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Waking up with headaches, have S9 data
#21
The xPAPs we use as folks with sleep apnea do not in any way breathe for you.

BiPAP (and all the other exhale/inhale pressure relief) detect either when you start breathing in or when you start breathing out, depending on the algorithm. I think. LOL

What it does, basically, is it senses when you are starting to end the inhale and it drops the pressure when you start the exhale. Then it detects when you are going to inhale and it increases the pressure.

Regardless, like I have said, if you are concerned you have mixed apnea, then you need to see the doc. If no central events happened during the sleep test, then you don't have a problem. My bet is on it all calming down as your continue your therapy. But you have to do whatever you need to be comfortable. Which is why talking to your doc would be a good thing.
PaulaO2
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Breathe deeply and count to zen.

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.




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#22
(10-19-2012, 12:22 AM)bryank1 Wrote: So I guess I was thinking that a bi-pap did what you described as a ASV.

Bryan, the ASV's are called bipaps by the manufacturers (Resmed VPAP Adapt and PR BiPAP Auto SV) as they do vary inhale/exhale pressure. They are the high end Bipaps with added features of epap range and ipap range (pressure support) as well as backup rate and they actively respond to breathing events.

Some people have the centrals/hypopneas go away after a while on CPAP. Some have them get worse. If it persists see your doctor and they should try BIPAP ST and eventually ASV if still not resolved (most insurance requires AHI > 5 with majority of events central or hypopneas).

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#23
Note I also had headaches after first starting CPAP. After 2.5 months on CPAP and BiPAP and little success I am now on ASV with AHI of 0.5. I had little trouble adjusting to it, though it is a bit wierd at times when it bumps up the pressure. It does not wake me, I only notice when falling asleep.

Do you know what the composition of your apneas was on your initial sleep study? (obstructive vs central vs hypopnea) If all obstructive, from my understanding it is more likely the centrals/hyps will go away. If you had alot of centrals or hypopneas then don't be surprised if they do not and make sure the doctor knows if your therapy is unsatisfactory.
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#24
(10-18-2012, 11:45 PM)bryank1 Wrote: My understanding is that bi-pap has the added function of exhaling with the cpap (positive pressure) to the user for the purpose of sort of jump starting a central apnea event.
If the machine works this way, then it should resolve the patients central apnea issues. Isn't it in a sense an automated breathing machine?

Some more advanced BiPAP machines do the breathing for you and are designed to treat more advanced SDB conditions. The same is true of other machines that are not BiPAP's.

I have a BiPAP and it doesn't do that. It just provides two levels of pressure. IPAP when I inhale and EPAP when I exhale.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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#25
(10-18-2012, 11:45 PM)bryank1 Wrote: My understanding is that bi-pap has the added function of exhaling with the cpap (positive pressure) to the user for the purpose of sort of jump starting a central apnea event.
If the machine works this way, then it should resolve the patients central apnea issues. Isn't it in a sense an automated breathing machine?

I had one night with a cluster of centrals with the longest being 25 seconds. That seems like a long time to stop breathing.

The correct term is bilevel. BiPAP is a trademark.

Bilevel machines reduce the pressure on exhale. This is mostly for people who have a hard time exhaling against the CPAP pressure. It's not really for central apnea. Some people think it may help centrals, some think it makes them worse.

Some more advanced bilevel machines have what's called "timed" or T mode. This is more likely to help with central apnea.

Even more advanced is an "ASV" Adaptive Servo Ventilator bilevel machine. ASV is sort of the "real" treatment for central apnea sufferers.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#26
Wow, great info. Just noticed one central where I stopped breathing for 51 seconds.
Yes there were centrals in the study, mostly obstructive. The 51 second event is more rare. Therapist is setting me up with a modem for monitoring And direct data to the doc.
Thanks much for explaining the machines. Even though My ahi is low (1.38), there are still centrals. I would feel better if those could be eliminated. It will be about a month before I see the Doc. Hopefully the headaches will go away over time.
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#27
A diagnosis of central sleep apnea (CSA) requires all of the following:
An apnea index > 5
Central apneas/hypopneas > 50% of total apneas/hypopneas
Central apneas or hypopneas occurring at least 5 times per hour
Symptoms of either excessive sleepiness or disrupted sleep
http://www.resmed.com/us/clinicians/abou...clinicians
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#28
(10-19-2012, 03:56 PM)bryank1 Wrote: Wow, great info. Just noticed one central where I stopped breathing for 51 seconds.
Yes there were centrals in the study, mostly obstructive. The 51 second event is more rare. Therapist is setting me up with a modem for monitoring And direct data to the doc.
Thanks much for explaining the machines. Even though My ahi is low (1.38), there are still centrals. I would feel better if those could be eliminated. It will be about a month before I see the Doc. Hopefully the headaches will go away over time.

Don't worry about the apneas being central. Worry about how long they are and how often they occur. Centrals are more worrisome because they're harder to eliminate and increasing the pressure may make them worse.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#29
(10-16-2012, 04:44 PM)PaulaO2 Wrote: BiPAP is not for central apnea. BiPAP (or bilevel PAP) can have an inhale and exhale pressure difference of more than 3 points.

Central events are common when first starting therapy. I'm too lazy today to go back and see how long you have been using the APAP.

However, clear airway events and central events are not necessarily the same thing. This is a topic of much discussion here and elsewhere. Some people say they are, some people say they are not.

If these clear airway events continue or worsen, you really need to discuss this with your doc. But, if you are just starting, my bet is that they will slowly subside, especially if none were seen during the sleep study.

I was told by the respiratory therapist from ResMed that a clear airway was a central apnea. That is what she said but my didn't come from my doc. Whats strange is that they come in a cluster close together spread out over about 1- 1/2 hrs. Like last night I had 20 clear airway, and only 4 obstructive and 1 hypopnea. So as far as doctors go is there not a clear definition of a clear airway? I would think since ResMed designed the device that they designed that function to be what she said was a central apnea, but I don't know.
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#30
(10-20-2012, 10:55 PM)bryank1 Wrote: I was told by the respiratory therapist from ResMed that a clear airway was a central apnea. That is what she said but my didn't come from my doc. Whats strange is that they come in a cluster close together spread out over about 1- 1/2 hrs. Like last night I had 20 clear airway, and only 4 obstructive and 1 hypopnea. So as far as doctors go is there not a clear definition of a clear airway? I would think since ResMed designed the device that they designed that function to be what she said was a central apnea, but I don't know.

A CPAP machine can't definitively tell whether it's really a central apnea. You have to have a belt around your waist to measure respiratory effort to definitively tell that.

Edit - Actually the belt goes around your chest.

The CPAP machine tries to tell as well as it can. When it says central apnea or clear apnea, it's probably a real central apnea. However, if you have a real central apnea, it may flag it as an obstructive apnea.

It's useful info, but not gospel.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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