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confused -new sleep doctor has stopped cpap
#1
I had (2) sleep studies - both showed AHI 20 (complex apneas). My doctor suggested Cpap with a pressure 10 (and later 14). After 4 mths, I had issues with insomnia (best nights getting 5hrs broken sleep) and increased centrals (112 centrals alone one night). The sleep doctor didn't seem interested in my concerns - stating the treatment is going well....so I went to another doctor.

Armed with 'sleepyhead' data etc - I saw this new sleep doctor who recommended stopping cpap and sleeping on my side.

Im confused - I went through all the tests etc to treat symptoms (daytime fatigue etc). No surprise (despite sleeping on my side), nothing has changed (still fatigued and have headaches)....

In situations with complex apnea (no heart issues), surely the course of action is cpap... then Bipap then ASV (or a trial on ASV)??

Does anyone have any suggestions?





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#2
Your new doctor is useless. Keep looking.

Edit: You don't want a pulmonologist for your sleep doctor if you're having mostly centrals.
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#3
I'm thinking either that or he wants to establish a baseline then look at options
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#4
(03-17-2016, 03:19 AM)big_dave Wrote: Your new doctor is useless. Keep looking.

Edit: You don't want a pulmonologist for your sleep doctor if you're having mostly centrals.



He is - explains things
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#5
My nurse/practitioner could not handle the fact I was waking most mornings about 0300-0400 and clearly had no intention of doing anything about it.
I paid to see the senior man, his best effort was to suggest I went to bed later, and that I see another nurse regarding a change of mask, which I had not raised as an issue, leak rates being reasonable.

Sounds like your quacks are as much use as ours.

The only reason I am taking further action is in the hope I might get my driving license returned, were it not for that I would likely say stuff it and let nature take its course.
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#6
When you do your Doctor shopping, be sure to ask if they are familiar with Central Apnea and Periodic Breathing. If you have a teaching hospital in your area you might want to start there. The standard treatment for Obstructive Apnea (CPAP) does not work for most cases of Central Apnea. An ASV machine is the usual treatment for Central Apnea. You will want to confirm that your new Doc will prescribe an ASV machine if your diagnosis is Central Apnea. Note that I mentioned Periodic Breathing. Periodic Breathing will look like Hypopneas during a Sleep Study. The Periodic Breathing can cause desaturations of O2 that keep you fromn sleeping deeply. A standard CPAP machine will convert Periodic Breathing Hypopneas to Centrals therefore the increase in Centrals. You did not mention that you had Obstructive Apnea events during your Sleep Study. Your Doc may have been counting Periodic Breathing events as if they were Obstructive in nature. Look at your sleep Study to see what was reported. An ASV machine can treat both Obstructive and Central Apneas. The initial settings might be different depending on whether Obstructive events are present. Sleeping on your side can also eliminate many Obstructive events but will not change the Centrals. Stay in touch and keep reading threads on this site related to Central Apnea.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#7
(03-17-2016, 02:57 AM)Sleeeppp Wrote: Does anyone have any suggestions?

Yes, speak up. The only advocate you have for your health is yourself. However, that said, given that you showed him the data and he gave a stupid answer (yes stupid), I'd look for a different doctor and report to the head of the clinic that this doctor had terrible advice.
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#8
(03-17-2016, 11:30 AM)Phill Wrote: My nurse/practitioner could not handle the fact I was waking most mornings about 0300-0400 and clearly had no intention of doing anything about it.
I paid to see the senior man, his best effort was to suggest I went to bed later, and that I see another nurse regarding a change of mask, which I had not raised as an issue, leak rates being reasonable.

Sounds like your quacks are as much use as ours.

The only reason I am taking further action is in the hope I might get my driving license returned, were it not for that I would likely say stuff it and let nature take its course.


I hear you!! It's not as though I want to do this treatment and pay $$ (in Aust, we have to pay full for machines - even b.... Res...d which is made here!)

Perturbed[/u]
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#9
(03-17-2016, 11:30 AM)Phill Wrote: My nurse/practitioner could not handle the fact I was waking most mornings about 0300-0400 and clearly had no intention of doing anything about it.
I paid to see the senior man, his best effort was to suggest I went to bed later, and that I see another nurse regarding a change of mask, which I had not raised as an issue, leak rates being reasonable.

Sounds like your quacks are as much use as ours.

The only reason I am taking further action is in the hope I might get my driving license returned, were it not for that I would likely say stuff it and let nature take its course.

I hear you!!!

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#10
Oh-jeezThank you for all the advise - affirms what I've been thinking.....

This new specialist is very senior in his field of sleep/ respiratory med (can't say too much....). When I went in to see him I had all reports, a report of data from SleepHead and several "Daily Events" showing the breakdown of apneas and the 'weird breathing' I do (and have done since a child).. I must say he (the doctor) looked gob-smacked when I handed all this information - and when my husband pointed to a few graphs and said "is this Cheyne/Stokes or periodic breathing?". The doctor said he wasn't sure and asked what I did for a living - I suppose 'one should know one's place'
:I

So, Plan C - find another sleep specialist...... Oh-jeez


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