I am probably going to be having another sleep study since it was pointed out to my Sleep Dr. that I'm having quite a few Central Apneas. And if I do, they will probably put me on BiPAP. this is afterr 5 months on APAP which was what was prescribed. Now that I "own" the APAP machine, I'm not sure what will happen if I am prescribed a BiPAP, if the DME will do the right thing and "exchange" the machine I own for the one I need or what. Since BiPAPs are the most expensive machines ($1200-1500+) I'd sure hate to put out that kind of money myself, although my husband says if that is what I need we will find a way to get it.
Now, supposedly the need for a BiPAP is because of the "backup pressure". However, in doing a comparison of the various BIPAP machines on Cpap.com it seems there is currently only one that has a backup pressure and that is the Knightstar. Does anyone know if there are others, perhaps even ones not sold by Cpap.com?
Also, for an emergency basis would a 420E be a safe alternative, since it recognizes CAs and does not increase pressue.
BiPaps and backup pressure
14 posts
• Page 1 of 1
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
sthnreb, I think "backup" is referring to "Timed" mode. Timed is available only in some bi-level machines -- the ones that offer "S/T" (spontaneous/timed) modes.
Bi-level machines are commonly called "bipap" even though "BiPap" is Respironics' trade name for some of their bi-level machines. Bipap has become a generic word - like "scotch tape" and "kleenex". Puritan Bennett has the Knightstar bi-level machines. ResMed's trade name for its bi-level machine is VPAP, as in the VPAP III.
Spontaneous refers to the patient's own breathing being what triggers the machine to go back and forth from Inhale to Exhale. Most bi-levels have settings that can be tweaked to make various aspects of the machine's inhale/exhale pressures be in sync with the user's breathing pattern. In other words, settings that can prevent the machine from starting the inhale pressure while the patient is still in the middle of exhaling, etc.
Timed (as in the "spontaneous/timed") bi-level machines refers to bi-level machins that are set to work like any other bi-level unless the patient stops breathing at all for a certain amount of time. Then the machine switches into "Timed" mode, automatically delivering a cycle of Inhale/Exhale pressures - alternating pressure nudges.
Automatically alternating between inhale/exhale pressures in "Timed" mode is the machine's way of trying to kick-start the brain into sending breathing signals again. Reminder messages to the brain. Using alternating inhale/exhale pressures to try to make the brain remember, "Oh, yeah, this is what I'm supposed to be signalling to the respiratory system - breathe in/breathe out."
Pressure alone can open the throat when an obstructive apnea happens. But in central apnea, the throat may already be open...the brain simply doesn't send the signal, "breathe now." There is no physical struggle going on to try to breathe, as there is when there's an obstruction. The body is not even making an effort to take a breath when it's a central apnea.
From what I've gathered from christinequilt's excellent posts about central apnea, true "Central Apnea" by itself is a very rare disorder. Most people have OSA (obstructive sleep apnea.) Some may have a mixture - both OSA and C A - without necessarily needing a bi-level machine at all, much less the most expensive ones that have "Timed" capability. A very rare few people have only Central Apnea.
As christinequilts has posted before, she has purely Central Apnea. Her bi-level S/T machine doesn't prevent all the centrals she has... but has cut the occurences down considerably.
When doctors recommend a Bi-level or "bipap" in general, I don't think they are necessarily talking about one with Timed capability (a "backup" pressure, if I'm understanding that phrase right.) Central apneas would have to be a very big component of the patient's disorder before a machine that has a "Timed" mode would be useful, I'd think. But I'm not a doctor!
Each of the three major manufacturers (Puritan Bennett, ResMed, and Respironics) has bi-level machines - allowing them to be set for Inhalation pressure and a separate Exhalation pressure. Not all bi-level models have a "Timed" feature. That's needed only for very specific reasons.
Some confusion can occur when talking about bi-level machines because different models have different features. Even if a bi-level doesn't have a "Timed" feature they still do have a multitude of settings that can be tweaked -- length of time for IPAP and EPAP, "rise time", etc. can be individually set - customizing the machine to to match the patient's own spontaneous breathing pattern and stay in sync with the patient's own breathing. Example: setting the exhale to last long enough that it doesn't switch to the higher inhale pressure before the user is really ready to begin inhaling.
