Replies to This Discussion

Permalink Reply by Duane McDade on October 7, 2009 at 4:06am

I hate to do this but, Oh my GOD! Does anybody know what Central Apnea is! I will speak middle class American here....Central Apnea is where your auto pilot shuts off while you sleep. The circuit in your brain that keeps you breathing while you sleep "shorts out" and you dont breathe. Your o2 level goes down and the people in the "you're gonna Die Room" wake you up so you breathe. The fact that you have been told you have Obstructive and Central Sleep Apnea is strange, Was your diagnosis done by a Machine? If so get a second Opinion.

• ▶ Reply

Permalink Reply by Jan on October 7, 2009 at 8:32am

Duane McDade said:

I hate to do this but, Oh my GOD! Does anybody know what Central Apnea is! I will speak middle class American here....Central Apnea is where your auto pilot shuts off while you sleep. The circuit in your brain that keeps you breathing while you sleep "shorts out" and you dont breathe. Your o2 level goes down and the people in the "you're gonna Die Room" wake you up so you breathe. The fact that you have been told you have Obstructive and Central Sleep Apnea is strange, Was your diagnosis done by a Machine? If so get a second Opinion.

• ▶ Reply

Permalink Reply by Jan on October 7, 2009 at 8:36am

Jan said:

Duane McDade said:

I hate to do this but, Oh my GOD! Does anybody know what Central Apnea is! I will speak middle class American here....Central Apnea is where your auto pilot shuts off while you sleep. The circuit in your brain that keeps you breathing while you sleep "shorts out" and you dont breathe. Your o2 level goes down and the people in the "you're gonna Die Room" wake you up so you breathe. The fact that you have been told you have Obstructive and Central Sleep Apnea is strange, Was your diagnosis done by a Machine? If so get a second Opinion.

Hi Duane-- I'm a newbie here so hopefully others will jump in to help. But, my understanding is that approximately 15% of people diagnosed with sleep apnea have a combination of obstructive and central apneas...and that people who have only central number less than 1%. While serious, certainly, my understanding is that it is treatable. I'm just looking for advice on what has worked for others. I go back to the sleep lab this evening.

Jan

• ▶ Reply

Permalink Reply by Vicki E Jones on October 7, 2009 at 8:42am

A lot of DME providers will provide you with a small, finger-clip pulse oximeter overnight, or for more than one night, free, if your sleep doctor orders it. I use one for 2 or 3 nights, twice a year. 2 or 3 nights because I am like the Princess and the Pea - change anything, slight discomfort, and I don't sleep, so I don't sleep the first night I have a pulse oxim on my finger, especially with some arthritis and Fibromyalgia and the finger clip on.

It records your oxygen levels, so gives an indication if the equipment is doing its job. The BiPap SV machines (ResMed VPAP Adapt SV, and Respironics Auto BiPap SV) record, but I'm not sure what data they record. My Respironics Auto BiPap SV has a SmartData card so that data can be downloaded by the RT or sleep center, and ResMed can have this, too. It will record without the SmartData card, but the optional SmartData card makes it easy for them to download to computer and examine the data.

The pulse oxim would certainly tell you if you are getting large leaks during the night, because presumably oxygen levels would drop if you were. I assure you, there IS a correlation between functionality during the day and how well the sleep apnea events were corrected at night.

My sleep neurologist told me that Central Apnea events cause neurological wakening with each event, although you think you are asleep. This is because the delay at the end of exhale - i.e. the delay in starting the next breath - makes the brain "wake" you to breathe i.e. the brain interprets it as you have stopped breathing.

That causes exhaustion during the day if not corrected. Frequently interrupted sleep. That's why I am on a SV machine, and I feel much better. On regular CPAP, I don't feel rested, due to the Central Apnea events.

Whether laser surgery is helpful depends on the cause(s) of the Obstructive sleep apnea. In my case, it wouldn't do anything, because the obstructive comes from the retrognathic lower jaw, only being able to sleep on my back, and the tongue flopping back. The oral appliance, to advance the lower jaw (or orthognathic surgery, if I hadn't take biphosphonates for 18 months), is more useful.

