Variable Breathing Central Apnea?

[SleepyinMD]

Hello.  I've been a compliant C/A-PAP user for 15 plus years and I still feel like it's not effective.  I've been to various pulmonologists/sleep specialist and they tell my that according to the numbers, the therapy is working.  I don't feel like it is as I am always tired and not motivated.  Can anyone of the experts on here take a look at my numbers and let me know what they think?  I'm concerned with the high variable breathing of 25%.  Could I have central apnea?  I recently had an EKG and my doctor said that looked good.  Any tips?

Thanks much from a longtime reader of this page.

   

[saltydawg2]

I'm sure someone else will show you up with a lot more knowledge than I. Something that jumps out at me is the sawblade looking pressure. I've seen fluctuations before, but not that an active pressure graph. Just hang in there for more help.

[Sleeprider]

The saw-blade looking pressure is an artifact of the Philips auto CPAP algorithm that trials a 2-cm change about every 20 minutes to evaluate its effect on flow. Also, the leak chart showing 28 L/min of leaks is the normal and expected leak rate of the mask, and no "excess" leak is reported. The variable breathing flag is unique to Philips, and when we discovered it, it was a bit of a puzzle. As it turns out, the VB algorithm turns off the Auto CPAP pressure changes and is not diagnostic of anything. https://www.apneaboard.com/wiki/index.ph..._Breathing

If you never want to see any of the above artifacts, then replace your Philips CPAP with a Resmed device. The Philips is no longer sold in the U.S. due to a recall and withdrawal from the market of all positive pressure therapy and ventilator devices. That alone should tell you all you need to know to encourage you to replace your machine. I'll add most members here have reported much better comfort and better efficacy using Resmed CPAP and bilevel machines. The truth is, there are no settings to address VB and flow limits, but with the Resmed Autoset, you actually get true bilevel pressure that can mitigate the flow limits which is the root cause of this problem.

[SleepyinMD]

Sleeprider- Thank you for all the info. The machine was a recall replacement and I think I have another year or so until insurance will cover a new one. 

Does the saw blading of the pressure affect my sleep? Possibly missing events?  Would I be better off not using auto and set it at a fixed pressure? Perhaps 12 or 13?  

Thanks again for taking the time to respond.

[Sleeprider]

Insurance will cover it now. That machine is discontinued. Just complain that no Philips device is approved for therapy. Your insurance should cover under the circumstances.

The changes in pressure affect some adversely, and are not noticed by others. It looks like crap, but may be inconsequential. You have an excellent AHI for a Philips device. Fixed pressure does eliminate that artifact, but if you zoom in on it, you will see the pressure change is very gradual, not saw-toothed. You are "best" off getting a Resmed and complaining, that you should not be required to use a recalled device replaced by another recalled device. If you take a look around this forum of thousands of members, you will find only a handful that still use a Philips CPAP.