Sleep lab results csa

Hello all ive asked for advice here and got it and so i was able to get an early appointment so he went over my results and said without cpap i stopped breathing 38 times per hour with cpap it went to 16 times per hour so he said obviously im not cured. So they where able to get me in to the lab tonight and maybe get me on a different machine that will work better for me. So hoping tonight brings answers. He did give me some nuvigil to help so i will see how that helps. Any advice on how to take this second sleep lab visit and does anyone use nuvigil? Thanks

Treat this second lab titration visit like you did the other lab sleep study.
Don't take the Nuvigil today..and yes, there are a few people here that do take it but for today you don't want to add anything that promotes wakefulness tonight because tonight you want to sleep for sure.
Bring your own mask that you are comfortable with just in case they don't have that one...again....you want to sleep as best you can tonight so anything that helps you sleep...a favorite pillow or whatever...bring it.

Ok thanks. Unfortunatly i already took the nuivigl today as i didnt plan to have the titration tonight and it seemed to help get me through the day but im crashing super hard i guess its worn off. I only took it because my doc told me to

Okay. Hopefully it won't affect your sleep tonight. There's still some of it left in your system even after the bulk of the half life is gone. Always scares me a bit because different people metabolize these meds differently.

Just hate to go through all the wiring up stuff to not be able to fall asleep or stay asleep....been there..done that and have that T shirt.

Good luck tonight. I don't know if they will try plain bilevel first or go straight to the central killing machine. All depends on lab protocol. You do need help with the centrals though so this is the first step.

Thank you very much. The tech is talking to the doctor and im going to talk to them to see what the plan is. Toward the end of my last titration they tried the bilevel thing i think but dont think they got enough info from it so we will see. Ill post up tonorrow

Are you the one who had CSA diagnosis on initial sleep study and they gave you a brick cpap machine....is that correct?
Well...at least all the bilevel machines (either plain or the ASV for centrals) are all full data and they can't slip a brick in on you.

Yes that is indeed me. They said they couldnt get much figured out because i didnt sleep much i kept waking up. But they did say i would need an auto asv but they still couldnt get the centrals all figured out but they found that with my brick cpap at 10cm my oxygen levels would drop fast and it didnt help really at all. So the tech said the docs will get together today and discuss and may gove me a sleep aid to help keep me asleep so that they can try and fix that issue but not sure if they can.

ASV titration can be a bit tricky when central sleep apnea is involved and of course if one wakes up often it makes for a more difficult titration. Gotta get the sleep first to be able to fix the problem.
You may need a sleep aid...for sure no wake promoting agents anywhere near a sleep study. It's hard enough to sleep with all the wires and stuff without adding wake promoting drug into things even if it is mostly gone out of your system by night fall....it isn't totally gone.

Sounds like ASV is your next step...they are heading in the right direction at least. Now to just get you to sleep so they can full evaluate the therapy. If it takes a sleep aid to get you there then so be it. Gotta start with sound sleep first to have any chance of finding suitable settings to deal with the CSA.

Ill post again when i hear from them again. But it seems that asv is the way they are going to go and he said if my oxygen levels keep droping they might add oxygen with it but he saod they stayed at 90 on asv so that acceptable just need to get the bugs worked out

Well the doctor called me and said the kther machines didnt help and made things worse. The tech daid it kept my oxygen level at 90 where as the other cpap stayed lower 80s. So hes giving me ambien and wants me to use that to see if that helps and wants me to get an mri

Talk with your doctors about [1,2].

[1]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741

[2]: Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes
Yoseph Mebrate, Keith Willson, Charlotte H. Manisty, Resham Baruah, Jamil Mayet, Alun D. Hughes, Kim H. Parker and Darrel P. Francis
J Appl Physiol 107:696-706, 2009. First published 23 July 2009; doi: 10.1152/japplphysiol.90308.2008
Link: http://www.ncbi.nlm.nih.gov/pubmed/19628721

Ok ill do that i read over them a little and dont quite understand so maybe they will.

Clinte89 wrote:Ok ill do that i read over them a little and dont quite understand so maybe they will.

Clinte89,

As an FYI, EERS is experimental and not a proven therapy. I have not read the other study.

I would follow Pugsy's advice as she knows more than doctors in the opinion of many posters on this board.

49er

I don't understand what is going on.
Ambien and a MRI? Still use a brick cpap? What else?
ASV kept O2 up but "didn't help".

Get copies of all your sleep studies in detail and not just the summary one page thing. I don't know what to do with them yet but maybe we can get Sludge to help us out.

Do you have central sleep apnea or not? or is it plain OSA or is it Complex Sleep Apnea?

Yep, Pugsy is the one to listen to. Lots of good advice to be had here, but in particular Pugsy is very knowledgeable and helpful. Guy named Sludge has a list of helpful posters on his signature that is worth checking out, IMHO.