Vicki in Illinois

**

Mark in Idaho said:

FYI,
93 hypopneas (???), and 12 respiratory effort related arousals.
Hypopneas is where your breathing is not sufficient to keep your oxygen levels where they need to be. They may be interupted apneas where your brain started you breathing better before you stopped completely.

The 'respiratory effort related arousals' are when you start to wake up due to your breathing difficulties. These were probably related to the Obstructive Apnea events as they can cause arousal more frequently. Central Apnea does not cause the same kind of arousals from my understanding.

Has anybody suggested laser tissue tightening or removal? My neighbor had great success when they removed some tissue and shrunk/tightened other tissue.

It appears that you averaged an apnea event each minute. If you breath at 10 Resperations Per Minute normally, you were probably not breathing for half of the 172 minutes. I would suspect that an event would need quite a few breaths missed to effect you blood Ox level. WOW !!

Did the report say what your oxygen levels were average and at the lowest. ?

I would love to have a recording PulseOx meter to sleep with to track my Oxygen levels. I bet my sleep oxygen levels coincide with my level of functioning each day.

• ▶ Reply

Permalink Reply by Vicki E Jones on October 7, 2009 at 8:56am

Jan -
No one can advise you, until the sleep lab does a titration with a machine to see what it does or doesn't correct, and at what settings (air pressure going into your mask).

In my case, an oral appliance was tried before any CPAP was tried, but I have the retrognathic (too far in or back) lower jaw (looks like a receding chin), and it is a small lower jaw, with a large tongue that flops back when I sleep.

The oral lower jaw advancement appliance is used by some people that have a normal lower jaw, just to bring the lower jaw forward a bit and open up airways. For some people this works, and there are many kinds of these. Mine is custom - my latest one from an orthodontist who gave me a cheap price. They tend to be quite expensive. If you prove medical necessity (sleep doctor can help with that), insurance may cover it.

CPAP is for obstructive sleep apnea, but if that is causing or contributing to the central sleep apnea, it may correct both. Sometimes long-standing obstructive, or some kinds of obstructive, cause the central sleep apnea. It can be a brain stem issue, but other things (hiatal hernia, acid reflux, mitral valve prolapse, heart failure, lung conditions, etc.) can contribute to sleep apneas.

If CPAP titration does NOT correct the central sleep apneas but helps the obstructive, then the sleep lab will do another overnight sleep study with either ResMed VPAP Adapt SV or Respironics Auto BiPap SV machine for central sleep apnea.

A good sleep lab will take it one step at a time, I think. There are many, many kinds of face masks - full face (nose and mouth), nasal (nose only), etc., etc. A good sleep tech will measure your face and have you try on several different things. You can go online to Google and key in CPAP masks, and then look over the different brands and types. There are so many. New ones are being introduced at a national trade show in the next couple of weeks, too. New designs come out all the time.

So no one can advise you, because each person's needs are unique and depend on causes, facial contours, etc.
A lot is by trial and error. Your equipment supplier should be one that will do a 30-day swapout if a face mask isn't working out, because insurance will pay for one mask every 3 months on Medicare, every 6 months on regular insurance, unless the regular insurance has no such restriction and your doctor shows medical necessity.

If the titration shows you need a very high pressure, some people need an oxygen bleed - an oxygen line going into a hole in the face mask to add oxygen. Or, you may need BiPap instead of CPAP. Who can say? Only your sleep doctor and sleep lab will know what you need, and you - when you try on different face maskss - if you are being put on CPAP or BiPap.

Vicki in Illinois

******

Jan said:

Jan said:

Duane McDade said:

I hate to do this but, Oh my GOD! Does anybody know what Central Apnea is! I will speak middle class American here....Central Apnea is where your auto pilot shuts off while you sleep. The circuit in your brain that keeps you breathing while you sleep "shorts out" and you dont breathe. Your o2 level goes down and the people in the "you're gonna Die Room" wake you up so you breathe. The fact that you have been told you have Obstructive and Central Sleep Apnea is strange, Was your diagnosis done by a Machine? If so get a second Opinion.