That's a very different kind of thing from having the most expensive bi-levels with a "Timed" feature. The S/T machine will operate in spontaneous mode until if/when a patient stops breathing. After a certain amount of time of no breathing, the machine will switch to "Timed" mode and do the kick-start inhale/exhale cycles on its own until the patient resumes spontaneous breathing.
Bi-level machines are commonly called "bipap" even though "BiPap" is Respironics' trade name for some of their bi-level machines. Bipap has become a generic word - like "scotch tape" and "kleenex". Puritan Bennett has the Knightstar bi-level machines. ResMed's trade name for its bi-level machine is VPAP, as in the VPAP III.
Spontaneous refers to the patient's own breathing being what triggers the machine to go back and forth from Inhale to Exhale. Most bi-levels have settings that can be tweaked to make various aspects of the machine's inhale/exhale pressures be in sync with the user's breathing pattern. In other words, settings that can prevent the machine from starting the inhale pressure while the patient is still in the middle of exhaling, etc.
Timed (as in the "spontaneous/timed") bi-level machines refers to bi-level machins that are set to work like any other bi-level unless the patient stops breathing at all for a certain amount of time. Then the machine switches into "Timed" mode, automatically delivering a cycle of Inhale/Exhale pressures - alternating pressure nudges.
Automatically alternating between inhale/exhale pressures in "Timed" mode is the machine's way of trying to kick-start the brain into sending breathing signals again. Reminder messages to the brain. Using alternating inhale/exhale pressures to try to make the brain remember, "Oh, yeah, this is what I'm supposed to be signalling to the respiratory system - breathe in/breathe out."
Pressure alone can open the throat when an obstructive apnea happens. But in central apnea, the throat may already be open...the brain simply doesn't send the signal, "breathe now." There is no physical struggle going on to try to breathe, as there is when there's an obstruction. The body is not even making an effort to take a breath when it's a central apnea.
From what I've gathered from christinequilt's excellent posts about central apnea, true "Central Apnea" by itself is a very rare disorder. Most people have OSA (obstructive sleep apnea.) Some may have a mixture - both OSA and C A - without necessarily needing a bi-level machine at all, much less the most expensive ones that have "Timed" capability. A very rare few people have only Central Apnea.
As christinequilts has posted before, she has purely Central Apnea. Her bi-level S/T machine doesn't prevent all the centrals she has... but has cut the occurences down considerably.
When doctors recommend a Bi-level or "bipap" in general, I don't think they are necessarily talking about one with Timed capability (a "backup" pressure, if I'm understanding that phrase right.) Central apneas would have to be a very big component of the patient's disorder before a machine that has a "Timed" mode would be useful, I'd think. But I'm not a doctor!
Each of the three major manufacturers (Puritan Bennett, ResMed, and Respironics) has bi-level machines - allowing them to be set for Inhalation pressure and a separate Exhalation pressure. Not all bi-level models have a "Timed" feature. That's needed only for very specific reasons.
Some confusion can occur when talking about bi-level machines because different models have different features. Even if a bi-level doesn't have a "Timed" feature they still do have a multitude of settings that can be tweaked -- length of time for IPAP and EPAP, "rise time", etc. can be individually set - customizing the machine to to match the patient's own spontaneous breathing pattern and stay in sync with the patient's own breathing. Example: setting the exhale to last long enough that it doesn't switch to the higher inhale pressure before the user is really ready to begin inhaling.
That's a very different kind of thing from having the most expensive bi-levels with a "Timed" feature. The S/T machine will operate in spontaneous mode until if/when a patient stops breathing. After a certain amount of time of no breathing, the machine will switch to "Timed" mode and do the kick-start inhale/exhale cycles on its own until the patient resumes spontaneous breathing.
Gosh, rested gal.
This was the best explanation of my bipap that I've ever read here (though I haven't read all of the posts).
I see now why some refer to the bipap as a kind of ventilator, regulating your breathing should you so stop breathing, correct? A ventilator is more of a constant breathing mechanism, doing all the breathing for a person who has stopped breathing altogether or needs assistance big time. I guess this works like a kind of ventilator, but allowing you to breath normally when breathing is working properly.
