Central/Neurological breathing problem

[jillplum]

I am newly diagnosed with a neurological breathing problem caused by a motor vehicle accident. My sats drop about 10% when I lie down, and in addition have central sleep apnea and Cheyne Stokes breathing. At night I use a S9 ResMed ST (set at 10/5) with supplemental oxygen at 3 l/min. I have so many questions about managing this condition, and would like to know if any of you have a similar diagnosis.

[Julie]

Are you saying your centrals are your neuro problem, or is that something (diagnosis?) different on top of the centrals?

[jillplum]

There is nerve damage, mostly affecting the diaphragm.
A partly paralysed diaphragm is assisted by gravity when upright, but is hardly functional when lying down.
Before I even go to sleep my SPO2 has dropped to between 89% and 91%.
During sleep I have further drops due to Central Sleep Apnea and Cheyne Stokes Breathing, resulting in my SPO2 being below 88% for a few hours a night.

[Julie]

I think you'll find that a number of us have varying diaphragm problems and some have Cheyne-Stokes. One thing - I'm not familiar with your machine - are you sure that's the full name and model #? It can make quite a difference to how well you're treated.

[JDS74]

Did you get titrated to the 10/5 pressures? With the diaphragm nerve damage, what does the doctor say about widening the pressure swings to compensate? My pressure swings when in ventilator mode when treating my centrals are 25/10.

If you don't have a copy of your sleep studies, getting them will provide very useful information in understanding what is going on.

BTW here is a link to some documentation on the S9 Series including the ST.
http://www.somnitech.com/_PDF/S9_VPAP_S ... MANUAL.pdf

[jillplum]

I was titrated during an 8 day stay in hospital - I came out of hospital on Wednesday, so this is all very new to me. Pressures above 10/5 were not producing a better result.
There is probably a lot of scarring in my chest as a result of fractures to sternum, ribs and clavicle, as well a two surgeries to try reconstruct a posterior SternoClavicular dislocation. I have had collapsed lungs/Atelectasis several times over the past year. I am therefore not able to fully expand my lungs.
Julie, I have the S9 ResMed VPAP ST machine.

[jillplum]

Last night my mask came loose and came off over a period of about an hour- luckily I woke up before my SPO2 dropped too low.

[JDS74]

Have the doctors suggested/decided against using an IPPB device to treat the atelectasis?
Your condition sounds very complex and difficult to treat.
I hope that things get better and you are able to attain some stability in your treatment.

[Julie]

Jillian - I suggest that rather than looking for others with similar problems (which may not help you as everyone is different medically, even if symptoms seem alike) why not just ask your questions and see where they go.