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trying to help my sister who is a new user
#1
trying to help my sister who is a new user
[attachment=29039]         [attachment=29039]First, let me say how much this forum has helped me with my Apnea therapy.  Some plain, simple advice got me going is a good direction, and taught me how to set up my machine for good therapy.  I sleep well, and my numbers are mostly very good.  My younger sister knows she has been struggling with Apnea for quite some time.  In these Covid times, she was unable to get a proper sleep study and titration.  She did a couple of "home studies" and her GP agreed that she had moderate sleep apnea and prescribed her a Res Med Auto 10....for Her.  I have been doing my best to get her set up on OSCAR so she can see what is going on.  I am including a screen shot that is very alarming to me.  She has no obstructive apneas, but lots of centrals.  The Flow Limits are very high.  I am looking for suggestions for her her.  I know very little about the treatment of central apnea, or these very high flow limits.  She also has an oximeter that she wears, and not surprising, her O2 sat levels get quite low.  I encouraged her to join this forum, but she is reluctant, and not used to this type of help.  I am very concerned for her, and am therefore reaching out for advice.
I'll include a couple of days of Oscar data, and a detail view, for your review.  Thank you in advance.


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#2
RE: trying to help my sister who is a new user
OK some info is going to be required. There was some sort of sleep study? If so, the report on the study needs to be requested. A detailed, multi-paged study. This can be scanned into a file on the PC and then attached here. That OSCAR shows almost all Central/CA/Clear Airway, all the same in this case.

Do this: have your sister request the detailed report. Also these are the setting edits for now, EPR and Ramp OFF, both of them. We need to limit the pressure swings due to CA. And the Min. pressure needs to go to at least 6, maybe 7, as 8 was reported as Median. Try that.

If the report shows what I think, we're likely to see pre-existing CA. If so, she will have to complain to doc on the high CA but word it more on fatigue and unrest is still high, even worse than before PAP. If the report shows CA then she'll need to aggressively pursue highlighting CA and that ResMed makes an ASV to combat CA, the AirCurve 10 ASV. Note all symptom/complaints to tell doc. Once the report is seen, I think doc needs to recognize high CA and go forward with an ASV titration. A regular BPAP will make this much worse.
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.
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#3
RE: trying to help my sister who is a new user
Thank you for your reply. She did not have a proper in lab sleep study done, only one of those "at home sleep study". I know those don't provide much detailed information. She is sure of existing CAs, and Oscar has confirmed this.
I will recommend those changes to her APAP device, and also encourage....insist that she find some way to have a proper sleep study and report done.
Thank you again for your insight, and I appreciate this forum.
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#4
RE: trying to help my sister who is a new user
Even that home study had to create some data, a report of some sort. Specific to CA, if it had a chest belt, this signifies that CA would be noted. Ask about that chest belt. So the home study can be valuable still.
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.
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#5
RE: trying to help my sister who is a new user
She does not really need another diagnostic sleep study. We know there is apnea as determined by the home sleep study, and the use of CPAP suggests that there are an unacceptably large number of untreated events. The objective is to achieve efficacy on a therapy device, and that will likely be an ASV (adaptive servo ventilator). The ASV provides pressure support on a breath by breath basis that allows spontaneous respiration to occur, but when a central apnea begins, it continues to supply pressure support that maintains her respiration rate and volume.

To get to that point, she needs to have a titration test in a clinic that attempts to find an appropriate CPAP pressure. If instead centrals occur, the titration test order must instruct the titration to move to ASV if central apnea is present. Our ASV wikis shows some of the information you need to understand titration and ASV http://www.apneaboard.com/wiki/index.php...ew_desktop You also need to know the criteria for justifying advanced PAP http://www.apneaboard.com/wiki/index.php...P_Machines

Finally, lots of great information on the Resmed Sleep Lab Titration Guide. Look at the information about ASV on page 38 https://www.resmed.com/us/dam/documents/...er_eng.pdf
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: trying to help my sister who is a new user
Great information!  Thank you again for you knowledge and insight.  
My sister now has an appointment with a sleep specialist.  I will encourage her to read your posts and educate herself as much as possible with the links you provided. 
Thank you again for you service to this community.
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#7
RE: trying to help my sister who is a new user
You're welcome. Best wishes it goes well. Sounds like your sis should join up. We don't bite, well mostly anyway. Coffee
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.
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#8
RE: trying to help my sister who is a new user
I am encouraging her to join the forum. I sent her a link, and she read our entire thread last night.  She was receptive to all information, so that’s a start.  She also said she would make a donation.  I think we will have a new member soon. ?
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