CENTRAL APNOEA - Which Resmed?

Pugsy wrote:You might want to check for sure about this but I thought that the S9 VPAP Adapt model no longer had mask restrictions.
The AutoSet CS2 and the VPAP Adapt SV are model names for the machines that were based on the S8 model line and yes, it did have some mask restrictions. If you notice the literature doesn't mention S9 VPAP anything and I believe we have some Adapt users here at the forum using nasal masks.

It's doubly confusing. There's an AutoSet CS, which is based on the S9 series. It may actually be the same as the VPAP Adapt, but just labeled differently in some countries. (Darn confusing ResMed naming.)

ASV machines like the VPAP Adapt may be more difficult to adapt to at first, but are the most powerful tools against CSA or Cheyne Stokes breathing. There is also ST mode bilevel/BiPAP/VPAP machines. They may be less difficult to adapt to, but the ASV will work for some people whom an ST mode machine won't help.

One thing that irritates me about ASV machines is that even though they cost much more than ST mode bilevel machines, they can't be set to do "simple" ST mode therapy. You can't "fall back" to the simpler therapy if you can't handle the strangeness of ASV.

Centralia, since you only need to get the correct machine to address your sleep problems, I suggest you do some reading about Adaptive Servo-Ventilation (ASV) therapy. Rested Gal put together a post with a list of Links to Central Sleep Apnea resources:

viewtopic.php?t=3025

Of particular interest and toward you comment, please review the following study:

Efficacy of Adaptive Servoventilation in Treatment of Complex and Central Sleep Apnea Syndromes
http://journal.publications.chestnet.or ... &issueno=6

In the study the researchers found that ASV is FAR more effective than all other therapy modes to address central sleep apneas.

Centrals are really difficult to understand, but you need to know exactly when you are getting centrals, if they are clustered, or occurring consistently throughout the night.

I've had a data machine for almost 2 years and I have looked at a lot of detail data. For about a year and a half my centrals averaged 3.5 (they have dropped some over the past 3 months). It's tough to get under an AHI of 5 when you start at 3.5 with centrals. But when I look at the data, I would get a lot of centrals right before I woke up, there were centrals off and on throughout the night, but the bulk would be stacked up in the last 15 minutes. I also found that if I had a lot of things on my mind, stressed out over work or I tossed and turned a lot, my numbers would also jump. All of this applies to short naps, because a 1 hour nap and a half-a-dozen short centrals before you wake up really tweaks the numbers.

My advice is to get into the detail data and find out what is going on. You also need to evaluate how you feel. A real CSA problem will severely impact the quality of your sleep and require special attention.

John

One of the beauties of posting a response is that once you hit the submit button, you are almost guaranteed that something will happen.

So last night I was fighting a little bit of a cold/sniffles and took some non-drowsy sudafed, (mistake), and that coupled with coffee a little earlier, I ended up with a pretty bizarre night of central readings.

I woke up after a few hours with an AHI of around 4.2, which is not great. When I tried to get back to sleep I could literally sense when I stopped breathing. First on one side and, then the other and then my back. Each time I would check my AHI readings and they went from 4.2 to 5.6 to 7.6 to 10.0. I didn't check the details as I thought they were obstructive apneas. I also had a pain under my arm on the left side, not very reassuring, so I decided to stay up and watch TV for a while. I added a pillow to prop me up a little more and went back to sleep.

In the morning I felt lousy. When I looked at my numbers I ended up with an AHI of 6.9, over 7 hours of sleep, with a central index of 5.8. Nearly all of those events that I felt were centrals. 18 in a 50 minutes and another 13 in 35 minutes.

I am only providing this to show how it is a combination of the details and how you feel.

John