[Treatment] Central sleep apnea

[Bob Difley]

I have been using ResMed AirSense 10 and AirCurve 10 VAuto machines for 2 1/2 years but my Central apneas are still too high. My daily average for the past month is 7.5 Central apneas while the total of Hypopneas and Obstructive apneas totals just 2.6. Though the same treatment is recommended for all apneas, it doesn't seem to be effective in reducing Centrals. Nor do I understand how the treatment for preventing my tongue from closing off my throat to breathing as in Obstructive apneas would have any positive effect on treating Centrals, which are caused by the brain - not the throat closing. It seems to me that the source of my central apneas should be pursued and whether an alternative treatment should be considered, but my doctor does not seem to be interested in any other approach other than to change my settings, which does not affect the number of Central Apneas. Suggestions?   Thanks.

[dmeRT]

find a different Doctor who knows what they're doing.

Sounds like you need a bipap ASV. which is the next step in treating your complex apnea. Most likely an in lab titration study will be required for insurance purposes. But you'll need a knowledgeable Dr. to understand this.

[Gideon]

You by your numbers are on your way  Obstructive AHI < 5 and Central AHI > 5

Here is a Wiki highlighting the requirements that Medicare uses and most insurance companies follow.

Justifying_Advanced_PAP_Machines

[SarcasticDave94]

'Will you walk into my parlour?' said the Spider to the Fly.
Your hand grasps some money, of which I'll soon pry.

Welcome to club ASV...

[ardenum]

Autoset 10 aircurve 10 vauto arent for treating central apnea. Its either aircurve 10 st or asv at this point. You can try finding s9 asv if you had to buy it yourself, s10 asv costs 6 grand.

The good thing about vauto is you have alot of combinations of settings to try out. First things first get an oxymeter, one that wraps around your wrist and has a tiny thingy extending from it to clamp your finger. Oxygen oversaturation could be one thing that causes the central part. In this case you could use an EERS settup to solve it without the need to change the machine.

Other issue could be not enough oxygenated blood reaching your brain, hypoperfusion. But lets not get ahead of ourselves and make a O2 measurement over a couple of days.

[E.W.]

Pardon the comment as I am not bothered by centrals but in my reading I came upon an interesting study.
It seems that in heart failure patients who also have mixed sleep apnia they benefited by going through cardio
rehab. They usually didn't see any reduction in there OSA but the centrals were reduced by about 50% after cardio
rehab. Ok this might just help those who have heart failure but who knows ?

[DeepBreathing]

...s10 asv costs 6 grand.

I think that's the RRP, but you should be able to get them much lower than that. My local suppler in Perth has them for AU$3,890 (about US$2,800). Supplier #10 has them for US$4,500. As always, you need to shop around, but the fact remains ASV is much more expensive that standard CPAP, APAP or bi-level machines.