Very High CA/CSR - Very Low AHI

[Miss Emerita]

It’s good to hear you’re getting the medical attention you need. Thanks for giving us the update.

[Pugsy]

Thanks so much for the update.
Sounds like you are in goods hands sorting it out and taking appropriate steps to get the old ticker running smooth again.
While I was researching the low sodium thing I was finding stuff that pointed to low salt causing heart issues but I also found that heart issues caused low sodium issues. Thus the "why" became very important to me. Didn't want to inadvertently ignore potential heart issues.

[dankoziolek]

Thanks for sharing your story. I was diagnosed with OSA 6 years ago. My first night on the BIPAP machine showed 60% periodic breathing. The sleep technician and doctor both told me not to worry about it. I tried to follow their advice, but I had already googled it. Regular use of the machine reduced the PB to about 30% until that Christmas when I found myself in a hospital bed looking at a whiteboard where the nurse had written congestive heart failure and A-Fib, wondering how the sleep doctor didn't know enough to refer me to a cardiologist before I had to be hospitalized. I had a new sleep study after I was cardioverted, and a new ASV machine that kept my PB numbers near 0 until I fell back into A-Fib. The numbers went up slowly after that. A year and a half later they were up to 25%. As soon as my cardiologist put me on a diuretic the numbers went back down to under 10% a night.

[deepsleep66]

Thanks for all of your input and suggestions. We finished the cardio work up yesterday. Echocardiogram, stress test and 24 hr holter monitor. A Fib is constant and characterized by minor variations in rhythm and absence of discernible 'p' wave - otherwise my heart is functioning well and healthy. Due to age and absence of other risks, stroke risk is considered only modestly elevated and coagulants are not recommended at this time. Central Apneas continue - most nights I have AHI of 25 - 30 with 90% being central apneas. CSR continues to be 25 - 50% of sleep time.

Will be seeing the sleep doc in 10 days to discuss all this and where to go from here.

Crazy thing is that I feel fine and my exercise capacity has definitely improved over the last few months.

[deepsleep66]

Changed the title now that I know the difference between CAs, OAs and Hypopneas. Sleep Dr believes that I will need an ASIV but the insurance co's will need convincing. Have just had a standard at home sleep test to prove that I have OAs when not on CPAP. I woke up several times gasping for breath. Doubt that the results will be a surprise. This will probably be followed up by a night in the sleep lab.

One interesting observation - it appears that if I have more than a small amount of wine or beer at dinner, I will have minimal CAs and CSR. If I abstain, entirely, I am likely to have an AHI as high as 30 with 35 to 35% sleep time in CSR.

[Miss Emerita]

Well that IS an interesting observation! So now your line is, “This? Oh, it’s purely medicinal.”

Keep us posted, would you?

[Okie bipap]

That is interesting. I started having AFIB problems this last spring, and they have put me on anticoagulants and a beta blocker to control my heart rate. The only time I have had a drink since I started having AFIB, my pulse rate was 90 when I checked it about four hours later. It normally stays in the 55 to 65 range. I don't know if that was caused by the alcohol or all of the sodium I had with my meal. We ate at a Mexican restaurant and I enjoyed the chips and fresh salsa. I normally stay on a low sodium diet. My mother was on a low sodium diet die to heart problems, and I never developed a taste for salt. What most people consider normal levels of salt, taste salty to me.

[deepsleep66]

Update - after undergoing an echocardiagram, cardiac stress test, 24 hour holter test, home sleep study (w/o CPAP), hospital sleep study etc, etc. I have been approved for and provided with a Resmed Air Curve 10 which appears to be working really well for me. I have to say that I'm a little mystified that the protocol for approving the new machine involves about $8000 of testing for a device that costs less than half that amount - especially since the most relevant results were the stats that were recorded by my original CPAP showing prevalence of Centrals and CSR. Also - having made my career in info tech, I see no reason why the machines should cost more than a high end smart phone. If anyone wants to attack the high cost of healthcare in the US, here's a great place to start.

[Miss Emerita]

Good to hear back from you, and especially good to hear you finally have the treatment you need. Is your machine the Resmed Air Curve 10 ASV? (There are several kinds of Resmed Air Curve 10 machines.)

I agree that the protocols don't make a lot of sense, least of all in a case like yours. Sigh.

[palerider]

I have been approved for and provided with a Resmed Air Curve 10

"a Resmed Air Curve 10" what?

"Aircurve 10" is a *line* of machines, all Resmed's current bilevel machines are called "aircurve 10".

[Biomed_ZZZ]

If I read it correctly , your doctor doesn't have you on a blood thinner (anticoagulant). If so, you may want to question your doctor about not being on a blood thinner. I was on baby aspirin and my cardiologist took me off of that, put me on a blood thinner and metropolol because of my Afib. Also had me see a more specialized cardiologist who I saw and I will be dealing with a corrective procedure on Tuesday. Part of that procedure is having a T. E. echo to see if I have any clots in my heart where they couldn't get to in a regular echo before they do anything. At least that's my experience having Afib.

Unfortunately, medical equipment is expensive because of all the requirements for it to pass the hoops to use it, at least in the USA. No saying it's right but by the time a machine is developed, prototyped, goes through the process, putting money away for law suits, continued refinement and profit for the shareholders the cost is there. An Airsense 10 autoset is about $900 US which is somewhat expensive but not too bad considering it's good for about 5 or more years. The scheduling that things "should be" replaced is the real money maker for any company. Masks at $160 and other items at $30 or $40 a quarter or sooner are the money making machines. I consider myself fortunate that my insurance company is supposed to cover the PAP device and supplies and originally they denied the claim.

Good luck!

[deepsleep66]

I have an Air Curve 10 ASV. I haven't updated my profile because I don't see it listed as one of the choices when I edit profile.

Regarding Afib treatment. I am on baby Aspirin. So far my cardiologist believes this is enough given my age and lack of other risk factors. He also wants to see what happens when CSA is under control.
In addition, my platelet count has been running low anyway (very bottom of normal range), plus I'm a little cautious: My mom also had Afib and was on thinners - and died from an uncontrolled hematoma in the brain that resulted from a bad fall at age 91. Her sister, who had Afib and didn't do thinners died of a massive stroke in her sleep at 89. To me it seems like a case where we need to pick our poison.

[Pugsy]

I have an Air Curve 10 ASV. I haven't updated my profile because I don't see it listed as one of the choices when I edit profile.

It's not in the equipment menu list because cpap.com doesn't sell it.
Just remove your current machine choice so nothing for machine shows and add AirCurve 10 ASV to your comments line.
That's what we do for all equipment that doesn't show up in the equipment choices.
All choices are tied to cpap.com's current inventory...they pay the bills for this forum.