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newbie question
#1
For some reason, Internet explorer kept deleting my posts and putting in the word Undefined. Here is my post!


First, I will be upfront. I believe people should be very pro active in their health. Trusting doctors to know everything has been a large problem in our society. I have had problems sleeping my entire life, and have been to many doctors for it. Lots of medications prescribed, most of which I chose not to take because they were merely to band aid the problem. No one ever found a real "problem". It is only recently, that my boyfriend watched me sleeping and said he thought I was stopping breathing. After TONS of research, especially on this forum, i realized I probably had sleep apnea. His description and use of a Zeo, made it even clearer, and i realized it was probably a mixture of Obstructive and Central.

I live in a very remote area, and also didn't have the money for a sleep study. I also read on this forum, that many doctors will give a patient a Resmed Auto and use the data as a sleep study. There was also a Dr on here who talked about empirical trials, and how there was little risk in trying a auto pap machine. Sooooooooo

I purchased a brand new (previously owned) Resmed S9 Vpap auto- climate line tubing, zest nasal mask. I know that many people on this forum feel a Dr is a must, so my apologies if any one is offended by my choice. I read all the forums and manuals and set it to auto and after 2 nights actually slept for 7 hours (with one bathroom break). I donwloaded my data into Resscan and SURPRISE- (not really) I have complex sleep apnea. In the 7 hours I had over 27 events- 11 Central and 15 obstructive. I plan on continuing to use it and read my data, but here is my main question:

If I truly have comlex apnea- should I use the Adapt machine, or is the S9 capable of handling both central and obstructive? From all that I have read, it seems that the S9 Vpap auto can detect the difference, but only treats obstructive. that would mean I am only getting half of the treatment necessary for a decent nights sleep in my case.

PLEASE NOTE- I understand that there may very well be a reason for the central (ie heart problem, brain problem etc) and will definitely be working with my general MD to check on these factors, but he is not versed in sleep disorders- and I dare say, many sleep doctors arent half as versed as the people on this forum are.

I would love to send someone my data and have them help explain it a little more clearly, if anyone is so inclined. Thank you to all who post on here. You have made it possible for me to finally find the cause for a lifelong problem.
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#2
So are you having Central events or are you just assuming you do?

If I understand it correctly, a Resmed VPAP auto is not for central apnea. It is a bilevel PAP. The VPAP Adapt is for treating central apnea.

PS: I deleted the duplicate thread.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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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#3
Thank you for deleting duplicate post. In res scan it showed I had 12 central apnea events and 15 obstructive events over 7 hours. All events were over 10 seconds long. I am wondering if vpap adapt treats OSA and CSA.
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#4
HI mermangel,
WELCOME! to the forum.!
Best of luck in finding the exact treatment that will work for you.
Hang tight for more responses to your post.
trish6hundred
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#5
(01-31-2013, 07:27 PM)mermangel Wrote: Thank you for deleting duplicate post. In res scan it showed I had 12 central apnea events and 15 obstructive events over 7 hours. All events were over 10 seconds long. I am wondering if vpap adapt treats OSA and CSA.

But that just gives you an AHI of 3.8 which is a good number. Events are not counted unless they are ten seconds or longer anyway.

I bet nearly all of us have some central events each night. So you having them are not unusual either.

Going by what they say at the ResMed site, the VPAP Adapt treat CSA. I would assume it can also treats OSA but it doesn't say it is for both. There's several here who use that machine so hopefully they can say for sure.

The machines used to treat CSA are notoriously difficult to get used to. I wouldn't want to use one unless I had to.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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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#6
I would suggest getting a recording oximeter and wearing it while you sleep to record your O2 levels (oxygen levels in your blood) for a few nights during these events. The O2 saturation recordings will probably mean a lot more to your doctor than AHI alone will (and might give you a better idea of what is going on). For the first couple of months on PAP I had CA levels similar to yours with 15 - 20 second event durations and my doctor said it was normal because the CAs were only making my O2 levels go from around 99% to around 92%. He said that my brain was making me stop breathing for a while because the high pressure was making me breath too hard (hyperventilating) and that the CAs would decrease as I acclimated to the pressure. He was right. I have one or two CA events per week that only last 10 or 12 seconds now that I've gotten used to the pressure. Your mileage may vary and and this is something you should discuss with your doctor, but I think he will be able to help you more if he has some oxygen saturation levels to look at (and you will be able to help yourself more with some O2 saturation data). You can pick up a recording oximeter pretty cheaply and I really believe it to be a very valuable tool for anybody with health issues like ours.
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#7
Thanks for all your support. All events are over 10 seconds. The CSA's are not always near the OSA's and there is one spot where I had a failry large cluster of them with no OSA's. The resmed Vpap auto says it differentiates between OSA's and CSA's but doesn't say it treats CSA's and the Adapt doesn't say if treat Osa's. I think the S9 is a great product, but Resmed is horrible for any kind of information or instruction. I had to read and search all over this forum to figure out how to use the climate line hose etc.

