Back On The Machine

Had a visit with sleep doc today, we agreed that my symptoms are still the same, fatigue, low energy...so, trying the machine again.
A Resmed Airsense 10 Autoset this time, I need to check what the difference is on the three models.

I have to say I am almost excited to try this, as I have better sleep now, there is a good chance it might work this time..

Stephen

You had significant CA events on a PRS1 Auto last time around. The autoset is not a better answer to that problem. I wish you well, and think a positive attitude helps, but did you discuss the abundance of CA in your previous results? You might have been better served with one of the Resmed Aircurve 10 VPAP models or PRS1 BiPAP. Do I recall you have some heart issues? If so, I think you're still on the wrong machine.

Hi there...

for whatever reason the docs here deny I am having centrals, and on the overnight sleep study I had last fall they did not find any...

I am due for a titration study with machine, in 4 months...I have a new sleep doc who at least listens a little to my story...lol

Stephen

Was the overnight sleep study done in a lab without cpap?

hi Pugsy, yes it was, I tried to get a CPAP titration back then, but things are pretty rigid in Canada, this time round at least I have the new sleep doc considering I may have "other" issues, hence he agreed to a titration study with CPAP after the next 4 months, I am really going to try to stay the course this time...

Stephen

Pugsy wrote:Was the overnight sleep study done in a lab without cpap?

This is related somewhat to your question.

What is Pugsy's knowledge as to when, and how, a determination is made to split the study- because when I went for mine, I was told that I might have to come back a second time. Part of the reason given was due to time to perform the study. By the time she had me all hooked up and had taken care of other guy there, it was about 10 p.m. I was there the whole night until about 6:30 a.m. the following morning.

Indeed, it turned out to be a split-night study, and I did not have to return for a second study. I should post the whole six (6) pages of the study, now that I know how to embed it, in a new thread.

I was not prepared to take the mask that night, and I don't remember going on it because I had sedated myself for the study.
But the technologist noted that I tolerated the CPAP well at 12cm, the level to which I was titrated. And my own oximetry testing seems to confirm the finding in the titration Treatment Breakdown Table.

Thanks in advance.

tedburnsIII wrote:when, and how, a determination is made to split the study-

Depends on what criteria a specific lab happens to use and how much time is left if a person reaches whatever criteria there might be later in the night. If there's not enough time left to do a titration then it will have to be done another night. Criteria can vary considerably between sleep labs.

StephenR wrote:I tried to get a CPAP titration back then, but things are pretty rigid in Canada, this time round at least I have the new sleep doc considering I may have "other" issues, hence he agreed to a titration study with CPAP after the next 4 months, I am really going to try to stay the course this time...

Sigh...I know they do things differently where you live.

If you didn't have any centrals during the diagnostic sleep study then I suspect these centrals are probably a by product of cpap pressure itself.
Complex Sleep Apnea.
I think I already shared this video with you a while back but just in case I didn't.
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

You have a doctor who will at least do a titration study later (I would prefer sooner but he is too far for me to go whip his ass so I guess it will have to wait ) and there is always the possibility that with time the centrals will stabilize and reduce or go away as your body adjusts to therapy. Since that is the only choice available at the moment I guess it looks like a good choice (since it's all we have).
It wouldn't be impossible for that to happen but you need to stick with the therapy religiously this time. No more pooh poohing it off and making excuses. We know for sure that you have Obstructive Sleep Apnea that for sure needs therapy. Treat what you can treat with this machine. Play around with EPR because it makes the machine work like a bilevel (but the max difference you can use is only 3 cm but that's better than nothing) and while I don't really think that bilevel will fix your issues...it's worth looking at while waiting the 4 months. Stranger things have happened.

Get a few nights on this new machine and then get me a couple of typical reports and we will see if maybe playing with EPR is an option. First we need to let the machine figure out what pressures you need for the OSA stuff.

Thanks Pugsy...

Yes I really have hit the wall this time, but I gave it my best shot with all the alternatives, which did help a bit...
I will get the manual for this machine and will download reports as I go along this week..

thanks Pugsy, I really appreciate the support...

Stephen

Stephan, best of luck in your therapy. You may need to push to get the CPAP titration sooner than later, and perhaps reports like I posted above from your previous experience will help that process. One can only hope your doctor is familiar with CSA and why it might not have been apparent in your diagnostic study. Pugsy's link is an excellent summary of the problem.

I look forward to seeing how this resolves for you, and I'm sure you will get support here on the forum.

So, major breakthrough on the SleepTech front. Had the usual, for me, experience on CPAP, controlled OAs, but horrible CAs. And in a conversation with the sleep tech this morning, he said, wonder of wonders, that indeed the higher pressures cause me to have CAs!!! after a year of frustrations and outright denial, there is was...

He confirmed that the machine I have on loan will not deal with the CAs, duh!!, but for now, that is the next few days, we will play with single pressures to deal with the OAs.

I feel that there is a little bit of light in the tunnel now, but still a ways to go to having restorative sleep....

So trying a single pressure of 10, I may ramp it up to that for 20 mins...

Stephen

Duh...

Until both the centrals and the obstructives are well managed it's going to be real tough to get any decent quality sleep and notice any improvement overall.
But use this time to get adjusted to therapy in general and with the mask and all that.
While it wouldn't be impossible for the centrals to go away on their own...it's not all that probable and you would have to go through months and months of really crappy sleep/therapy to maybe get there and that's a real big maybe.

Yup, and reread Sleeprider's reply re. lobbying for an Adapt. I wasted over a year before finally finding a doc who prescribed a machine that ridded me of my CENTRALS, as well as obstructives: ResMed's VPAP Adapt ASV. Respironics also has a similarly good machine. Best of luck.

its hard to get anywhere in Canada, we have a lousy medical system that is archaic and poorly staffed..so I do what I can...

relief is coming..lol

Stephen

StephenR wrote:Had a visit with sleep doc today, we agreed that my symptoms are still the same, fatigue, low energy...so, trying the machine again.
A Resmed Airsense 10 Autoset this time, I need to check what the difference is on the three models.

I have to say I am almost excited to try this, as I have better sleep now, there is a good chance it might work this time..

Stephen

Look at your central apneas (Clear Airway Apnea). If you have more of those than Obstructive Apnea, in your shoes I would take back the Autoset you're again trying and insist on trying the Adapt. It's designed to take care of centrals in its ASV and ASV Auto modes, and it also has a CPAP mode.