Too Late for CPAP?

[richb]

Here is the WARNING from ResMed http://www.aasmnet.org/articles.aspx?id=5562

[Sleeprider]

And the Philips Respironics response, basically in agreement: http://www.prnewswire.com/news-releases/...84444.html

The Resmed study in 2015 really complicated things for CHF patients, because they tend to have cheyne-stokes breathing and central apnea, which are not treated with CPAP, but are a natural for ASV. However, if the CPAP pressure makes you feel better, then it is probably not a bad solution, but it needs to be supplemented with oxygen because it won't treat many of the sleep apnea architecture of the CHF patient. Talk about a catch 22. I would prefer this come from your doctor, but a qualified professional should discuss the options, and reasons for rejecting ASV if that is the course. Then he should modify your CPAP prescription to include O2. It's ridiculous that you should learn this from a forum, and not from your doc.

[OldCoot]

I feel like I've been going downhill fast since I got on this CPAP machine, even though I don't have trouble using it anymore. During the day I am wiped out. Can't stay awake. Literally falling asleep while sitting or standing up.

Sleepyhead stats haven't improved either. The last AHI number I saw was 44 I think.

Is it dangerous to stop using the CPAP cold turkey? I'm planning to go back on my oxygen machine (no forced air pressure, just tubes in my nose) to sleep tonight. I used oxygen without the CPAP during my nap this afternoon and I don't feel any worse... maybe better.

Still waiting for my doctors help... hope to hear something soon... my primary care doc said he was going to get me set up with a pulmonary doc, and my cardiologist said he'd be in touch next week when he gets back from vacation.

Any other ideas would be greatly appreciated.

[Sleeprider]

It's not dangerous to stop using it in your case. The CPAP cannot treat periodic breathing and central apnea, and it may make it worse. You need a doctor that listens.

[OldCoot]

It's not dangerous to stop using it in your case. The CPAP cannot treat periodic breathing and central apnea, and it may make it worse. You need a doctor that listens.

Thanks, Sleeprider.

My wife and I just went to Walmart to pickup an Oximeter. When I got home my first two readings were 97 and 100. Not bad, eh?
My pulse was in the mid 50s.

I really appreciate your help.

OldCoot

[richb]

Hi OldCoot,

I have been hoping that you would give us an update. I have Central Apnea as well. I quit using the machine I was given (CPAP) when it made things worse as well. I felt better because the machine was converting what had been largely Hypopneas into Cheyne Stokes type Apneas. I needed an Echo Cardiogram to be sure my ejection fraction was over 45% and was prescribed an ASV machine by my new sleep doc. In your case you might not qualify for an ASV machine but there are several other strategies (to treat Periodic Breathing and CSR) that have been tried with CHF patients. The first is treatment of the CHF. Another strategy is sleeping on your side. There is a great deal of literature on the subject of Cheyne Stokes Breathing and CHF. There is some cautionary reporting on the use of O2 therapy and CHF. Primarily that O2 therapy is only indicated for O2 levels that fall below 90%. The study also suggests satisfactory O2 levels of 92% to 95%. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561277/ If you do any research on your own be sure to filter for studies done in the past year. You are going to want to team up with your Cardiologist to figure out the best strategy for you. Keep us posted. This is a subject which I am much interested in.

Rich

[OldCoot]

Just wanted to come back and say thanks for helping me get on the right track and off the wrong machine. (I can't believe how much worse I feel since I started that CPAP machine. I don't think I got off of it a minute too soon.)

Looks like I'll be getting in to see a pulmonologist... hopefully in the near future. My cardiologist and primary care doctor are setting things up for me. Plus, the clinician from the medical supply for ResMed called me today and then she faxed the stats to both doctors to let them know about my AHI and Cheyne Stokes. (She scared me!)

Anyway, I'd probably still be going downhill fast on the wrong CPAP machine if it hadn't been for you all, so thanks again!

I'll let you know what happens...

[chill]

I am happy to hear this is going to work out well for you!

[richb]

Good to hear that you are now on the right track. There are a couple of medications that are used to treat Periodic Breathing/Cheyne Stokes Respiration. The medication strategy is similar to strategies used to treat High Altitude Sickness. However you may not need anything for the Cheyne Stokes because much of it may have been aggravated by the incorrect machine and will reduce on its own without the CPAP.

Rich

[old82]

Good to hear that you are now on the right track. There are a couple of medications that are used to treat Periodic Breathing/Cheyne Stokes Respiration. The medication strategy is similar to strategies used to treat High Altitude Sickness. However you may not need anything for the Cheyne Stokes because much of it may have been aggravated by the incorrect machine and will reduce on its own without the CPAP.

Rich

Richb
What are those medications for Cheyenne stokes that you mentioned?

old82