I will definitlely buy an oximeter and keep looking at my data. When I have a week or two under my belt, I will post it. Thanks again.
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#8
(02-01-2013, 01:26 AM)mermangel Wrote: Thanks for all your support. All events are over 10 seconds.

The machines only count an event if it lasts ten seconds or more. So the fact it lists them doesn't automatically diagnose you with central apnea.

mermangel Wrote:The CSA's are not always near the OSA's and there is one spot where I had a failry large cluster of them with no OSA's.

The two are different events, totally independent of each other. They can happen at any time during the night.

mermangel Wrote:The resmed Vpap auto says it differentiates between OSA's and CSA's but doesn't say it treats CSA's and the Adapt doesn't say if treat Osa's.

I did some more research. From ResMed site:

Quote:The VPAP™ Adapt is an adaptive servo-ventilator with a backup rate specifically designed to treat central sleep apnea (CSA) in all its forms, including mixed sleep apnea, complex sleep apnea (CompSA) and periodic breathing such as Cheyne–Stokes respiration (CSR). The VPAP Adapt is available with Ramp functionality and a choice of auto-adjusting EPAP in ASVAuto mode or fixed EPAP in ASV mode.

and

Quote:The VPAP™ Auto is an auto-adjusting bilevel device designed to address the unique needs of noncompliant OSA patients while providing quiet and comfortable therapy.

mermangel Wrote:I think the S9 is a great product, but Resmed is horrible for any kind of information or instruction. I had to read and search all over this forum to figure out how to use the climate line hose etc.

I will definitlely buy an oximeter and keep looking at my data. When I have a week or two under my belt, I will post it. Thanks again.

When you go to the ResMed site, and you find a particular product you are looking for, on the right hand side will be some menus to expand. Usually they are "Information Guides" and "User Manuals" or similar. It's usually .pdf files.
http://www.resmed.com/us/products/climat...c=patients
http://www.resmed.com/us/assets/document...lo_eng.pdf

Most of the time, the information guides are useless brochures.

But to be honest, I think you are making too big a deal of this. You have the Elite which is a good machine. You say it is reporting both "central" events as well as obstructive. While the algorithm of these machines are getting better, they still do not compare to a sleep study. That's why they call them "Clear Airway" events rather than Central events. The machine can take a good guess at whether the airway is open or not but it can't tell if you are struggling or just laying there.

An AHI of 3.8 is really good. You are getting great treatment. Anything less than 5 is the goal and zero is the Holy Grail.

Are you still feeling tired?
How long have you been using your Elite (or any CPAP)?
How long do the events last?
Do the CA events happen during high pressure peaks?

There's so many things to take into consideration when looking at the data. You cannot jump to any conclusions. Based on what you have said so far, I still don't think you have complex apnea. But then, I'm not a doctor or sleep tech. I'd just hate for you to waste your money on an expensive machine you do not need.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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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#9
ResScan Report Interpretation Guide
http://www.apneaboard.com/ResScan_Interp...-Guide.pdf


Resmed S9 AutoSet and Elite detect central sleep apnea
when central apnea detected (open airways) the Autoset do not increase pressure

whats the leak and "how do you feel"

leak rate more than 24 L/min can cause reduced efficacy of treatment and disturbed sleep

one need to get leak under control and get a decent sleep before rely on data or hope for good therapy


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#10
To sum up some of the points already made:
1. AHI of 3.8 is below the accepted level of 5.0 to say your therapy is effective. This is very good.

2. xPAP's do sense "clear airway" events. This may be a central apnea, but only a fully wired and instrumented sleep study can be sure. It's information, but don't take it too literally.

3. I agree totally with using a pulse oximeter to monitor blood oxygen levels. Apnea's have two major health impacts, sleep interruption and blood oxygen level decrease. Both cause physiological problems, organ damage (brain, heart, kidneys, pancreas, etc.) being a big one. The sleep interruption can manifest as fatique and the dreaded "Brain Fog" we all know too well. This is a simple statement and not 100% correct, but you get the point.

4. No doctor is bad. No treatment is worse. (IMHO)

What we can help you with is looking at your pressure settings. Sometimes it is possible to lower the upper pressure (inhalation) and decrease "clear airway" events and still keep "obstructive" events in check. You can obtain manuals for your machine, ResScan or Sleepyhead software, and guidlines for pressure setting on this forum.

Let us know how we can help. Welcome, we're glad you're here.
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