Great explanation. Think I'll print it out and tack it to my wall. (I have a crappy memory)
Thanks again,
Linda
This was the best explanation of my bipap that I've ever read here (though I haven't read all of the posts).
I see now why some refer to the bipap as a kind of ventilator, regulating your breathing should you so stop breathing, correct? A ventilator is more of a constant breathing mechanism, doing all the breathing for a person who has stopped breathing altogether or needs assistance big time. I guess this works like a kind of ventilator, but allowing you to breath normally when breathing is working properly.
Great explanation. Think I'll print it out and tack it to my wall. (I have a crappy memory)
Thanks again,
Linda
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Linda, I think what you're describing would happen only if it is a bipap model that offers a "Timed" feature. Most bipaps do not have that. Most bipaps will NOT switch into doing timed IPAP/EPAP cycles if you stop breathing. I think most bipaps would just sit there waiting for your breath to trigger the next inhale or exhale - they wouldn't try to kick-start you. I could be very wrong about that.I see now why some refer to the bipap as a kind of ventilator, regulating your breathing should you so stop breathing, correct?
I just wouldn't want anyone to think that all BiPaps (bi-level machines) can do the kick-start timed thingy.
post subject
I had central apnea way before OSA. Probably since birth, but only know that when I married young, my new husband would talk about how I occasionally quit breathing way back then. He said about the time he was ready to panic, I would gasp and begin breathing. This wasn't a big, constant thing, but more sporadic.
My first sleep study diagnosed both, central and OSA. The OSA came around the age of 45, and that's when I began snoring. Never did before.
2nd study found no central, but that wasn't surprising because I don't believe I do it every night, just occasionally.
3rd study like the 2nd.
I have the Resperonics BiPAP pro 2. Since my central is no big deal, I won't worry about the kick-starting kind. But am curious as to whether mine has that capability. Anybody know?
My first sleep study diagnosed both, central and OSA. The OSA came around the age of 45, and that's when I began snoring. Never did before.
2nd study found no central, but that wasn't surprising because I don't believe I do it every night, just occasionally.
3rd study like the 2nd.
I have the Resperonics BiPAP pro 2. Since my central is no big deal, I won't worry about the kick-starting kind. But am curious as to whether mine has that capability. Anybody know?
S/T mode machines -- just for rent by DME
My DME informed me that I will be renting my S/T mode box for $650/month
for the rest of my life ... I can not "rent to own" because they are providing
7 by 24 hour service (they come out once/year to change the filters), just
in case the machine breaks in the middle of the night. I guess I am
supposed to hope they get there with the replacement machine before
I need my next breath. My Doctor diagnosed me with very serious
Central Apnea [of course I am not a Doctor -- I learned that from Rested
Gal ]. Since the machine will be breathing for me at 14 times per
minute, I guess I won't be posting much longer to this forum. Who
would like my ResMed FF mask and Aussie heated hose? I can put
these in my will with your name. Just because I have HIV and sneeze
a lot ... that should not discourage you.
for the rest of my life ... I can not "rent to own" because they are providing
7 by 24 hour service (they come out once/year to change the filters), just
in case the machine breaks in the middle of the night. I guess I am
supposed to hope they get there with the replacement machine before
I need my next breath. My Doctor diagnosed me with very serious
Central Apnea [of course I am not a Doctor -- I learned that from Rested
Gal ]. Since the machine will be breathing for me at 14 times per
minute, I guess I won't be posting much longer to this forum. Who
would like my ResMed FF mask and Aussie heated hose? I can put
these in my will with your name. Just because I have HIV and sneeze
a lot ... that should not discourage you.
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Guest
This is Christine (IllinoisRRT),
If it makes you feel any better...
I was SO confused about BiPAPs when I started doing home health care. In the hospital setting, ALL BiPAPs were "timed", or had a back-up rate to them. In home care, though, BiPAP is IPAP/EPAP, no back up rate. We refer to (and I don't know if this is just our company or what) a BiPAP with a back-up rate (or "timed" feature) as an NPPV (noninvasive positive pressure ventilation). Out of 170 patients or so, I only have two on NPPV. One is in end-stage respiratory failure, and the other has myasthenia gravis.
