Very high events!

Ashton · Post by **Ashton** » Thu Sep 30, 2021 7:35 pm

Hi guys,

Only just finished my sleep study a few months ago and was told I have central and obstructive and I’m having 94 events per hour… I’m 31 fit healthy don’t smoke or drink so after that I was prescribed a cpap with a pressure of 6.0 then went to 7.0 and my events dropped to around 60!

I was then told this is the best it will get and see you later. Not sure if anyone can help me reduce my events or does this seem ok ? Im very new to all this so sorry if I’m asking simple questions

Pugsy · Post by **Pugsy** » Thu Sep 30, 2021 8:50 pm

AHI of 60 is HORRIBLE when you are on a cpap machine.

Get OSCAR and lets see exactly what kind of events you are having.

OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

viewtopic/t158560/How-to-post-images-for-review.html

If primarily CA/Central apneas then a plain cpap machine is unlikely to ever work well for you.
You may need a different kind of machine.

Post a typical detailed report and lets see what we have to work with.

zonker · Post by **zonker** » Thu Sep 30, 2021 9:50 pm

Ashton wrote: ↑
Thu Sep 30, 2021 7:35 pm
Hi guys,

Only just finished my sleep study a few months ago and was told I have central and obstructive and I’m having 94 events per hour… I’m 31 fit healthy don’t smoke or drink so after that I was prescribed a cpap with a pressure of 6.0 then went to 7.0 and my events dropped to around 60!

I was then told this is the best it will get and see you later. Not sure if anyone can help me reduce my events or does this seem ok ? Im very new to all this so sorry if I’m asking simple questions

whoever told you this should be slapped! no, 60 per hour is horrid. even most sleep docs seem to agree that you want to get under 5. and around here, we shoot for under 2.

follow pugsy's advice and her links. we can get you through this.

what machine are you using? i'm sorry if you filled out your equipment profile. the forum has a bug and won't show us. so please let us know and if you can, put it in your signature along with mask.

oh! and welcome to the zoo.

palerider · Post by **palerider** » Thu Sep 30, 2021 9:56 pm

zonker wrote: ↑
Thu Sep 30, 2021 9:50 pm

Ashton wrote: ↑
Thu Sep 30, 2021 7:35 pm
Hi guys,

Only just finished my sleep study a few months ago and was told I have central and obstructive and I’m having 94 events per hour… I’m 31 fit healthy don’t smoke or drink so after that I was prescribed a cpap with a pressure of 6.0 then went to 7.0 and my events dropped to around 60!

I was then told this is the best it will get and see you later.
whoever told you this should be slapped! no, 60 per hour is horrid.

Not slapped, fired and shamed.

zonker · Post by **zonker** » Thu Sep 30, 2021 10:00 pm

palerider wrote: ↑
Thu Sep 30, 2021 9:56 pm

zonker wrote: ↑
Thu Sep 30, 2021 9:50 pm

whoever told you this should be slapped! no, 60 per hour is horrid.
Not slapped, fired and shamed.

fired and shamed AFTER they are slapped.

Pugsy · Post by **Pugsy** » Thu Sep 30, 2021 10:21 pm

zonker wrote: ↑
Thu Sep 30, 2021 10:00 pm

palerider wrote: ↑
Thu Sep 30, 2021 9:56 pm

zonker wrote: ↑
Thu Sep 30, 2021 9:50 pm

whoever told you this should be slapped! no, 60 per hour is horrid.
Not slapped, fired and shamed.
fired and shamed AFTER they are slapped.

I was thinking more along the lines of being drawn and quartered.

I got no patience right now for crappy medical care. This stuff isn't that difficult to learn.

Ashton · Post by **Ashton** » Fri Oct 01, 2021 3:25 am

Thanks for the fast reply
i will attach a few screenshots from Oscar for you

ill update my signature in the meantime i just purchased a new RESMED auto set 10 with a P10 nasal pillow mask
I'm pretty horrified after trawling a few CPAP forums and seeing people with such low numbers...
the Dr said my centrals cant be helped as i am on a pain patch that's causing them and i have to live with it

GrumpyHere · Post by **GrumpyHere** » Fri Oct 01, 2021 3:58 am

Ashton wrote: ↑
Fri Oct 01, 2021 3:25 am
the Dr said my centrals cant be helped as i am on a pain patch that's causing them and i have to live with it

Assuming your pain patch is opioid based, your doctor is not up to speed on types of CPAP treatments available.

Adaptive servo ventilation (ASV) is effective for opioid-induced central apneas.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031404/

I believe palerider has several ResMed ASVs for sale. You should PM him.

Transcutaneous electrical nerve stimulation (TENS) also have been shown effective in treating some chronic pain conditions.

Pugsy · Post by **Pugsy** » Fri Oct 01, 2021 6:17 am

Ahh...I expected a truckload of centrals and my next question was going to be "what meds are you taking?"

Your doctor is an idiot. No way around it. Centrals caused by pain meds can be dealt with and fairly easily with the right machine.

You need a machine that will deal with your obstructive apnea and essentially breathe for you when the centrals happen and you are not breathing on your own. While the AutoSet will do a great job with the obstructive side of things it can't force you to breathe....so it can't help with the central side of things.

This machine is the best one IMHO for people who have both obstructive apnea and central apnea.
https://www.resmed.com/en-us/healthcare ... ve-10-asv/

Just because medications are causing the centrals doesn't mean nothing can be done.

Sometimes with cpap use and some tweaking we can get a reduction in central numbers to a more acceptable level but it's not going to happen in your case. Just too many and the cause of the centrals really makes it difficult...When we do get lucky and the centrals reduce it is because the centrals are triggered by something else.

