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[split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
#31
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
waldo1945,

Sincere best wishes you and your wife get the needed machines for proper therapy. As in ASV machines. It's possible you might have to fight a bit to get these, but it'll be worth it. Your low oxy level, the LVEF pass, and the high central count showing will help.

A possible tip to assist: (if true) make frequent complaints that current therapy isn't helping, but is in fact making you feel worse off.

Coffee
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

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#32
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Waldo, good news and glad to hear your doctor was receptive to your work to document issues. The problem with complex apnea is its inconsistency, and it is too easy for a patient to be shown to be "treated" on CPAP, only to fail repeatedly. I look forward to your next phase of treatment with ASV.
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#33
RE: ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
I just thought I'd quote the very first response to your initial post on the forum...I think the writing has been on the wall from the beginning.

(05-28-2018, 10:22 AM)Sleeprider Wrote: Waldo, it appears you may need ASV therapy for the central apnea. I we could get a better picture of your settings and results my recommendation is going to be fixed pressure at the lowest pressure you tolerate without causing obstructive apnea, and turn off all pressure support.  It's a little hard to tell what your current settings are, but your pressure support appears to be at least 5-cm.  That alone will increase your central apnea quite a bit.  

I'm going to ask for your post to be moved to a new thread so we can give you some individual attention.  Note my signature link on how to organize a Sleepyhead chart.  The information there will help us much more.
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#34
RE16: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Thank you Sleeprider.  Now that I have proved the cluster central apnea problem to my pulmonary doctor using his settings, I have now switched the machine settings to CPAP with 8.6 pressure as you suggested in a previous email.  I will let you know what happens while I await an ASV titration sleep study. Note that I had been using CPAP setting of 10 for the past five years before the BPAP setting was recommended based on last years sleep study.
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#35
RE: RE16: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
(06-15-2018, 02:33 PM)waldo1945 Wrote: Thank you Sleeprider.  Now that I have proved the cluster central apnea problem to my pulmonary doctor using his settings, I have now switched the machine settings to CPAP with 8.6 pressure as you suggested in a previous email.  I will let you know what happens while I await an ASV titration sleep study. Note that I had been using CPAP setting of 10 for the past five years before the BPAP setting was recommended based on last years sleep study.

By using the doctor's settings, you created the opportunity to move up to ASV, and this is the dilemma I have when coaching someone to reduce complex events using CPAP and low EPR and similar "tricks".  It may get improvement in the results, but it does nothing to help move someone to that next level that could be much better.   Keep us posted on how this goes.
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#36
RE17: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Just a quick update.  Our medical insurance has approved an overnight lab titration study for an ASV machine for me.  The sleep study date is August the 1st unless there is a cancellation before then.  This has been after I have been using a BPAP for a little over a year and CPAP for the previous 15 years.  I am currently using the BPAP in CPAP mode with a high pressure just enough to keep the obstructive apneas under control and a small amount of pressure relief (2 psi) for exhale comfort.  I have done the same setup for my wife's CPAP.  Just different high pressure settings and pressure relief settings for her.  My wife's centrals range from none to up to three per hour none of which are clusters like mine.  So our pulmonary doctor will not try to get my wife on an ASV machine since he feels the centrals are sufficiently under control with CPAP and not interfering with her sleep quality or duration.
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#37
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Another quick update. There was a cancellation in the sleep study schedule so I have completed my ASV study. I will not know the results for another week but I felt like I slept well using their ASV machine for six hours.
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#38
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Congrats on getting that ASV PSG/Sleep study done. Let us know results when available.
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

Wiki Info for Beginners
Sleepyhead Chart Organization
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#39
RE19: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
I have attached my ASV Sleep Study summary.  It basically suggests getting an ASV machine set to the normal start settings of EEP at 5, minimum pressure support of 3 and maximum pressure support of 15.  It also says that I slept for two hours continuously of the six hours at the lab and I had no apneas or snoring during the six hour session.  My blood oxygenation level mean was 96% but I only achieved ten minutes of REM sleep.  I did have vivid dreams and felt more rested than normal after sleeping with their ASV machine.  

Remember that my central apneas occur in clusters but only in eight to ten days of the month. So the chances of them occurring during this two hour session of sleep was not very good.  Fortunately, using the Resmed memory card to record my nightly sleep habits and Sleepyhead to display the data caught the central apnea clusters. One note of interest, I am having to tell my equipment supplier that I want the memory card when they supply the machine.  Apparently, the Resmed machines are now being shipped without the memory cards because of the remote login provided by the machine.  Please be aware that the detailed data provided by the memory card is not available via the remote login feature of the Resmed Machines and you need the memory card to use Sleepyhead or the Resmed program.

So I have provided the attached ASV sleep study results to my equipment provider and requested they get preauthorization from my medical insurance company to order the Resmed S10 Aircurve ASV Auto with the memory card.  I have also asked my doctor, who received a copy of my complete sleep study, to provide an ASV machine prescription.  We now wait some more to see what happens.

I hope the ASV machine is provided and we can start fine tuning the settings.  Thank you all for your continued support.


Attached Files
.pdf   ASV Summary B.pdf (Size: 260.41 KB / Downloads: 26)
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#40
RE: [split] ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea
Looks like another member is finally on his way to solving the central apnea clusters. I'm not too alarmed about a lack of REM given you have had no time to adapt to this machine and were in a clinical setting. It would be interesting to review the machine data and see what pressure support was utilized during the session, as that can be a pretty good indicator of hypopnea and central events. The machine is also capable of reporting the spontaneous breathing percent.

We look forward to you joining the ever growing gang of ASV renegades here. They seem to be an unruly bunch. Have you verified they will dispense Resmed?
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