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[Treatment] Help with Central Apnea
#1
Help with Central Apnea
Hello Apnea Experts,

I'm looking for help in dealing with my central apnea. For a long time I have been tweaking with my CPAP settings to try to reduce my central apnea, without any success. Can anyone provide me with some guidance please? I have a Resmed Airsense 10 with a Resmed F30i mask, which I have found the most comfortable after using the Dreamwear full face and the Airtouch F20 for quite some time.

What kind of info should I have to post here so the experts can understand what's going on with my sleep? I'm posting some info here, but I'm not sure if this is what you need.

Thanks a lot!!!


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#2
RE: Help with Central Apnea
Welcome to the forum.

Does your country require sleep studies and/or titrations before issuing PAPs? If they do, then next is do you have copies that you can post in detailed and redacted/blacked out the personal info? Otherwise any info you were told about the CA? Also follow-up with us about how you feel. Are the CA the cause of feeling the therapy is compromised and you feel it will be better with lower CA? This type of questioning helps as this is likely some of the same info your doc, if involved, would need to help decide on better therapy actions.

Since you are not using Ramp, good idea really BTW, the only other thing I'd suggest is to lower EPR to off, but you're only using EPR 1 now and this may increase Flow Limits. This may be as good as it gets with this AutoSet. In other words, if info on your CA past were present, it would help us determine if a different ResMed called ASV would be ideal. The ASV is ResMed's answer to combatting CA.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Help with Central Apnea
Thank you for your quick reply and valuable insights. My most recent sleep test is from July 2017 (attached). It seems that central apnea was already an issue before using CPAP. The reason I'm concerned with CA is sometimes I wake up in the middle of the night when I need to take a deep breath, most likely for not having breathed for too long.

Before taking the ASV ($$$) route, is there anything you would suggest in terms of CPAP settings?


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#4
RE: Help with Central Apnea
I don't know what or if any action helps, as is you're on EPR 1 no ramp already. And your Flow Limits are something of an issue. And yes CA is a problem. Your study states 7.4 Obstructive 24.1 Central 1.8 mixed and 0.8 unclassified. My opinion is you should have been on ASV already, the ResMed AirCurve 10 ASV is best in the business.

With your AutoSet, unless there's pressure edits we can suggest to limit pressure swings but do not hinder current therapy, about the only thing is EPR Off. I think what's going to happen is most any edit we suggest may make CA go lower but other things like FL go up.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Help with Central Apnea
Understood! Thanks a lot for your time Dave.
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#6
RE: Help with Central Apnea
Welcome, you could try the zero EPR for a bit and see the results and how it changes your feel of the therapy. It may help or it could get worse. If it feels bad just add back the EPR 1. It is your choice if you want to try it. And you'd not need to continue a whole night if this feels worse.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Help with Central Apnea
In general, we find more steady, lower pressure without EPR minimizes central apnea. That said, the test shows that CA is 3 to 1 higher than obstructive, so I expect eventually you will seek out ASV therapy. Current settings are 8.0-15.0 with EPR 1. From chart posted it looks like pressure may optimize at 9 to 11 pressure without EPR. A lot of people have order the ASV from Supplier #2, and purchased the "gently used" units for $1598 USD that comes with a 1-year guarantee. SecondwindCPAP has proven to be very supportive of their exported products.
Sleeprider
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#8
RE: Help with Central Apnea
something else Dave alluded to that you can try with your apap if you haven't already is to titrate a fixed pressure looking for the most comfortable balance between obstructive and central events. typically, lower pressure reduces ca but increases oa & vice versa. you can do this in cpap mode or by setting min = max (I believe the latter is preferable because if I remember correctly, the former won't report flow limitations). if you find a setting that yields ahi under 5 & you feel okay, you may be good to go or you can incrementally experiment with min-max ranges; but fixed pressure is often better for mixed apnea on apap. I'd turn epr off while titrating if you choose to try this. failing this, you'd probably need to move to an asv.
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#9
RE: Help with Central Apnea
Awesome! Will try these settings and if they don't work, I'll get an ASV from secondwindcpap. Thanks again!

(01-18-2021, 06:55 PM)sheepless Wrote: something else Dave alluded to that you can try with your apap if you haven't already is to titrate a fixed pressure looking for the most comfortable balance between obstructive and central events. typically, lower pressure reduces ca but increases oa & vice versa. you can do this in cpap mode or by setting min = max (I believe the latter is preferable because if I remember correctly, the former won't report flow limitations). if you find a setting that yields ahi under 5 & you feel okay, you may be good to go or you can incrementally experiment with min-max ranges; but  fixed pressure is often better for mixed apnea on apap. I'd turn epr off while titrating if you choose to try this. failing this, you'd probably need to move to an asv.

Thanks for your input sheepless
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#10
RE: Help with Central Apnea
Yes sheepless was correct, it was there and for some reason I didn't finish the thought. Worst case is you try something as this and it feels badly or makes stats worse. But I would advise feel and comfort over numbers if that makes sense. Do not compromise feel/comfort for chasing down lower stats. Let us know how it's going.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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