ASV machines are limited in supply and expensive and insurance notoriously makes a lot of hurdles to jump before they will pay for ASV.
But your biggest hurdle is your doctor....if he isn't on board to help fight insurance it's a lost cause.
The fight for ASV, that insurance pays for, starts with the doctor.

How would you feel about trying things on your own with a machine purchased privately?
It can be done and isn't really all that difficult.

Pugsy · Post by **Pugsy** » Fri Oct 01, 2021 6:23 am

Palerider does have some ASV machines (used by his brother who recently passed away) for sale and he could also help with the settings.
He has the older big brother model of the AirCurve 10 ASV that I linked to above.

Pugsy · Post by **Pugsy** » Fri Oct 01, 2021 6:59 am

https://www.cpaptalk.com/memberlist.php ... le&u=45763

Should you wish to contact Palerider...above link provides a link to sending a private message.

I don't remember all the particulars about the machines he has but I think S9 Adapt model which is essentially the same as the AirCurve 10 ASV in terms of what it does. ResMed just called it a different name but functions all were the same.

Ashton · Post by **Ashton** » Fri Oct 01, 2021 7:19 am

well the DR and clinic seemed to think that ASV isn't the way to go because right off the bat i asked how we can reduce centrals and he said there is nothing that can be done for you.. i was shocked!

they couldn't even help me source a CPAP machine i ended up going online and purchasing one outright for myself which is this one and i forked out $1400 for machine and mask about a month ago.

more than happy to try second hand heck im willing to try anything to get a better sleep!

Also yes medication i am on is opiate based but ive cut down Nealy 80% from where i was a year ago. i am healthy fit and also have exercise induced asthma not sure if that can cause it?

heres a shot from one of my bad nights too

Pugsy · Post by **Pugsy** » Fri Oct 01, 2021 7:33 am

We've had forum members here in the past that were in the same situation as you with the pain meds and centrals.
Their doctors put them on ASV right out of the box.
I do remember one member who finally was able to ditch the pain meds and was able to also ditch the ASV machine.
If I remember correctly his sole problem was the centrals and didn't have OSA so didn't even have to go to regular cpap/apap.

One thing I want to mention about the S9 models....you have to download to OSCAR at least once every 7 days or you lose some detailed graphs. Summary numbers are always there but the machine overwrites some detailed data file every 7 days.

Also....you need to lock the SD card when putting it in your computer. S9 models are the only machines where you have to write protect the SD card when it goes in the computer....
Windows 8 and higher...and some Macs will add a little text file to the SD card and while OSCAR doesn't care that file is on the SD card the S9 models care and won't work with that file on the SD card. There is a work around but just easier to write protect the SD card to start with than having to do the extra/complicated work to remove the offending file.

GrumpyHere · Post by **GrumpyHere** » Fri Oct 01, 2021 9:07 am

One solution to the S9 SD card problem is getting hold of a Toshiba FlashAir card version 3 or 4.

It's a wifi enabled SD card that can serve files via WebDAV.

They are out of production.
And they are expensive as old stock "new in the box" units.

But I was luckily able to snag a used one for $40.

I have it configured as an access point.

I download the data every morning without moving a SD card back and forth at the expense of needing to switch WiFi network before and after the import.

Some people integrate it into their main WiFi network.

=====
In case you do get hold of one.

This is how I managed to configure it as an AP for OSCAR wireless data transfer

You can update the card with airflash tool up to its final firmware.

Insert it into the CPAP machine.

Allow reformating. Let the CPAP do its thing until the screen returns to the menu.

Remove and reinsert the FlashAir card.

Card will start-up with a default AP
SSID Flashair_mac-address
Default wifi password 12345678

Connect to the FlashAir AP.

In a browser issue the following sequence of config commands.
The AP should return a success message.

Code: Select all

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123

MASTERCODE must be 12 char and be hex 0-9 A-F

Code: Select all

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123&APPAUTOTIME=0

Turns off AP timeout

Code: Select all

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123&WEBDAV=2

Turns on WebDAV allowing SD card to be mounted as a drive for OSCAR import

Code: Select all

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123&APPSSID=CPAP&APPNETWORKKEY=PassKey

Changes SSID to CPAP & passcode to PassKey

You need to re-connect to the FlashAir AP with the new WiFi credentials.

Mount SD fs at \\192.168.0.1\ as a drive letter root directory from which you can import into OSCAR.

The commands can actually be consolidated into just 2 requests.

Code: Select all

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123&APPAUTOTIME=0&WEBDAV=2&APPSSID=CPAP&APPNETWORKKEY=PassKey

If you are comfortable accessing your router, you can make the FlashAir a client of your WiFi network.

Send the following commands with the appropriate WiFi credentials.
APPSSID=Your_SSID
APPNETWORKKEY=Your_Network_PWD

Code: Select all

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123

http://192.168.0.1/config.cgi?MASTERCODE=0123ABCD0123&WEBDAV=2&APPAUTOTIME=0&WEBDAV=2&APPSSID=Your_SSID&APPNETWORKKEY=Your_Network_PWD&APPMODE=5

Reconnect to your normal WiFi network.

Access the router.

Find the IP leased to the FlashAir.

Make it a static DHCP if possible.

Mount the SD fs at the IP issued by the router.

Edit: Added info for Client Mode.

zonker · Post by **zonker** » Fri Oct 01, 2021 10:51 am

Pugsy wrote: ↑
Thu Sep 30, 2021 10:21 pm

I was thinking more along the lines of being drawn and quartered.
I got no patience right now for crappy medical care. This stuff isn't that difficult to learn.

reading further, i see the doc has all kinds of "justification".

i'm just happy the op has found the forum and can get the help s/he needs.

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