CSA information needed

I have been on bipap pro2 with a mirage FF, with heated humidifier for just over a week. Today I received a copy of the fax to my family physician giving results of my sleep study. Bipap settings 17/13, AHI 85.7, SaO2 85%. With these numbers and a reference to central apnea, should I be overly concerned? I am not set up for any followup appointments with either my GP or the sleep Doc. Should I anticipate further checks. Most all of the posts here are in reference to obstructive sleep apnea. I have read on the net that central apnea is a result of the breath signal not getting from the brain to the breath controls. It seems that the posts dealing with masks and machines will be the same. Is there another board dealing with central apnea or is it included here? Anyone have web sites for info for central?
Thanks (just a bit concerned)

Hi Mo,

I use a bipap too. 19cm/13cm is my pressure. Central sleep apnea can be because of high pressure used to clear obstructive sleep apnea.

If your prescription is written with a back-up rate or for a timed bilevel, you should be just fine with your bipap.

I know it can be a little overwhelming to get a diagnosis of severe sleep apnea, but it is completely treatable, as many here can attest to.

Titrator

Maybe I've misunderstood something, Titrator. I was on straight cpap with a pressure of 8cm. I was still exhausted so they did a straight titration study. The results were that they thought I would do well on bilevel set at 20/16. Do I need to worry about central apneas now?

Jeanne

P.S. My O2 never got below 93% on either study.

Hi Nantex,

Your pressure is up there like mine. Welcome to the end of the trail.

The bipap is used by people with central apnea. The pressure drops down making it easer to exhale, hence improving central apnea that is brought on by high pressure.

Titrator

MOsleep, if you can find posts by christinequilts on this message board and on the talkaboutsleep message board, I think you'll find some very enlightening information from her about central apnea.

Titrator,

I never registered any central apneas. Just obstructive and quite a few hypopneas. Should I be questioning why they are putting me on bipap?

While I was on the higher pressure, all arousals were eliminated.

Jeanne

Hi Nanetx.

You shouldn't worry why they put you on bipap. It is most likely your pressure level. If I got anyone past 17cm, I put them on bipap without question. it is more comfortable for the patient to be on a bipap.

Some people would say Autopap all the way, but their is a time and place for everything. The bipap works incredibly well at high pressure. There is a reason that they cost twice as much as most cpap and autopaps. They are build to go to very high pressure and they are sturdy.

Titrator

Thanks, Titrator! You've put my mind at ease. My doctor is very willing to put me on autopap if this doesn't work out.

Sorry MoSleep for taking up your posting for my questions!

Jeanne

Titrator wrote: Some people would say Autopap all the way
Titrator

I've always said if ones apnea events are severe and frequent, an Autopap may not be a better choice.

Wading, the term severe and frequent is kinda ambigious. I ve usually have two clusters of apneas that gets my overall AHI to about 10-12 over 8 hrs. Usually a few centrals.But i'll tell you it varies so much. Some nites my AHI is 7, others its 12-15. I'm now switching sleeping meds to see if theres a change.

Hi, wanted to say thanks to all who posted replies. Any information is more than I had when I started Bipap, just over a week ago.
The sleep report did go on to say that they administered Bipap at 17/13 for 28.5 minutes with 0 obstructive and mixed apnea, 31 central apnea and 1 hypopnea.
I will do a search and do some reading of the person named in the replies.
Thanks

I've always said if ones apnea events are severe and frequent, an Autopap may not be a better choice.

I agree with you, Wader, IF you're talking about cases where the person is still having severe, frequent events on autopap.

Even then, since each autopap manufacturer has their own algorithms, it might be that one autopap (and the range it was set for) would handle a particular case of hard, fast apnea events well, and another brand of autopap would not be able to cope with it as well.

But if we're talking simply about "severe, frequent" events being observed in the sleep study, I'd still opt for a trial on autopap at home rather than going onto a bipap with a high inhale pressure, no matter how comfortable it could be made with a lower exhale pressure.

Why would I want the trial on autopap first if a high pressure was prescribed that usually leads to a bipap? Mainly because of the mask leak problems people on high pressure have ahead of them.

I'm not a doctor, nor a sleep professional.... but, imho, even "severe, frequent" events during a titration would not necessarily rule out the chance that the problems could be prevented fine at lower pressures most of the night with an autopap. If apnea events do hit hard and fast all night while using an autopap, then, yes, another type of machine like bipap might be better. Personally, I'd still want to try at least two brands of autopap before going to bipap.

Given the advantages of autopaps in finding the right pressures to use when people have changing conditions -- weight gain/loss, new meds, physical/mental stress changes, even temporary changes such as one sleep position or another -- I'd always opt for at least a trial on autopap.

How many times have we read posts from people who were prescribed a high pressure from their sleep study titration, but upon a trial with autopap at home found the autopap didn't have to use that high pressure much, if any?

I think a distinction needs to be made between whether we're talking about "severe" during a titration, or "severe" while using an autopap. If it's deemed "severe", and even if it requires a high pressure during titration, I think there's a good case to be made for at least a trial at home on autopap.

If the problem remains severe while using an autopap, or the pressure that even an autopap with C-flex has to use most of the time is difficult to exhale against, then I'd go for a bipap.

Just a very non-medical two cents worth.