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Weinmann SOMNObalance suitable for central apnea?
#1
Weinmann SOMNObalance suitable for central apnea?
Two months ago, I was diagnosed with sleep apnea. AHI (#/hour) was 38.9 (CA 33.3, OA 2.7, MA 0.5, HA 2.5) and desaturation index (#/hour) was 14.9. My medical insurance covers only selected CPAP and APAP machines, and no ASV machine, so my sleep doctor prescribed me Weinmann SOMNObalance e machine, based on his experience in central apnea treatment. Four weeks ago, I got Weinmann SOMNObalance e machine, set up in APAP mode with 4-14 hPa pressure range. Using the machine, I sleep better. I still feel somewhat tired during the day, but less than before. AHI average for the last four weeks was 3.0 (CA 2.7, OA 0.3) and the maximum AHI recorded was 4.7 (CA 4.3, OA 0.7). Should I be happy with this machine, or should I start saving for an ASV machine?

I've read that underlying health conditions cause most cases of central sleep apnea. Should I be worried? My doctor hasn't send me to any additional medical checks after my central apnea diagnosis. Should I request some additional medical checks? What additional checks would you recommend?
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#2
RE: [split] Weinmann SOMNObalance suitable for central apnea?
G'day Dark. Welcome to Apnea Board.

I've split your post out into its own thread so that it will get more detailed attention and advice.

By the way, I was in Croatia a few weeks ago, but didn't get to Zagreb. It's a stunningly beautiful country!
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#3
RE: [split] Weinmann SOMNObalance suitable for central apnea?
Welcome Dark!

Those are not bad numbers for starting out.  The machine seems to be doing a good job on the central apnea.  It can take some time for your body and brain to adjust.  I had similar numbers and they drifted down over several  months.  I did make some pressure changes over that time, which has an effect.

I don't know enough about your machine to offer any suggestions on how you might further lower the CA.  I am surprised at the effectiveness of an APAP machine on your central apnea.
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#4
RE: [split] Weinmann SOMNObalance suitable for central apnea?
Where exactly do the numbers you provided come from?
straight from the machine? from WeinmannSupport? Sleepyhead (which version if so)? or the "stupid" diary on the SD-Card?

Hwo do you get along with your mask?
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#5
RE: [split] Weinmann SOMNObalance suitable for central apnea?
The Weinmann has a great reputation as an auto CPAP, and there is a good review of it in the forum Product Review section.
http://www.apneaboard.com/forums/Thread-...-Auto-CPAP
http://www.apneaboard.com/forums/Thread-...Obalance-e

It is a CPAP and not intended to treat central apnea. Your good results are unexpected, but hopefully they will continue. Some people do respond positively to CPAP and do not require ASV. It looks like you are one of the lucky ones. Your machine produces detailed data. You can get a copy of the software through the forum here: http://www.apneaboard.com/forums/Thread-...hines-only

My suggestion is for you to track the data on your machine and learn what pressure range is most effective. It is likely that your best results are when your machine is at a relatively low pressure, and that more CA occur at higher pressures. You can learn what works best by studying the data, then limiting the pressure range on your machine to those best settings.
Sleeprider
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#6
RE: [split] Weinmann SOMNObalance suitable for central apnea?
@DeepBreathing:
Thank you! I would like to visit Australia one day.

@chill:
I'm still new to all this, and I'm just studying my sleep data for now. I haven't seen any drift in my numbers jet, just some minor oscillations from night to night.

@TBMx:
Numbers are from WeinmannSupport. I'm also using Sleepyhead 1.0.0-beta-2 and I like it more than WeinmannSupport, but it has limited support for WM_DATA.TDF file format and it has some bugs. It only reads DayCompliance part of WM_DATA.TDF and it skips older data from WeekCompliance part of that file. Also, when I read my card more than one time it messes up event lists. I've already looked at the source code and WM_DATA.TDF file and I will try to improve it if I could.

The JOYCEone mask came with machine and it isn't perfect for me. There is too much pressure on the end of my nasal bone. It looks like the mask it's too small for me. In the first week I got sore on my nose, and since then I put adhesive bandage on my nose every night. The sore is gone now, but I need a better mask.

@Sleeprider:
I downloaded WeinmannSupport. I will check the relation of my central apnea and hypoapnea to pressure. Thank you for your suggestions!
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#7
RE: [split] Weinmann SOMNObalance suitable for central apnea?
personally I can't stand the JOYCE masks (although I use the FF ones) because of their (virtually non-existant) very low vent-flow. Makes it somewhat impossible for me to breath.

As you have a very low pressure: the SomnoBalance (SB) uses obstructive Pressure Pulse (OPP) to distinguish between central / clear ariway apneas (CA) and obstructive apneas (OA). That gets more reliable the higher the pressure is. With a FFM I found, that below 6 cmH2O it is totally unreliable and tends to flag OAs as CAs (false positive). 6-7 cmH2O is somewhat of a "greyish" area ... higher than 7 turns out to be pretty reliable.
(this does not make it bad at what it does - other devices simply avoid the distinction in the low-pressure-ranges or are comparable - even with FOT)

So if you see a lot of CAs mostly in the lower pressure ranges the best strategy would be: raise your minimum pressure first and see if that fixes them. (This sounds totally contradictory - even in your case - but most are simply false positives)
central (or more precise unobstructive) Hypopneas are a bit more complicated than that ... best to show you, if you post charts.

As I have the same device, I claim to know a bit of it ... if you are interested in the algorithm or how the machine adjusts the pressure, scores events (and to what to make of them) you can start by reading up on costas' posts about the prisma 20a from Löwenstein (formerly Weinmann). (the Prisma is the new incarnation of the SB ... they are not exactly the same but they are 'comparable' regarding the auto-algorithm)
.. or just ask^^ (I literally crawled a couple of times through the SB [without bragging too much])
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#8
RE: [split] Weinmann SOMNObalance suitable for central apnea?
Thank you, TBMx! I will try to increase Pmin from 4 hPa up to 7 hPa in the next few days and compare the numbers.
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#9
RE: [split] Weinmann SOMNObalance suitable for central apnea?
In the last week I increased Pmin from 4 hPa to 5 hPa and then to 6 hPa. I didn't notice a significant drop in CA or cH, but my average AHI was a little lower (AHI 2.84) than it was on Pmin 4hPa (AHI 3.26). I still have some longer CA events, and some of those events end in waking up. I decided to buy a SleepyHead compatible oxymeter to see how severe those CA events are.
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#10
RE: [split] Weinmann SOMNObalance suitable for central apnea?
Thanks to TBMx, I can import Weinmann data in SleepyHead now, and I can track my data and post some graphs.

Here are some CA events from my graphs.

One of the longest CA events (49 seconds) with a regular breathing pattern afterwards:
[Image: g2gEBV1.png]

CA event with a different breathing pattern afterwards:
[Image: vT54dXr.png]

CA event with another breathing pattern afterwards that looks like two shorter apneas:
[Image: Rkff6zr.png]

CA event that woke me up and force me to take of the mask:
[Image: TbTknk1.png]

Double CA events followed by possible third event 2 minutes later that didn't trigger an event:
[Image: qMZZLXO.png]

OA, cH, CA event sequence:
[Image: ge90iu4.png]

Another CA event preceded by two possible apneas that didn't trigger an event:
[Image: lg83sjG.png]

CA event followed by 3 minutes of irregular breathing with some apnea like parts:
[Image: Qv34u6H.png]
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