If it makes you feel any better...
I was SO confused about BiPAPs when I started doing home health care. In the hospital setting, ALL BiPAPs were "timed", or had a back-up rate to them. In home care, though, BiPAP is IPAP/EPAP, no back up rate. We refer to (and I don't know if this is just our company or what) a BiPAP with a back-up rate (or "timed" feature) as an NPPV (noninvasive positive pressure ventilation). Out of 170 patients or so, I only have two on NPPV. One is in end-stage respiratory failure, and the other has myasthenia gravis.
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christinequilts
- Posts: 489
- Joined: Sun Jan 23, 2005 12:06 pm
Rested Gal gave a good summary. It is true that many people with both OSA & CSA/Mixed Apnea do well with regular CPAP. Some may need a regular BiPAP which does cost 2-3 times what a CPAP cost because it is a more complex peice of equipment and they are not as common. A regular BiPAP does not do anything if the user doesn't take a breath- it only changes from IPAP to EPAP when the users inhales & exhales. If you stop breathing it stays at the EPAP (exhale) pressure until you start to inhale with the next breath. I have never seen a good explination on why it works for CSA- l liken it to geting a rythym in your head that is hard to break...kind of like humming a silly song all day long because you heard it earlier only in this case you are the one who sung the silly song in the first place.
In some cases (but not all), people with severe CSA need BiPAP ST which is much more similar to what people think of as a ventilator. BiPAP ST's are much more expensive- online they run around $3000+ or so, montly rental from a DME runs $600-800, purchase through a local DME is $5000-7000. They are a lot more complex with a lot of safety features built in and not as many are sold. With Medicare- and I assume some other insurances- they are in a completely different catergory then CPAPs in that they are rented for life because they must be maintained & a backup machine needs to be supplied immediately (I literally can call in the middle of the night and have a backup machine to my house within hours...I own my own backup so I don't need that service but its there).
BiPAP STs are actually classified as pressure support ventilators but they do not force a person to breath- they only assist. Mine is set up with a back up rate of 10 breaths per minute so if I don't start breathing within 6 seconds of ending a breath cycle my Synchrony switches between IPAP (inhale) & EPAP (exhale) at a regular rate to try to get me to breath. Unfortunetly I'm pretty stubborn & don't always take the hint so even with my BiPAP ST I have 30+ central events per hour, some of which last 40-60 seconds or even longer. My case is definantly not the norm- most people with CSA get bettter results from xPAP therapy.
There are just a handful of BiPAP STs on the market- there are 2-3 times more regular BiPAPs on the market. I don't know much about the PB BiPAP- I'm not sure if I can even remember anyone mentioning using it on any of the sleep board as a regular BiPAP let alone as a BiPAP ST. On the Cpap.com BiPAP page you need to click on COMPARE ALL BiPAPS to see all they carry instead of just the most popular 5.
I know you posted earlier that your autoPAP was noting possible central events- were any noted on your original sleep study & titration? Really without a full sleep study there is no way to say that they are centrral events. It could be that your machine is being too sensative or is misreading what is happening. I know some autoPAPs have various adjustments to make them work better for each individuals- have they tried tweaking them for you to see if it makes a difference? How many central events do you average per hour according to your autoPAP? How are you feeling?- better since starting xPAP? more or less awakenings? more or less sleepy during the day? etc
Christine
In some cases (but not all), people with severe CSA need BiPAP ST which is much more similar to what people think of as a ventilator. BiPAP ST's are much more expensive- online they run around $3000+ or so, montly rental from a DME runs $600-800, purchase through a local DME is $5000-7000. They are a lot more complex with a lot of safety features built in and not as many are sold. With Medicare- and I assume some other insurances- they are in a completely different catergory then CPAPs in that they are rented for life because they must be maintained & a backup machine needs to be supplied immediately (I literally can call in the middle of the night and have a backup machine to my house within hours...I own my own backup so I don't need that service but its there).
