for the sleep study and post it here before switching to a new machine. It would really help to know what you are dealing with first. Anyway, concerning your screen shots: The first one is probably an arousal because you took a big breath right before the event. The ones in the second screenshot look real. In the third, these could be real or it could be REM sleep. Hard to tell. I don't see any flow limitation (flat topped inhalation) so I'm not sure a regular bilevel (in spontaneous mode) would help you. Again, I think you should really try to get your hand on your sleep study. It would help a lot. You could be experiencing central hypopnea, hence why your median tidal volume is so low and why the cpap is not helping you.
09-27-2019, 11:45 AM
RE: Should I switch to Bi-PAP and is it worth it for me?
@alex
It was a Watch-PT ambulatory sleep study. There was something on my chest but not a belt. It was a sort of small circular medallion thing that I was advised to tape to my mid-chest to hold it in place. In the sleep study report it mentions that "But as we are testing for obstructive sleep apnea and are interested in the time that you were asleep...". I have looked at the report and there is no mention of metrics or testing for Central Sleep Apnea. Only Apnea, Hypopnea, REM and Oxygen Desaturations. It may have been an Obstructive Sleep Apnea only sleep study. I had a RDI(Respiratory Disturbance Index) of 21.9. From the report it says: ...RDI was found to be 21.9. This score is calculated in a very similar way as the AHI but an additional type of respiratory event named RERA are also counted. RERA is Respiratory Effort related Arousal and is essentially a very short arousal of a few seconds that follows partial occlusion of the airways. The normal range of the RDI score is also 5 or lower. There's not really very good facilities for sleep studies in my country. There's isn't even a sleep center as far as I can tell though one may be opened in the near future.
09-27-2019, 12:05 PM
RE: Rapid Breathing. Some Centrals
I had missed that you had a significant number of CA events. It's possible you might want the ASV or SV type bilevel if those are a regular feature of your sleep. I recall seeing that breathing pattern before, and I do think the ASV was ultimately the solution. Supplier #2 is very reasonable in their prices of the S9 Adapt and Aircurve 10 ASV. They both target minute vent which in your case is interesting. You are showing a tidal volume of only 260 mL and a minute vent of 5.74 L/min with respiration rate of over 25 bpm. Your breathing pattern is very irregular and ASV would work to slow the respiration rate and make each breath count, while also eliminating CA and H events. My second look at this is that you'd be better off with ASV than with Vauto or ST.
I am going to merge your two threads. Considered together, the symptoms clearly point to ASV as your best solution.
Sleeprider
Apnea Board Moderator www.ApneaBoard.com ____________________________________________ Download OSCAR Software Soft Cervical Collar Optimizing Therapy Organize your OSCAR Charts Attaching Files Mask Primer How To Deal With Equipment Supplier 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.
09-27-2019, 12:11 PM
RE: Should I switch to Bi-PAP and is it worth it for me?
I have merged the new thread by PR560 concerning his rapid breathing, with this previous thread concerning the use of bilevel. These subjects are not only related, but cannot be considered separately.
Sleeprider
Apnea Board Moderator www.ApneaBoard.com ____________________________________________ Download OSCAR Software Soft Cervical Collar Optimizing Therapy Organize your OSCAR Charts Attaching Files Mask Primer How To Deal With Equipment Supplier 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.
09-27-2019, 01:40 PM
RE: Should I switch to Bi-PAP and is it worth it for me?
Sleeprider, thanks for merging the threads.
Supplier #2 has an S9 Adapt SV for $1050 and S9 Adapt SV Auto for $1250. The S10 Aircurve ASV for about $1749 Based on my not so deep pockets, seems the S9 Adapt will do just fine. I am guessing an ASV can still be configured to work like a standard Bi-PAP? This is in case find that I don't need the backup rate or it is too aggressive. Can it be turned off? Also, I'm guessing Auto SV is better especially for self-titration or is Standard SV okay as well?
RE: Should I switch to Bi-PAP and is it worth it for me?
Agreed. I would go with the ASV if I were you. Your events don't seem to be predominantly obstructive in nature.
09-27-2019, 03:34 PM
RE: Should I switch to Bi-PAP and is it worth it for me?
I would encourage you to get the Adapt SV Auto which is a more advanced machine that will adjust EPAP within a set range to resolve CA. I believe it also has the Easybreathe pressure forming that makes it much more comfortable. I'm going to have DeepBreathing post his thoughts since he is very familiar with the S9 ASV, and there can be a significant difference based on model.
Sleeprider
Apnea Board Moderator www.ApneaBoard.com ____________________________________________ Download OSCAR Software Soft Cervical Collar Optimizing Therapy Organize your OSCAR Charts Attaching Files Mask Primer How To Deal With Equipment Supplier 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.
09-27-2019, 05:21 PM
RE: Should I switch to Bi-PAP and is it worth it for me?
Just a note an ASV or the Vpap adapts cannot be used as a basic BiLevel as you cannot turn off the backup rate.
If you can pay the extra for the Vpap Adapt with the Auto ASV mode as it will also do the fixed epap ASV mode but not the other way round. |
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