Hi Duane-- I'm a newbie here so hopefully others will jump in to help. But, my understanding is that approximately 15% of people diagnosed with sleep apnea have a combination of obstructive and central apneas...and that people who have only central number less than 1%. While serious, certainly, my understanding is that it is treatable. I'm just looking for advice on what has worked for others. I go back to the sleep lab this evening.

Jan

• ▶ Reply

Permalink Reply by Jan on October 7, 2009 at 9:02am

Vicki E Jones said:

A lot of DME providers will provide you with a small, finger-clip pulse oximeter overnight, or for more than one night, free, if your sleep doctor orders it. I use one for 2 or 3 nights, twice a year. 2 or 3 nights because I am like the Princess and the Pea - change anything, slight discomfort, and I don't sleep, so I don't sleep the first night I have a pulse oxim on my finger, especially with some arthritis and Fibromyalgia and the finger clip on.

It records your oxygen levels, so gives an indication if the equipment is doing its job. The BiPap SV machines (ResMed VPAP Adapt SV, and Respironics Auto BiPap SV) record, but I'm not sure what data they record. My Respironics Auto BiPap SV has a SmartData card so that data can be downloaded by the RT or sleep center, and ResMed can have this, too. It will record without the SmartData card, but the optional SmartData card makes it easy for them to download to computer and examine the data.

The pulse oxim would certainly tell you if you are getting large leaks during the night, because presumably oxygen levels would drop if you were. I assure you, there IS a correlation between functionality during the day and how well the sleep apnea events were corrected at night.

My sleep neurologist told me that Central Apnea events cause neurological wakening with each event, although you think you are asleep. This is because the delay at the end of exhale - i.e. the delay in starting the next breath - makes the brain "wake" you to breathe i.e. the brain interprets it as you have stopped breathing.

That causes exhaustion during the day if not corrected. Frequently interrupted sleep. That's why I am on a SV machine, and I feel much better. On regular CPAP, I don't feel rested, due to the Central Apnea events.

Whether laser surgery is helpful depends on the cause(s) of the Obstructive sleep apnea. In my case, it wouldn't do anything, because the obstructive comes from the retrognathic lower jaw, only being able to sleep on my back, and the tongue flopping back. The oral appliance, to advance the lower jaw (or orthognathic surgery, if I hadn't take biphosphonates for 18 months), is more useful.

Vicki in Illinois

**

Mark in Idaho said:

FYI,
93 hypopneas (???), and 12 respiratory effort related arousals.
Hypopneas is where your breathing is not sufficient to keep your oxygen levels where they need to be. They may be interupted apneas where your brain started you breathing better before you stopped completely.

The 'respiratory effort related arousals' are when you start to wake up due to your breathing difficulties. These were probably related to the Obstructive Apnea events as they can cause arousal more frequently. Central Apnea does not cause the same kind of arousals from my understanding.

Has anybody suggested laser tissue tightening or removal? My neighbor had great success when they removed some tissue and shrunk/tightened other tissue.

It appears that you averaged an apnea event each minute. If you breath at 10 Resperations Per Minute normally, you were probably not breathing for half of the 172 minutes. I would suspect that an event would need quite a few breaths missed to effect you blood Ox level. WOW !!

Did the report say what your oxygen levels were average and at the lowest. ?

I would love to have a recording PulseOx meter to sleep with to track my Oxygen levels. I bet my sleep oxygen levels coincide with my level of functioning each day.

THANKS-- this is very helpful. I think I am just getting anxious/nervous because I go back tonight to be fitted for an appliance and mask. It looks to me like it is a lot of trial and error.

Thanks again,
Jan

• ▶ Reply

Permalink Reply by Vicki E Jones on October 7, 2009 at 9:13am

Jan -
Be sure to tell you RT (Respiratory Therapist) or Technician that you want to see different kinds of masks (full, nasal, etc.). Full masks include Respironics ComfortGel, Respironics ComfortFull, and many others. st you. Nasal masks include the popular Swift II nasal pillows and nasal masks and mini-masks.