BiPAP STs are actually classified as pressure support ventilators but they do not force a person to breath- they only assist. Mine is set up with a back up rate of 10 breaths per minute so if I don't start breathing within 6 seconds of ending a breath cycle my Synchrony switches between IPAP (inhale) & EPAP (exhale) at a regular rate to try to get me to breath. Unfortunetly I'm pretty stubborn & don't always take the hint so even with my BiPAP ST I have 30+ central events per hour, some of which last 40-60 seconds or even longer. My case is definantly not the norm- most people with CSA get bettter results from xPAP therapy.
There are just a handful of BiPAP STs on the market- there are 2-3 times more regular BiPAPs on the market. I don't know much about the PB BiPAP- I'm not sure if I can even remember anyone mentioning using it on any of the sleep board as a regular BiPAP let alone as a BiPAP ST. On the Cpap.com BiPAP page you need to click on COMPARE ALL BiPAPS to see all they carry instead of just the most popular 5.
I know you posted earlier that your autoPAP was noting possible central events- were any noted on your original sleep study & titration? Really without a full sleep study there is no way to say that they are centrral events. It could be that your machine is being too sensative or is misreading what is happening. I know some autoPAPs have various adjustments to make them work better for each individuals- have they tried tweaking them for you to see if it makes a difference? How many central events do you average per hour according to your autoPAP? How are you feeling?- better since starting xPAP? more or less awakenings? more or less sleepy during the day? etc
Christine
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Janelle
Christine,
I printed out EVERYTHING for the last 5 months and gave them to my RT who was supposed to fax or carry them down the street to my Sleep Dr. After a call with the Dr.'s very wonderful nurse, the NP has decided to have me do another sleep test. Trying to coordinate with the lab now to set a date. I had no Centrals on my original sleep test, but on the titration I had an index of .93. I am/was sleeping about 5-6 hours a night with sometimes as many as 23 centrals, quite often more centrals than hypopneas. This was on APAP. I generally had a pretty good night's sleep and had felt much better than when i started but was still getting sleepy driving in the afternoon if more than 30 minutes or so.
Since my APAP (420E) has gone in for repair/replacement I am currently using a Remstar Choice CPAP set at 7. I had ordered a new 420E from Cpap.com when the other went haywire and have left it unopened until this afternoon, waiting to see what was going to happen with my Dr. After a week or so on the CPAP I was waking up tired, went back to taking naps, so I decided the damn thing wasn't set at a high enough pressure ((I was originally titrated at 8 which I told them, but I average about 7 most nights on the APAP), so said, what the heck, I'm going to probably keep the APAP as a backup anyway since I'm not likely to get a small BiPAP/ST if I do need one, and I travel so much that after one weekend with the CPAP I have come to greatly appreciate the lighter weight of the 420, and ripped open the box, hooked it up and just laid in bed for about an hour and a half, trying to get rid of my sciatica pain and knee pain, and enjoyed the whisper quiet whoosh of the 420 compared the the rush of the Choice.
Betting I sleep better tonight and don't wake up tired tomorrow.
I printed out EVERYTHING for the last 5 months and gave them to my RT who was supposed to fax or carry them down the street to my Sleep Dr. After a call with the Dr.'s very wonderful nurse, the NP has decided to have me do another sleep test. Trying to coordinate with the lab now to set a date. I had no Centrals on my original sleep test, but on the titration I had an index of .93. I am/was sleeping about 5-6 hours a night with sometimes as many as 23 centrals, quite often more centrals than hypopneas. This was on APAP. I generally had a pretty good night's sleep and had felt much better than when i started but was still getting sleepy driving in the afternoon if more than 30 minutes or so.
Since my APAP (420E) has gone in for repair/replacement I am currently using a Remstar Choice CPAP set at 7. I had ordered a new 420E from Cpap.com when the other went haywire and have left it unopened until this afternoon, waiting to see what was going to happen with my Dr. After a week or so on the CPAP I was waking up tired, went back to taking naps, so I decided the damn thing wasn't set at a high enough pressure ((I was originally titrated at 8 which I told them, but I average about 7 most nights on the APAP), so said, what the heck, I'm going to probably keep the APAP as a backup anyway since I'm not likely to get a small BiPAP/ST if I do need one, and I travel so much that after one weekend with the CPAP I have come to greatly appreciate the lighter weight of the 420, and ripped open the box, hooked it up and just laid in bed for about an hour and a half, trying to get rid of my sciatica pain and knee pain, and enjoyed the whisper quiet whoosh of the 420 compared the the rush of the Choice.
