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Totally Confused by Airsense 10 Data - Centrals - Problem machine... ?
#41
Hi again Mike. It looks like you need a new Doctor as well as a new ASV machine. A recording pulse oxymeter will document the severity of your CA events in terms of O2 desaturations. You might start at a place like this when looking for a new sleep doctor. https://www.ucsfhealth.org/clinics/sleep...rs_center/ You might also ask your personal physician for a recommendation. You need to have a frank conversation with your new Doctor. You will need to know that the new Doc is familiar with Idiopathic Central Apnea as well as Mixed Apnea. Your SH graphs are not showing any OA events so I doubt we are talking about mixed Apnea. In my case I spent some time with the PA (showed her all of my graphs and charts) and then went on to the Sleep Doc. I needed more sleep studies, of course, which included titrations in various CPAP modes to show that those types of machines failed to treat my CAs. I finally did get my ASV machine but it took 5 sleep studies in total. My original sleep doc and his staff failed to recognize the periodic breathing and CA events in my original sleep study. I had all hypopneas with O2 desaturations. They thought that because they saw "effort" that I had Obstructive Hypopnea. They were unfamiliar and improperly trained to see Central Hypopneas on a Polysonogram. My CPAP machines (I had 2 because they thought the first was defective) converted the Central Hypopneas to Central Apneas just like yours. It is time to make the move. You have tried just about everything to make your machine work for you. Your present machine can't treat you because it is not designed to do so. You need an ASV machine and need to go through the hoops to get one. The sooner you start the better.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#42
(01-01-2017, 09:20 PM)richb Wrote: Hi again Mike.  It looks like you need a new Doctor as well as a new ASV machine.  A recording pulse oxymeter will document the severity of your CA events in terms of O2 desaturations.  You might start at a place like this when looking for a new sleep doctor.  https://www.ucsfhealth.org/clinics/sleep...rs_center/  You might also ask your personal physician for a recommendation.  You need to have a frank conversation with your new Doctor.  You will need to know that the new Doc is familiar with Idiopathic Central Apnea as well as Mixed Apnea.  Your SH graphs are not showing any OA events so I doubt we are talking about mixed Apnea.     In my case I spent some time with the PA (showed her all of my graphs and charts) and then went on to the Sleep Doc.  I needed more sleep studies, of course, which included titrations in various CPAP modes to show that those types of machines failed to treat my CAs.  I finally did get my ASV machine but it took 5 sleep studies in total.   My original sleep doc and his staff failed to recognize the periodic breathing and CA events in my original sleep study.  I had all hypopneas with O2 desaturations.  They thought that because they saw "effort" that I had Obstructive Hypopnea.  They were unfamiliar and improperly trained to see Central Hypopneas on a Polysonogram.  My CPAP machines (I had 2 because they thought the first was defective) converted the Central Hypopneas to Central Apneas just like yours.  It is time to make the move.  You have tried just about everything to make your machine work for you.  Your present machine can't treat you because it is not designed to do so.  You need an ASV machine and need to go through the hoops to get one.  The sooner you start the better.  

Rich

Hi again Rich & Sleeprider

Apologies for long delay in getting back to you - been trying to figure a few things out first... Smile

Couple of updates:

A. Not sure how it will pan out, but I did finally get my Sleep Doctor to look at my situation again - he agreed that data from the last two months shows almost nothing in the way of obstructive sleep apnea, and almost all CA events...

B. He is in the process of scheduling another overnight titration study for me.

C. In the meantime, I contacted my online DME who provided me with the AirSense10 APAP - they in turn have had several conversations with RESMED. I know it's "highly" unlikely, but Resmed agreed to test (and if necessary replace under warranty) my AirSense10 APAP machine, given that I'm only seeing CA events and previous sleep studies have apparently shown none... I don't hold out a lot of hope, but it is another step that I can cross off and it eliminates one other possibility - My Airsense10 machine is currently on the way back to Resmed...

D. In the meantime, I am going to resurrect my old RESPIRONICS BIPAP AUTO M-SERIES machine and see what happens with that... Smile

E. I would still consider buying my own ASV machine if I can find one for a decent price, but having purchased the AirSense10 out of my own pocket, I am hesitant to spend a lot more money... I have contacted a couple of DMEs that provide RENTAL machines, but none of them seem to rent an ASV machine... Sad

Couple of quick questions:

1. It's been a long time since I used my Respironics BiPap machine and I have forgotten the various settings... any advice on what settings I could maybe start with, given that I was on a very small APAP range of 5.0 - 6.4 ?  Looks like I need to set something for MAX IPAP, MIN EPAP, MAX PRESSURE SUPPORT & BIFLEX (Just Pressure relief - correct?)  -  I'm guessing to maybe start with MAX IPAP=8 and MIN EPAP=5 ?

2. This old Respironics BiPap has no SD card, but does have an EncorePro Smartcard - I am hoping that I can use latest EncorePro card to read some data (and SUPERSLEEPER has been kindly assisting me with EncorePro install on another thread...) - no idea if this older machine has the ability to detect/display CA events... ?

Many Thanks
Mike
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#43
How to setup a BiPAP Auto M-Series...We have been all over the place with the CPAP and EPR. Pretty much found that centrals and hypopnea occur throughout a wide range of both. I don't see a high likelihood of success, and remember the M-Series won't distinguish apnea type. I would set EPAP min 5, PS min 2, PS max 4 and IPAP max at 10 based on where you've been since the thread started. You're going to have to see the data in Encore rather than Sleepyhead.
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#44
(02-23-2017, 09:30 PM)mymontreal Wrote: Couple of updates:

A. Not sure how it will pan out, but I did finally get my Sleep Doctor to look at my situation again - he agreed that data from the last two months shows almost nothing in the way of obstructive sleep apnea, and almost all CA events...

B. He is in the process of scheduling another overnight titration study for me.

Hi Mike,

Before or when scheduling the titration, I suggest verifying the titration will be an ASV titration.

Good luck.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#45
(02-27-2017, 01:54 AM)vsheline Wrote:
(02-23-2017, 09:30 PM)mymontreal Wrote: Couple of updates:

A. Not sure how it will pan out, but I did finally get my Sleep Doctor to look at my situation again - he agreed that data from the last two months shows almost nothing in the way of obstructive sleep apnea, and almost all CA events...

B. He is in the process of scheduling another overnight titration study for me.

Hi Mike,

Before or when scheduling the titration, I suggest verifying the titration will be an ASV titration.

Good luck.

Great point vsheline!

Regards
Mike
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#46
Also, if your legacy machine allows PS Min to be same as PS Max, then I suggest setting them both to 1. That would be similar to EPR of 1.

Also, Respironics is way slower in raising the pressure than ResMed machines, so you might consider raising the Min EPAP closer to the average Pressure used by the AirSense 10.

Good luck.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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