Central Apnea: O2, ASV or both??

[Bright Choice]

I have been bugging my DH about getting a sleep study since I started with cpap (I am now on ASV). Well, the sleep study finally happened and DH came up with a diagnosis of moderate sleep apnea, primarily centrals (AHI was 20) with a lot of sleep fragmentation. The doc who interpreted the data said first thing to try would be supplemental O2 and if that didn't help then do a titration.

I have some pre-conceived ideas about that and wanted to check in here with you smart folks to ask if O2 alone is a legit therapy for central apneas. It might be easier for my DH, but I doubt that it suffices.

First night after getting the report I put my oximeter on him. What a shocker the next am! Baseline SpO2 was 82% and he had 105 minutes with SpO2 < 88%! He had a restless night and felt crappy the next day, no surprise. Next night he had O2 on and SpO2 levels were good but he still felt he had a bad night. I guess that speaks for itself.

We are off to Albuquerque next week to get him evaluated by an expert and I know he will be in good hands. I am just checking in to get some of your input re: central apneas. I just need a little ammunition in case I meet with ASV resistance on DH's part.

[Pugsy]

Please confirm...his baseline O2 is 82% as in.. this is what he has showing while awake too?

[Bright Choice]

Please confirm...his baseline O2 is 82% as in.. this is what he has showing while awake too?

That was night time SpO2. He is fine during the day, very active, whitewater kayaking 5 days a week. Awake he is ok. Good point, thanks for pointing that out.

[JohnBFisher]

To answer your question, here's a quote:

When comparing oxygen therapy to ASV, CSA-CSR is reduced to a greater extent by ASV than oxygen therapy over 8 weeks but oxygen therapy is better accepted.

So, in essence your DH will better accept oxygen, but it does not work as well. If he can tolerate it, I would recommend ASV therapy instead.

Here's the article:

http://emedicine.medscape.com/article/304967-treatment

It seems to be on point for your case.

[Bright Choice]

To answer your question, here's a quote:

When comparing oxygen therapy to ASV, CSA-CSR is reduced to a greater extent by ASV than oxygen therapy over 8 weeks but oxygen therapy is better accepted.

So, in essence your DH will better accept oxygen, but it does not work as well. If he can tolerate it, I would recommend ASV therapy instead.

Here's the article:

http://emedicine.medscape.com/article/304967-treatment

It seems to be on point for your case.

Thanks John! I knew I could count on you for good info!!

[Jordy]

Hey Bright Choice,

Centrals can be tricky, I was tested on both a Bipap and a ASV unit. Neither were able to completly stop my drops in SpO2. I ended up either having to do a ASV W/ Oxygen for a BiPap W/ Oxygen for about the same result. I went with the Bi-Pap because of the cost issue.

Right now if I use my Bi-Pap without extra O2 My stats drop. If I use just the O2 at night my stats never drop, and I do not seem to have as many epsoides of centrals. However I do have some, and I do not feel as rested in the morning.

So what I have found is that just O2 stops my De-Stats. But leaves me tired.
With just the machine, I have De-Stats and don't feel as well.
Both the Machine and O2 seem to be needed to feel the best.

Oh, and I have CSA, so hopefully that experance helps a bit

[Bright Choice]

Hey Bright Choice,

Centrals can be tricky, I was tested on both a Bipap and a ASV unit. Neither were able to completly stop my drops in SpO2. I ended up either having to do a ASV W/ Oxygen for a BiPap W/ Oxygen for about the same result. I went with the Bi-Pap because of the cost issue.

Right now if I use my Bi-Pap without extra O2 My stats drop. If I use just the O2 at night my stats never drop, and I do not seem to have as many epsoides of centrals. However I do have some, and I do not feel as rested in the morning.

So what I have found is that just O2 stops my De-Stats. But leaves me tired.
With just the machine, I have De-Stats and don't feel as well.
Both the Machine and O2 seem to be needed to feel the best.

Oh, and I have CSA, so hopefully that experance helps a bit

Jordy, that's really helpful! DH's desats are better w/O2 but sleep still not great. I hope it can all be controlled w/ASV and no need for O2. That was true for me, my desats disappeared with ASV. Thanks for your input.