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+--- Thread: Apnaes: difference between Central / Obstructive ? (/Thread-Apnaes-difference-between-Central-Obstructive)
RE: Apnaes: difference between Central / Obstructive ? - Sleeprider - 01-05-2021
Therapy after 01:00 looks much better. It's still a lot of events that will ultimately require ASV to resolve. The urgency of changing therapy is related to how well you can function with this level of sleep breathing disorder.
RE: Apnaes: difference between Central / Obstructive ? - Camera Obscura - 01-05-2021
I already function better than before treatment with CPAP.
I will continue getting used to the sleeping with mask.
In a few weeks it will become time to evaluate with my sleeping center. In the mean time I will rely on you and the forum to optimise actual treatment.
It will be good to have all arguments to present a demand for a change in treatment if necessary.
How convinced are you that it will be inevitable? This based on your experience and knowledge.
Do you consider me as a severe case?
RE: Apnaes: difference between Central / Obstructive ? - Sleeprider - 01-05-2021
Your improvement at lower pressure and EPR is significant, and central apnea will often respond to CPAP treatment that is optimized. Your charts don't give us the AHI or the individual event index (CAI, OAI, HAI), so you may want to include that in your posts. I doubt you will be free of central events, but they may well be controlled adequately or even well. As I said above, the urgency of changing to a therapy that targets central apnea depends on how well you feel and function with what we can accomplish on CPAP. We have had a number of people that do well on CPAP, but I can't predict the odds on if you will achieve efficacy.
RE: Apnaes: difference between Central / Obstructive ? - Camera Obscura - 01-05-2021
Thank you!
Where can I find the event index figures. I can not use OSCAR.
RE: Apnaes: difference between Central / Obstructive ? - Sleeprider - 01-05-2021
AHI statistics may be available in a non-graphic report, or on-screen. I'm not familiar with your machine or software, but it would be unusual not to have the events scored somewhere. If I had to guess, your AHI appears to be at least 10/hour, excluding the period where you made the pillow adjustment. It is interesting the lower pressure not only reduced the CA events, but OA is significantly reduced. This further points to a central apnea condition. I don't know how it works in France, but you will need to ask your doctors for a titration test with ASV if CPAP does not improve things even further.
RE: Apnaes: difference between Central / Obstructive ? - Camera Obscura - 01-05-2021
Thank you.
What does a titration test consist of?
RE: Apnaes: difference between Central / Obstructive ? - Sleeprider - 01-05-2021
It is a clinical evaluation under CPAP BiPAP or ASV that determines what your pressure requirements and efficacy is for a treatment. No clinical evaluation is actually required because ASV is completely automatic, but most people are required to try ASV in a clinical test to prove it is effective. In most cases, the test starts with CPAP pressure and moves to other therapy as needed. The link below is the Resmed Clinical Titration Protocol for all types of machines. This document not only tells you what happens in titration and the decision tree used to select the appropriate machine, but it explains precisely what these machine are intended to treat and how they do it. Good reading. You should read CPAP, VPAP and ASV sections.
https://www.resmed.com/us/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
RE: Apnaes: difference between Central / Obstructive ? - Camera Obscura - 01-05-2021
Thank you , I will start reading now.
Is it possible to for you to contact other Loewenstein users to see if there is a need/whish to study the possibility of submitting data to OSCAR?
RE: Apnaes: difference between Central / Obstructive ? - Camera Obscura - 01-05-2021
From reading I conclude that the difference between iPAP and EPAP should be maintained at 4.
It seems to me that I a a bit squeezed in my values of 6-7
I am going for 5,5 - 8,5
What do you think of these ?
RE: Apnaes: difference between Central / Obstructive ? - SarcasticDave94 - 01-05-2021
I don't think there's a hard/fast or required rule that states PS, the difference between EPAP to IPAP, must be 4.