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Central apnea issues with Covid - Printable Version

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Central apnea issues with Covid - kevrx - 12-17-2020

All,

Unfortunately, my brother contracted Covid.  When he did, his central apneas increase from less than 1 to around 10. Other apneas are about the same.  He is on apap min pressure 9, max 20, EPR 3.  I am considering having him reduce the EPR to 0 or 1.  I am curious if anyone has had a similar problem and if they were able to make any changes to pressure settings that helped.

Thank you,

Kevrx


RE: Central apnea issues with Covid - SarcasticDave94 - 12-17-2020

I have Complex Apnea slanted towards high Central Apnea, I have never had COVID, and I'm currently not being treated for any apnea or COVID.

My totally uninformed opinion, because we don't see his sleep study or OSCAR charts, or before and after COVID charts, is this: No I don't think COVID made his CA go up. One of three things did cause it. 1 he has CA that needs treated with ASV or 2 they went up on a specific night only or 3 both these apply.

Without seeing any data, I think it may be acceptable to eliminate the EPR and if Ramp is active nix it too. AND get brother to make an Apnea Board account. AND download OSCAR. AND show us the data.

You're welcome and Happy Christmas and a Merry New Year! lots-o-coffee


RE: Central apnea issues with Covid - kevrx - 12-17-2020

He has been on apap for years and has not had significant central apnea in the past.  It is pretty obvious when he got Covid with these graphs.


[attachment=28753]


RE: Central apnea issues with Covid - sheepless - 12-17-2020

covid has a lot of consequences. from what I've read, one of the first and potentially worst symptom in many cases is respiratory. intuitively I'd think that would bear more on obstructive than central apnea but idk. while there's probably a better explanation, I imagine his physical and mental stress levels are way up and I think it's possible that might trigger breath holding, even in sleep.

thinking on it a little more, if it is hard or painful to breathe, I'd think we might try to protect ourselves from that by slowing and pausing our breathing, holding our breath, having central apnea.


RE: Central apnea issues with Covid - SarcasticDave94 - 12-17-2020

OK we have a bit of data and your continued explanation. BTW do not take my post as a sarcastic thing. I was serious about what was said by me, and I take your brother's situation serious. Data like Dec 2 is like I mentioned, a bad CA night thing. The later stuff is apparently the elevated CA issue we're dealing with. Enact the edits suggested by whomever responds, myself or otherwise that you'd accept. Again drop the EPR to 0 and cut any applicable Ramp. If that doesn't help, look at the pressure stats involving his OSCAR data on the left panel summary on the Daily tab below the orange AHI number and regarding the range of listed by you at 9-20. That is the next edit we can do with this APAP. Unfortunate, I don't know if there's much to anything else on this machine to help. Now if any guru suggests differing mine, then take theirs over mine. I'm great at my own therapy as far as that goes, and OK-ish on helping others on settings. That's the best I have for you.

Sincerely, best wishes you and brother get through this fine. And update us please.


RE: Central apnea issues with Covid - Dormeo - 12-18-2020

I see that the respiration rate has trended upward too. Honestly, I'd recommend that he talk about these changes with the doctor who is treating his COVID.


RE: Central apnea issues with Covid - kevrx - 12-18-2020

Unfortunately his doctor said there was nothing they could do for him because he is not severe enough.  I had him turn EPR down to 1 but it didn't change much.  Maybe like sheepless said it is how the disease is affecting the way he is breathing.  Maybe its not true central apneas.


RE: Central apnea issues with Covid - SarcasticDave94 - 12-18-2020

Hey a little lightbulb briefly flashed on...Ask your brother about this scenario

Since he's become sick, is it possible he's moving around on the bed a lot more than otherwise he would due to being sick, say from on his back to left or right side, shifting around lots, stuff like that? Can the possible position changes cause breath holding during the possible shifting around, elevating CA flags?


RE: Central apnea issues with Covid - Sleeprider - 12-18-2020

If your brother is still symptomatic, he should be contacting his primary physician about therapeutics like Regeneron casirivimab and imdevimab administered together (formerly known as REGN-COV2 or REGEN-COV2). The point is to administer therapeutics before a patient is severely ill and change the course of disease progression. These therapies have been approved and made available, but they are not suitable once a patient is in the hospital.


RE: Central apnea issues with Covid - OpalRose - 12-18-2020

I think now is not the time for worrying over increased apnea numbers.  Anyone with an illness, let alone COVID, will notice an increase in AHI.

The increased respiratory shows he is working harder to breathe.  If it were me in this situation, I would opt for comfort, and less on the numbers.

Have him experiment with the EPR and concentrate on how it feels.  Even through he is seeing an increase in CA's, it may be more comfortable to keep it at 1 or 2.  

It would be good if his doc was a Pulmonologist, as he could better advise about use of Cpap and COVID.