What's Best Machine for Central or Complex Apnea?

[CentrallyTired!]

Currently I have Respironics BiPap AutoSV. I think it's probably the best one for me--But this one seems to have some malfunctions. They've tested it and insist it's fine but I'm not convinced.
So I'm going to get another used machine... And am just wondering if anyone else who suffers from Central (or combo) apnea prefers others? I like this one because you can set everything it seems... And I like mine maintaining low (about a 7) almost cpap (rather than bipap) pressure UNTIL it detects I'm not breathing. At that point I need a "Burst" of air and I set it to have freedom to way up the pressure as it sees fit. I set a back up breaths per minute.
I don't like being forced to breathe in and out when I'm not having a problem breathing, and at least one other SV unit I inquired about wouldn't give me freedom to do otherwise.
But maybe someone else has more knowledge?
Thanks!!
PS I think it's not working right, for two reasons.
1) Like said I program it not to go into bipap higher pressure on the inhale, UNTIL it detects I'm not breathing. But SOMETIMES it starts doing it anyway when I'm not asleep yet and I'm still breathing fine. Plus sometimes I can sit up wide awake, and HOLD my breath (to test it)--and it doesn't "kick in!"
2) Related to the last sentence, I'm certain there are times I have apneas when sleeping that it's not kicking in properly--just doesn't seem to detect properly always that I'm not breathing. Doctor tells me machine card shows I'm "doing fine" (under 5 events)--but if the machine isn't DETECTING when I stop breathing than the report obviously wouldn't reflect it either.

[Julie]

Machines won't work properly if you're awake at any conscious level... they're programmed to respond to asleep breathing and holding your breath, etc. won't fool them. Either get Sleepyhead - it's free - and 'prove' the machine's working, or just stop trying to second guess it because you can't. Can you not just accept the times it goes to a higher pressure (probably because you're not relaxed but watching it) for a minute?

[JDS74]

You have an excellent machine for complex apnea. It is the same one I use.

When you are awake and "hold your breath" to see if the machine will switch into ventilator mode (that's what it is doing to correct/treat a central apnea, what is really happening is that you are closing your airway and the machine detects that as an obstructive event and not a central event. I believe that it is possible but quite difficult to just stop breathing without closing your airway to simulate a central apnea but I have not been successful in doing so.

During the transition between being awake and being asleep, it sometimes happens that we experience what looks to the machine like a central event but what is in reality just a pause in your breathing pattern that is momentary in nature. The ASV machine will react immediately to one of these "pauses" and do a single cycle ventilation. Its one of the "features" of this type of machine and after a while, you will become used to this behavior an no longer notice it.

Most users of PR ASV machines set the backup rate to Auto rather than a fixed number and let the machine vary it as needed during the night. At least one user I have corresponded with has such a slow breathing rate a night (normal for them) that they had to set the backup rate to a low number or they could not get to sleep. That is quite unusual and I know of only one person for which that is the solution.

As you mentioned, the range of adjustments for the PR ASV machine is remarkable and allows for much better fine tuning.

Lastly, if you could post your machine and mask information using the User Control panel it would simplify things for other wishing to help. Unfortunately the PR ASV machine won't show up that way so you will need to put it as text in the comments section to get it to display. Many older machines are like that since CPAP.com only supports the display for equipment they have in stock for sale.

[andycole]

In my case, my ResMed Aircurve 10 ASV resulted in NO centrals only hypo's and UA's. That is primary purpose of ASV - control.

[palerider]

re: 2) you can't be certain unless you examine the flow data from the machine carefully and see if there are times when you are having apneas, and the machine doesn't flag anything, and doesn't react.

[tmoody]

OP, I have complex apnea, and I've been using the same machine you have, for a month now. I agree it's disconcerting to have it kick into a ventilator cycle while I'm still awake, but it happens every night and by now I'm used to it. In fact, I make game of trying to sync my breathing so it doesn't do it, which is actually not a bad way to fall asleep.

As for holding your breath to trigger a ventilation, or "timed breath", it's not hard. Just exhale and relax, don't inhale right away and don't close your airway. It'll kick in soon enough.


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[CentrallyTired!]

thanks so much everyone!!!