Central Apnea, Afib, High blood sugar

[thegrons]

Hey all;

This is my first post. I've been using a Resmed S8 for years and last year was diagnosed with Afib and pre-diabetic. I started on the CPAP machine after I had a cardiac stent in 2012 and have been clean since then. I was biting through a mouth guard a month prior to going on the machine, now I don't do that anymore.

I've been checking my blood sugar for the past month (its been trending up for 4 years) and it averages 105-110 during the day and soars to 130+ while I'm asleep. It stays high in the morning until I eat some carbs, and then my body snaps out of the nocturnal blood sugar syndrome. Both my cardiologist and family practice docs say that my central apnea might be the culprit. I just started researching the central apnea fixes and have been overwhelmed with the information. Oxygen machines, Resmed S11 Servo.... Not sure what to do.

There aren't too many sleep docs around and the ones I saw a decade ago didn't do much to help me. My family practice doc wants to start me on Metformin but I think this is not treating the root cause (but might keep me from type 2 diabetes until I figure out the apnea fix).

Any advice?


Thanks,

[Deborah K.]

I'm so sorry to hear about all your health issues.  I can't comment on those, but we might be able to help you improve your therapy and comfort if you download Oscar, our free apnea reporting program, then post Oscar charts.  Oscar charts reveal all sorts of information about each night's sleep.  You can download Oscar at the top of every page in the black ribbon.  Once you have set up Oscar, you can easily copy a daily chart by pressing the F12 button (FN+F12 for Mac).

I hope you will use Oscar. It's an extremely useful tool for determining the best settings for your machine.

Again, welcome, and best wishes for great therapy and comfort!  

[thegrons]

Thanks I tried using OSCAR and it doesn't seem to give me the data that the resmed software does? OSCAR even miscalculates the dates and only shows the date from midnight until three AM. I'll have to get used to it?

Thanks for the response.

[SarcasticDave94]

Welcome to Apnea Board,

OK, if I'm reading right, you'd like to possibly diagnose and treat Central Apnea. This is almost regardless of CA cause, one treatment is a ResMed AirCurve 10 or 11 ASV. The specific task of this guy is treating Central Apnea. However it will treat the rest of the Apnea and Hypopnea too, equally well.

How to get there? I'm thinking get your doctor into a discussion, get them to agree with you to order an overnight Titration including bilevel and ASV. By the way, the ResMed ASV stands for Adaptive Servo Ventilator.

One type of Central Apnea that I'm thinking about might not be for the ASV, and one health concern if this SERVE-HF is still in effect restricts it.

If CA are from known brain damage, that patient might be better on a real ventilator class device like the ResMed Astral 150. If that's definitely not you, then ASV should be a possible OK.

Next, here's the SERVE-HF aspect. This is a flawed test involving ASV testing with those with CHF (Congestive Heart Failure). If you get into the process of getting ASV, you'll need an imaging department to do an echocardiogram to check for CHF. A cardiologist will review the findings. The item to target is your LVEF%, 45% or higher is acceptable. My own was 55% when going to ASV, no issues from it for the 2 years in ASV.

The Titration: this is an overnight in the lab similar to a diagnostic sleep study, expect they mask you up to a test CPAP that does bilevel, ASV, etc modes as well. The goal is to introduce you to sleeping with ASV and find out objectively what the results are. They might in your case need a split study to get a baseline sleep minus CPAP input to see CA first. If you have a diagnostic sleep study with CA present about half, you want this to prove CA are there. Might allow you to only need the Titration itself.

Insurance may require you to try a bilevel without a backup breath rate, like a ResMed AirCurve 10 or 11 VAuto. The ASV special CA combat tool is the backup breath rate which forces a quick blow of Pressure Support, attempting to kick you into a breath. However not truly a ventilator, the ASV cannot initiate the breath.

Regardless of outcome stick with a ResMed machine. Ask more questions, hope this helps a bit.

PS I have predominant idiopathic CA, and COPD besides. ASV worked great until COPD blocked it for me. My CA on the diagnostic was 124 to 24 Obstructive. ResMed AirCurve 10 ASV got me to OSCAR chart showing about AHI 0 to 3.

[Crimson Nape]

As listed here in the OSCAR Wiki, the S8 is not a supported model.
https://www.apneaboard.com/wiki/index.ph...d_by_OSCAR
- Red

[Deborah K.]

Sorry, I did not know Oscar would not work for the ResMed S8.

[thegrons]

Thanks Dave;

I will ask my doctor for a sleep specialist referral and keep these the 11 ASV in mind! Wow I checked the prices on those, I hope I can take one of them for a test drive?

[SarcasticDave94]

Would your primary doctor order the test directly? Sleep specialists aren't required, even for ASV.

PS if you were attempting self pay, look up Supplier #2 or on the Web search DOTMed for ResMed AirCurve 10 ASV. This nets you a used or refurbished unit. This method may just require your primary to give you a script, no testing etc.

[thegrons]

Thanks I will ask her next week!

---

Yes I checked them. $2,500

[SarcasticDave94]

On DOTMed I've seen an ASV for $1,400. Go to their website and using the search bar, ResMed AirCurve 10 ASV, and it may be the first item. Make certain it's ASV in the listing, and I would call to question the hours and again making certain it says ASV. Also you'll need to get a good feel for if the seller is trustworthy.