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Howdy, ya'll! Been a long journey for me. Second time around with CPAP. Long story short. Did the home test. Diagnosed with OSA. Went on APAP. Tons of centrals. Switched to BIPAP with backup breath after back and forth with Kaiser. OAs and CAs under control but some "unidentified" and lots of hypos. RT says I should try full-face mask, but can't get comfortable with it. I've been tweaking my settings and getting way better results but unsure what to do now. OSCAR data attached. Thx
03-26-2025, 12:53 PM (This post was last modified: 03-26-2025, 12:55 PM by jdougc.)
RE: New member. Help with hypos
You are having positional apnea, tucking your chin and cutting off your airway, no pressure increase can open it. A soft cervical collar will help .
Are you a side sleeper? If you sleep on your back , consider a wedge pillow or an adjustable bed.
good luck .
You might be able to lower your pressures if you get a collar and wedge pillow .
Why did they put you on a ResMed
ST-A for Central Apnea? They didn't think of ASV? You'll maybe be better off with the ASV, it also has backup breath rate.
You don't have any other lung conditions except Apnea?
Those events flagged are probably Positional Apnea.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Curious why you think I have positional apnea. Don't doubt it but it's the first I've heard it mentioned. I would love to try an ASV but it was a battle to get this machine. They're trying to tell me ASVs are only for patients with serious lung problems. Originally they wanted to put me on a regular BIPAP even though it was pretty clear – to me at least – that the high pressure was causing the CAs. And to be fair, it seems to work on my OAs and CAs, but I have UAs and hypos to deal with now. It's like each time it solves a problem it creates a new one, and I've heard so many contradictory things I don't know what to think
03-26-2025, 05:28 PM (This post was last modified: 03-26-2025, 05:38 PM by jdougc.)
RE: New member. Help with hypos
I usually look at the flow rate, from 1:20 to 4:30 you have clusters of events.
No settings can stop this.
You probably need a soft cervical collar, which can work wonders.
Good luck . https://www.apneaboard.com/wiki/index.ph...onal_Apnea
I would not make pressure changes until the positional apnea is resolved . No settings can stop this.
03-26-2025, 05:32 PM (This post was last modified: 03-26-2025, 05:43 PM by SarcasticDave94.
Edit Reason: Add screenshots
)
RE: New member. Help with hypos
Positional Apnea is indicated due to the clusters of Hypopnea.
The supposed professional you've been dealing with has therapy and devices backwards, ASV treats Central Apnea and ST-A is a mini ventilator that treats lung disease like COPD. And the ST mode you're using is the old method of treating Centrals. Bonus, ResMed has a cheaper ST machine than your currently likely not necessary ST-A, but if the Central Apnea treatment is necessary the ASV is definitely the best answer.
Look up what ResMed has indicated for machine usage.
As for the Central Apnea showing on the test, you need to have your copy of that detailed report.
PS here's 2 screenshots from the ResMed Titration guide stating machines and usage indications.
You may want another doctor helping your therapy if you're able to replace them. They're not really very good at their job, and are guessing at what machine you need.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
For sure I'll try the cervical collar and report back.
Just to clarify. AFAIK my diagnosis was for moderate OSA with an AHI in the low 20s. I don't think I had any CAs until I started on APAP which led me to believe that I was experiencing treatment emergent central sleep apnea though that was never confirmed. The ST-A does seem to treat the centrals bc they're not showing up in the data, but there's some gray area because as I understand it UAs can mean OAs or CAs.
If it's only treatment emergent Central Apnea, the AutoSet might be OK. Better with VAuto at the most. You're being very over treated on the ST mode you didn't need.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
You may be right but how would I know what machine I need? I'm basically flying blind here. I was skeptical that regular BIPAP would help with my centrals based on what I'd read online and expressed it to the RT but instead of explaining it to me or contradicting me in any way this was the machine the doctor prescribed.
Maybe all of American health care is like this but I can't be the only one who feels like I'm trying to get something that they don't want to give – i.e. treatment for my medical condition – and have to fight them tooth and nail for it because they do not give a f*** and/or want to spend the least amount of time and money on the patient as possible. It's an adversarial rather than a collaborative relationship