Betting I sleep better tonight and don't wake up tired tomorrow.
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christinequilts
- Posts: 489
- Joined: Sun Jan 23, 2005 12:06 pm
Janelle-
I think I remembered you posting taking narcotic pain meds at night for a back problem? They can cause centrals in some people so it is something you need to be aware of. In my case it was obvious that I had CSA long before I started on long term pain meds though it wasn't diagnosed. The problem is that a lot of people with chronic pain also have Alpha Wave Intrusion (awake brain waves showing up in deeper stages of sleep). They know it has to do with pain & there are some meds they can use for the Alpha Wave Intrusions. Most of the info on Alpha Wave Intrusion on-line is linked to Fibromyalgia & Chronic Fatigue Syndrome which makes sense as they both have a combination of non-restorative sleep & pain.
My original sleep study showed severe Alpha Wave Intrusion & severe Central Sleep Apnea. In my case my sleep doc feels me staying on my pain meds for my knee pain is more important even though they could possibly be making my CSA worse because without the pain meds the Alpha Wave Intrusions would cause as much trouble as the central if not even more. The good thing is that since my apnea has been treated my pain has been been reduced significantly...amazing what getting even some restorative sleep can do for you isn't it? I take about 40% less pain meds then before I started BiPAP ST...unfortunately it didn't seem to lesson my centrals that much (sigh...I guess my sleep doc probably realized that but I had to try & I am very happy that my pain is much more under control now with a lot less medication now). My pain management doctor specifically noted the diagnosis of Alpha Wave Instrusion as objective proof for my chronic pain and justification to continue narcotic pain meds. When I saw a neurologist who was a sleep specialist for my headaches his nurse asked about my Dx of Alpha Wave Intrusion (she had never heard of it) and he said it meant I really, really had bad sleep apnea which I found funny for some reason.
Here are a couple links you might want to check out:
http://research.unc.edu/endeavors/win2000/sleep.htm
http://www.emedicine.com/pmr/topic47.htm
http://members.aol.com/fibroworld/sleeplit.htm
I would ask your sleep doc about the Alpha Wave Intrusion to see if that could explain some of your sleep problems. I hope your next sleep study can help figure out what is going on so you can get better sleep. I keep hoping they can figure out a way to better control my Central apneas so I could get a decents nights sleep...I keep thinking that if I feel this much better with still having 30+ central apneas per hour what would I feel like if they could get it down to 5 per hour or less.
I think I remembered you posting taking narcotic pain meds at night for a back problem? They can cause centrals in some people so it is something you need to be aware of. In my case it was obvious that I had CSA long before I started on long term pain meds though it wasn't diagnosed. The problem is that a lot of people with chronic pain also have Alpha Wave Intrusion (awake brain waves showing up in deeper stages of sleep). They know it has to do with pain & there are some meds they can use for the Alpha Wave Intrusions. Most of the info on Alpha Wave Intrusion on-line is linked to Fibromyalgia & Chronic Fatigue Syndrome which makes sense as they both have a combination of non-restorative sleep & pain.
My original sleep study showed severe Alpha Wave Intrusion & severe Central Sleep Apnea. In my case my sleep doc feels me staying on my pain meds for my knee pain is more important even though they could possibly be making my CSA worse because without the pain meds the Alpha Wave Intrusions would cause as much trouble as the central if not even more. The good thing is that since my apnea has been treated my pain has been been reduced significantly...amazing what getting even some restorative sleep can do for you isn't it? I take about 40% less pain meds then before I started BiPAP ST...unfortunately it didn't seem to lesson my centrals that much (sigh...I guess my sleep doc probably realized that but I had to try & I am very happy that my pain is much more under control now with a lot less medication now). My pain management doctor specifically noted the diagnosis of Alpha Wave Instrusion as objective proof for my chronic pain and justification to continue narcotic pain meds. When I saw a neurologist who was a sleep specialist for my headaches his nurse asked about my Dx of Alpha Wave Intrusion (she had never heard of it) and he said it meant I really, really had bad sleep apnea which I found funny for some reason.
