dragon800 - Therapy Questions

[Sleeprider]

Dragon, take a look at our Wiki for Respiratory Drive http://www.apneaboard.com/wiki/index.php...tory_Drive

It might help to understand what mechanism is at play when you have this repeated pattern of apnea and hyperventilation. This is a natural feedback loop that we all have, but in your case, the stimulation of CO2 to respiratory drive is likely delayed. You end up meeting your respiratory requirements on average, but once the oscillation starts, it just doesn't level out like a normal person. This is where ASV intervenes and prevents the initial sag in respiration that starts this loop.

[dragon800]

thank you for the fast reply. I have esr on because I hate the feeling of trying to breathe out against the pressure but if it can help with the CA's I guess I have to try dealing with it. At first I was just given the machine by a homecare place and my doctor said they just do compliance. I learned about this forum and beiong able to see the results just days ago so I called the doctor yesterday told them what I know and they seemed super surprised I'm still having apneas with the machine. They obviously know nothing about it but I can't hold it against them they are just general care. So they called back and are sending a referral to a pulmonologist. I just hope I can get in quick it took months to get this CPAP. My chest hurts everyday and I feel like crap. At least I'm making progress though it took years to get a doctor to find out I had sleep apnea. I think it's my age. I went to the ER when I was about 30 with my chest pain and they told me it was indigestion. Ended up developing neuropathy which they cant identify the cause but now I think it might be the sleep apnea. Ah, sorry for rambling.

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Thanks I'll check out the respiratory drive on the wiki.

[dragon800]

so on another forum i found that opioids can cause central apnea. Ive been on methadone for years. I would have mentioned that but it's a bit embarrassing and i really didn't think it would have anything to do with this. It seems this is the likely culprit and the ASV machine is likely what I need. Anyone here have any expertise on opiates and central apnea?

[Dormeo]

I'm sorry you felt embarrassed to mention your treatment with methadone. Your doctor is having you take methadone for a reason, and I'm sure it's doing you good.

Please tell the sleep doctor about the methadone, if you haven't already. That's an important piece of information, and it should help the doctor put you on the path toward better apnea treatment. Keep us posted!

[Sleeprider]

Any opioid medication can result in central apnea issues and is treatable with the ASV. We have had several members in the past that required ASV to deal with the opioid induced central sleep apnea. The prescribing doctor should be aware of this common side-effect and could review your CPAP results and prescribe the appropriate ASV therapy, or refer you to a specialist to mitigate the problem. It is essential that any physician responsible for your sleep disordered breathing therapy be made aware of this issue.

[dragon800]

i got the paperwork on my heart tests and it says left ventricle 55-60% ejection fraction is that caused by the sleep apnea? I put the machine back to auto 7-15 and slept on my side and got a score of under 5 two nights ago but then last night it was back in the 30's. Seems my apnea is all over the damn place.

[Dormeo]

About left ejection fractions, from a trusted web site:

https://www.mayoclinic.org/tests-procedu...q-20058286

Yours would appear to be normal.

And yes, CAs are really frustrating because they bounce around so much from one night to another. Did you feel better, worse, or about the same on the nights when the CA index was lower?

[dragon800]

Thats strange that site says mine is normal my doctor told me thats bad

[Dormeo]

Definitely follow up by asking your doctor to explain why your numbers are bad, what numbers he expects to see, and what he is going to do to help you. A lot of doctors don't appreciate having something from the internet quoted to them, but I think it'd be fine to say you've been trying to educate yourself and noticed that the Mayo Clinic site says your numbers are in the normal range.

[dragon800]

Well it's a relief according to trusted sites that it's normal. I will have to ask him why. I tried last time but he pretty much shoved me out the door however, I rescheduled with my original heart doctor which is super nice i only had this other guy for the test. its a annual check up thats still a ways away though so maybe I'll see if he will talk to me on the phone.