Be sure to let your technician know that new masks are being introduced at an annual trade show in the next week or two. ResMed is coming out with a gel mask, though I don't know if it is at the show. DeVillbiss is coming out with a gel mask that is called EZ Fit or Easy Fit, actually made by Weinmann, makers of the Soyala mask.

The nasal masks or nasal pillows approach (just look at nasal masks on one of the CPAP suppliers that sell online) may be something you prefer, but it is individual preference. It will probably take you a week to get used to anything, because it is new and unfamiliar. The fact a mask fits well doesn't mean you will find that particular type of mask comfortable, so do ask if there is a 30-day swap-out return privilege. Masks must be returned in new condition.

I have returned masks on swap-out by cleaning them with a dish soap called Green Works natural dish soap, Free & Clear variety. No fragrance, no dye. I squirt one or two squirts in my bathroom sink, run in lukewarm water, soak the mask in that for 30 minutes, then rinse it with cool water thoroughly and let it dry on a clean towel. That works for me.
Cheap way to clean masks.

If you are put on a SV machine for the central apnea, though, it calls for a full face mask, not nasal masks, simply because it ramps up and down (the air pressure), and ramps up higher than a CPAP machine, meaning all that air would be going only in your nostrils, which can be uncomfortable. The SV machines are not really designed for nasal masks or nasal pillows.

For the ResMed Adapt SV machine for central apnea, there are a lot of masks it won't accept. It is made for ResMed products, mostly. The Respironics SV is a little easier to deal with, and I am using that. I am even using Swift II nasal pillows with it, since I have problems with full masks due to the retrognathic lower jaw and flat facial contours. I am finding that I can use the Respironics ComfortGel mask, though.

Vicki in Illinois

*******

If you have time today, go online and see the different kinds that are out there.


Jan said:

Vicki E Jones said:

A lot of DME providers will provide you with a small, finger-clip pulse oximeter overnight, or for more than one night, free, if your sleep doctor orders it. I use one for 2 or 3 nights, twice a year. 2 or 3 nights because I am like the Princess and the Pea - change anything, slight discomfort, and I don't sleep, so I don't sleep the first night I have a pulse oxim on my finger, especially with some arthritis and Fibromyalgia and the finger clip on.

It records your oxygen levels, so gives an indication if the equipment is doing its job. The BiPap SV machines (ResMed VPAP Adapt SV, and Respironics Auto BiPap SV) record, but I'm not sure what data they record. My Respironics Auto BiPap SV has a SmartData card so that data can be downloaded by the RT or sleep center, and ResMed can have this, too. It will record without the SmartData card, but the optional SmartData card makes it easy for them to download to computer and examine the data.

The pulse oxim would certainly tell you if you are getting large leaks during the night, because presumably oxygen levels would drop if you were. I assure you, there IS a correlation between functionality during the day and how well the sleep apnea events were corrected at night.

My sleep neurologist told me that Central Apnea events cause neurological wakening with each event, although you think you are asleep. This is because the delay at the end of exhale - i.e. the delay in starting the next breath - makes the brain "wake" you to breathe i.e. the brain interprets it as you have stopped breathing.

That causes exhaustion during the day if not corrected. Frequently interrupted sleep. That's why I am on a SV machine, and I feel much better. On regular CPAP, I don't feel rested, due to the Central Apnea events.

Whether laser surgery is helpful depends on the cause(s) of the Obstructive sleep apnea. In my case, it wouldn't do anything, because the obstructive comes from the retrognathic lower jaw, only being able to sleep on my back, and the tongue flopping back. The oral appliance, to advance the lower jaw (or orthognathic surgery, if I hadn't take biphosphonates for 18 months), is more useful.

Vicki in Illinois

**

Mark in Idaho said:

FYI,
93 hypopneas (???), and 12 respiratory effort related arousals.
Hypopneas is where your breathing is not sufficient to keep your oxygen levels where they need to be. They may be interupted apneas where your brain started you breathing better before you stopped completely.

