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[Treatment] struggling to breath
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Robo64 Offline

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Sex: Male
Location: NSW - Australia

Post: #11
RE: struggling to breath
Thanks again for all your help and replies, its good to be able to talk about this condition here as no one around me realy understands anything about apnea.

I tried to add 2 jpg's not sure if they will display. The waveform graph is my first our of sleep. Clock is out should be 12pm not 1.

Thanks

[attachment=2274]
[attachment=2275]
03-19-2016 05:39 AM
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Robo64 Offline

Members

Posts: 8
Joined: Mar 2016

Machine: dreamstation
Mask Type: Full face mask
Mask Make & Model: trialing nasal &full
Humidifier: dreamstation
CPAP Pressure: 6-15 auto
CPAP Software: EncorePro

Other Comments:

Sex: Male
Location: NSW - Australia

Post: #12
RE: struggling to breath
Well it appears the attachments worked. The first hour of sleep looks pretty bad to me, but realy not sure, I would be interested to hear your comments. Like I said I have a titration study next week, shoud I be taking any of these graphs with me.

Thanks
Rob64
03-19-2016 05:47 AM
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DeepBreathing Offline
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Sex: Male
Location: Perth, Western Australia

Post: #13
RE: struggling to breath
That's pretty ugly. It's a bit hard to tell from these charts but it looks like some of those apneas are well over a minute long, which is worrisome. The number of central apneas is also a possible concern - was your home sleep test able to distinguish central from obstructive apneas? It's possible that they have been brought on by the therapy (in which case they will hopefully go away again) but if they were there in your initial study then you might need to think about a different therapy approach. The other possibility is that if you weren't sleeping properly, dozing in and out of sleep, that these could just be spurious artefacts called "sleep / wake junk".

I'd definitely take those charts to your titration study. In fact I'd call the clinic before the study, explain that you are seeing a lot of central apneas and ask them to ensure you are titrated for bilevel and ASV therapy at the same time. ASV (adaptive servo ventilation) is the only way to totally eliminate central apnea. The good news is that they work really really well. The bad news is that they cost more than twice as much as a regular machine.

Given the ASV are so expensive you'll want to work through the other options first. You might be lucky and the centrals will just go away as your system adjusts to therapy. Or a lot of them might be sleep / wake junk, which should also settle down as you get used to the machine. But don't get yourself locked into purchasing a machine until you're confident it's the right one for you.

DeepBreathing
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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.
03-19-2016 07:16 AM
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richb Online

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Location: Vermont

Post: #14
RE: struggling to breath
(03-19-2016 05:47 AM)Robo64 Wrote:  Well it appears the attachments worked. The first hour of sleep looks pretty bad to me, but realy not sure, I would be interested to hear your comments. Like I said I have a titration study next week, shoud I be taking any of these graphs with me.

Thanks
Rob64

The sleep study tech most likely will not be allowed to discuss your sleep study with you. It is going to be important to get a titration on an ASV machine at some point during your sleep study. As I mentioned previously, you need to be sure that your sleep Doc has specified that ASV settings are used during a portion of your sleep study. Your graphs show that your current machine is not working for you. In fact it is probably making things worse. Show the graphs to your sleep Doc.

Rich
03-19-2016 07:19 AM
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vsheline Offline

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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Post: #15
RE: struggling to breath
(03-19-2016 07:16 AM)DeepBreathing Wrote:  In fact I'd call the clinic before the study, explain that you are seeing a lot of central apneas and ask them to ensure you are titrated for bilevel and ASV therapy at the same time. ASV (adaptive servo ventilation) is the only way to totally eliminate central apnea.

(03-19-2016 07:19 AM)richb Wrote:  It is going to be important to get a titration on an ASV machine at some point during your sleep study. As I mentioned previously, you need to be sure that your sleep Doc has specified that ASV settings are used during a portion of your sleep study. Your graphs show that your current machine is not working for you.

I agree with DB and Rich. Waiting until the titration to ask that the titration include ASV would be a mistake.

I think the titration will likely only follow doctor's instructions, and you would likely need to insist that the doctor give expanded instructions to the sleep test clinic ahead of time. And you would need to call the sleep clinic ahead of time to verify they have received the expanded instructions and will include ASV in the titration as needed.

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.
(This post was last modified: 03-19-2016 07:54 PM by vsheline.)
03-19-2016 07:32 PM
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Robo64 Offline

Members

Posts: 8
Joined: Mar 2016

Machine: dreamstation
Mask Type: Full face mask
Mask Make & Model: trialing nasal &full
Humidifier: dreamstation
CPAP Pressure: 6-15 auto
CPAP Software: EncorePro

Other Comments:

Sex: Male
Location: NSW - Australia

Post: #16
RE: struggling to breath
Quote:was your home sleep test able to distinguish central from obstructive apneas? It's possible that they have been brought on by the therapy (in which case they will hopefully go away again) but if they were there in your initial study then you might need to think about a different therapy approach. The other possibility is that if you weren't sleeping properly, dozing in and out of sleep, that these could just be spurious artefacts called "sleep / wake junk"

My home sleep study Did show centrals, they were in majority, but not as many as I am having now. You mentioned sleep/wake junk, that is a definite possibility as I toss and turn a lot, it takes ages to g to sleep as I am concentrated on my breathing.

I read in other posts here that most people hold their breath when turning over, causing false clear airway apenia, this coud be the case with me, I often find myself holding my breath, even during the day.

Quote:I agree with DB and Rich. Waiting until the titration to ask that the titration include ASV would be a mistake.

I'm hearing ya, I will contact the doctors office tomorrow, will probably only get the secretary, but I will push the issue.

Thanks for all for your advice
Robo64
03-19-2016 09:34 PM
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vsheline Offline

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Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #17
RE: struggling to breath
(03-19-2016 09:34 PM)Robo64 Wrote:  My home sleep study Did show centrals, they were in majority, but not as many as I am having now.

Hi Robo64,

I think perhaps a third of new CPAP users initially have 5 or more centrals per hour of sleep, and for about half of these new users the centrals will gradually reduce in number and become insignificant, less than 1 or 2 per hour, over the course of the initial weeks or few months of regular use, as our systems become accustomed to breathing under pressure.

But if centrals were in the majority during your diagnostic sleep study (without CPAP) then your centrals are not going to go away on their own as you become accustomed to PAP therapy.

If the number of centrals you are having continues to be in excess of 5 per hour of sleep and continues to outnumber the obstructive apneas per hour of sleep, then you need ASV therapy.

Good luck,
--- Vaughn

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.
(This post was last modified: 03-20-2016 12:54 AM by vsheline.)
03-20-2016 12:52 AM
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kwhenrykerr Offline
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Sex: Male
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Post: #18
RE: struggling to breath
Robo64 how are you doing ?

Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
08-17-2016 02:46 PM
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