Here are a couple links you might want to check out:
http://research.unc.edu/endeavors/win2000/sleep.htm
http://www.emedicine.com/pmr/topic47.htm
http://members.aol.com/fibroworld/sleeplit.htm
I would ask your sleep doc about the Alpha Wave Intrusion to see if that could explain some of your sleep problems. I hope your next sleep study can help figure out what is going on so you can get better sleep. I keep hoping they can figure out a way to better control my Central apneas so I could get a decents nights sleep...I keep thinking that if I feel this much better with still having 30+ central apneas per hour what would I feel like if they could get it down to 5 per hour or less.
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Janelle
From what I read in those articles it is intrusion during Delta sleep. During my first sleep study I had NO delta sleep. Second sleep study very very little and that was attributed to me taking Gabitril which is a drug for epilepsy used to get delta sleep. Currently I'm on Neurontin which is a similar drug, so it will be interesting to see what this next sleep study shows (scheduled for the 16th of May--so I've got a wait--supposedly so the dr. and insurance can make nice with each other and cover it).
Narcotic pain killers don't affect me much as far as sleepiness. I've been told I have a very high drug tolerance. I used to routinely take 2 Ultracets (considered a non-narcotic) which are equal to one 5/325 Vicodin. Now I'm having to take 2 of the 5/325 Vicodin generic and sometimes up to 3 to just get the pain down so I can GET to sleep. I also use Aspercreme on the bone spur areas on my left foot which do not respond to narcotic pain killers or therapy. (I'm a mess!). Only thing which helps that particular pain is the cortisone injections I get in my back which bathe all the nerves all the way to my toes with cortisone. Taking oral cortisone did nothing for my spur pain. Hopefully in a few months a new sonic procedure will be approved to remove them.
Before I was put on the ultracet and vicodin I was taking 4 Ibuprofen every 4 hours nearly all day long.
Narcotic pain killers don't affect me much as far as sleepiness. I've been told I have a very high drug tolerance. I used to routinely take 2 Ultracets (considered a non-narcotic) which are equal to one 5/325 Vicodin. Now I'm having to take 2 of the 5/325 Vicodin generic and sometimes up to 3 to just get the pain down so I can GET to sleep. I also use Aspercreme on the bone spur areas on my left foot which do not respond to narcotic pain killers or therapy. (I'm a mess!). Only thing which helps that particular pain is the cortisone injections I get in my back which bathe all the nerves all the way to my toes with cortisone. Taking oral cortisone did nothing for my spur pain. Hopefully in a few months a new sonic procedure will be approved to remove them.
Before I was put on the ultracet and vicodin I was taking 4 Ibuprofen every 4 hours nearly all day long.
posted subject
My daughter takes neurontin (and other things) for her back. She's been the whole circuit with Neurologists, tests, PT, you name it. Cortisone shots, now something they inject into the area in a complicated procedure guided by Xray. Not cortisone. She had a slip and fall, landed right on her bottom and has never been the same since.
Chronic pain is a bitch. I have it, too.
Neck, hips, back, shoulders. I'm getting ready to get my torn rotator cuff with bone spurs fixed soon.
Good luck to you, and I hope you get the best treatment, Janelle. You sound worse off than I.
I have no shoe, you have no foot.
Chronic pain is a bitch. I have it, too.
Neck, hips, back, shoulders. I'm getting ready to get my torn rotator cuff with bone spurs fixed soon.
Good luck to you, and I hope you get the best treatment, Janelle. You sound worse off than I.
I have no shoe, you have no foot.
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Guest
Hi Janelle I am guesing you don't know why your haveing centrals. there are alot of treatments out there depending on why your haveing centrals. All I can add is that if they set the rate to low on the BIPAP it most likely will never give you a breath. ( you breath 12 times a min and they set the rate for 8 ) if its set to high it may cure your centrals but for the most part the patients that I have titrated with a back up rate was aroused from sleep when the machine forced a Breath. Centrals are a tough nut to crack Good luck .
I would recommend the VPAP III ST from Resmed for a Bi-level with a back up rate. Its the only one you can really play with to get good settings.
I would recommend the VPAP III ST from Resmed for a Bi-level with a back up rate. Its the only one you can really play with to get good settings.
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