The 'respiratory effort related arousals' are when you start to wake up due to your breathing difficulties. These were probably related to the Obstructive Apnea events as they can cause arousal more frequently. Central Apnea does not cause the same kind of arousals from my understanding.

Has anybody suggested laser tissue tightening or removal? My neighbor had great success when they removed some tissue and shrunk/tightened other tissue.

It appears that you averaged an apnea event each minute. If you breath at 10 Resperations Per Minute normally, you were probably not breathing for half of the 172 minutes. I would suspect that an event would need quite a few breaths missed to effect you blood Ox level. WOW !!

Did the report say what your oxygen levels were average and at the lowest. ?

I would love to have a recording PulseOx meter to sleep with to track my Oxygen levels. I bet my sleep oxygen levels coincide with my level of functioning each day.

THANKS-- this is very helpful. I think I am just getting anxious/nervous because I go back tonight to be fitted for an appliance and mask. It looks to me like it is a lot of trial and error.

Thanks again,
Jan

• ▶ Reply

Permalink Reply by Jan on October 7, 2009 at 2:31pm

Mark in Idaho said:

FYI,

93 hypopneas (???), and 12 respiratory effort related arousals.

Hypopneas is where your breathing is not sufficient to keep your oxygen levels where they need to be. They may be interupted apneas where your brain started you breathing better before you stopped completely.

The 'respiratory effort related arousals' are when you start to wake up due to your breathing difficulties. These were probably related to the Obstructive Apnea events as they can cause arousal more frequently. Central Apnea does not cause the same kind of arousals from my understanding.

Has anybody suggested laser tissue tightening or removal? My neighbor had great success when they removed some tissue and shrunk/tightened other tissue.

It appears that you averaged an apnea event each minute. If you breath at 10 Resperations Per Minute normally, you were probably not breathing for half of the 172 minutes. I would suspect that an event would need quite a few breaths missed to effect you blood Ox level. WOW !!

Did the report say what your oxygen levels were average and at the lowest. ?

I would love to have a recording PulseOx meter to sleep with to track my Oxygen levels. I bet my sleep oxygen levels coincide with my level of functioning each day.

Thanks for responding. I am wondering if these are the numbers you are asking about-- of course, I don't exactly know what they mean:

"Minimum Oxygen saturation was 76%, mean oxygen saturation was 92%. During sleep time the SaO2 was below 90% for 20.8 minutes. "

My total sleep time for this test was 172 minutes out of 429 minutes. But-- I slept much much worse at the lab than I do at home -- which is probably why I am not dead yet ;-0

Thanks for your assistance and insights.

Jan

• ▶ Reply

Permalink Reply by Vicki E Jones on October 7, 2009 at 7:47pm

Jan -
I don't know of anyone who sleeps well at an overnight "sleep" study.
With electrodes/glue on our heads, etc., how could anyone sleep a lot?

The labs have their own criteria for whether we slept, and how much.

Vicki

****

Jan said:

Mark in Idaho said:

FYI,

93 hypopneas (???), and 12 respiratory effort related arousals.

Hypopneas is where your breathing is not sufficient to keep your oxygen levels where they need to be. They may be interupted apneas where your brain started you breathing better before you stopped completely.

The 'respiratory effort related arousals' are when you start to wake up due to your breathing difficulties. These were probably related to the Obstructive Apnea events as they can cause arousal more frequently. Central Apnea does not cause the same kind of arousals from my understanding.

Has anybody suggested laser tissue tightening or removal? My neighbor had great success when they removed some tissue and shrunk/tightened other tissue.

It appears that you averaged an apnea event each minute. If you breath at 10 Resperations Per Minute normally, you were probably not breathing for half of the 172 minutes. I would suspect that an event would need quite a few breaths missed to effect you blood Ox level. WOW !!

Did the report say what your oxygen levels were average and at the lowest. ?

I would love to have a recording PulseOx meter to sleep with to track my Oxygen levels. I bet my sleep oxygen levels coincide with my level of functioning each day.

Thanks for responding. I am wondering if these are the numbers you are asking about-- of course, I don't exactly know what they mean:

"Minimum Oxygen saturation was 76%, mean oxygen saturation was 92%. During sleep time the SaO2 was below 90% for 20.8 minutes. "

My total sleep time for this test was 172 minutes out of 429 minutes. But-- I slept much much worse at the lab than I do at home -- which is probably why I am not dead yet ;-0

Thanks for your assistance and insights.

Jan

• ▶ Reply

Permalink Reply by Vicki E Jones on October 7, 2009 at 8:11pm

Jan -
It sounds like they want to do an overnight CPAP titration first, to see if it corrects both obstructive and central sleep apnea. If it does not, they should schedule an overnight study with either ResMed VPAP Adapt SV or with Respironics Auto BiPap SV, which are the only machines for Central Sleep Apnea. If they can do half a night with each, great, but they will probably choose only one. The Respironics is more user-friendly, in my opinion.

The ResMed Adapt SV gave me 100% correction in overnight titration study, and the Respironics gives me 99%. I had to switch from ResMed to Respironics because of specific problems I have with fitting, facial contours, etc., but most people could use the masks that the ResMed accepts and don't have my issues.

It will take some time to find out what works for you, and what you are comfortable with.
Vicki

*****


Jan said:

Vicki E Jones said:

Jan -
Hard to say if you need CPAP or the more complicated machines for Central Sleep Apnea.

With that high a level of obstructive sleep apneas, correcting the obstructive with CPAP, or
with an oral appliance that advances the lower jaw, or both may get rid of the Central events.
You won't know until they decide what to do for the obstructive events.

They should do an overnight titration with whatever machine they feel is appropriate, to see
what air pressure you need, and whether it corrects the obstructive and the central.

There are many different machines, masks, little nasal masks that just go around the nose or
end of nose, nasal pillows that go under the nostrils (soft silicone), many different headgear
systems - some simple, some elaborate, brands, styles.

For the more complicated machines for the Central Sleep Apnea, there are only two machines,
but it seems to me they should first try an oral appliance, or oral plus CPAP. There are some
very small CPAP machines out there, and some fairly comfortable face masks and nasal pillows.
I have problems with allergies and facial contours, but you are not likely to have that.

Vicki
******

Jan said:

Hi-- I took an overnight sleep study last week and am scheduled to go to the lab again tomorrow night to be fitted with equipment. The results of the test were that I have severe sleep disordered breathing. During the 172 minutes I actually slept, they recorded 20 central apneas, 94 obstructive apneas, 93 hypopneas (???), and 12 respiratory effort related arousals. (I don't rven know what the last two things are but will continue to research)

What is scariest to me is the large variety of equipment available and the number of stories I have read on here and other sites about the difficulties in figuring out the right equipment and making sure that technicians/insurance companies don't short change you or steer you to cheaper equipment.

Frankly, if need be, I can pay for the equipment out of pocket.

Given the variety of issues I have going on-- I am wondering if anyone is able to narrow down to several models the very best equipment I should be looking at? I do travel some, but that needn't be the main consideration.

Thanks for your help, I do feel under some time pressure given tomorrows scheduled visit to the sleep lab.

Jan

Thanks, Vicki, for your quick reply. I had some serious TMJ treated a number of years ago, so I am probably not going to be very happy with any oral device that moves my chin forward....but I'm receptive to anything that will work. I received a two page report from that initial test and the lab said "The patient has mixed apnea. A CPAP titration study shoudl bbe performed to determine the efficacy of this devive in treating the patients sleep related breathing disorder and to determine the correct pressure blah blah...

I've read about "automatic machines" and also BiPap machines and was wondering if anyone had a view on whether these are features I should be looking at...

• ▶ Reply

Permalink Reply by Jan on October 7, 2009 at 8:20pm

Vicki E Jones said:

Jan -
It sounds like they want to do an overnight CPAP titration first, to see if it corrects both obstructive and central sleep apnea. If it does not, they should schedule an overnight study with either ResMed VPAP Adapt SV or with Respironics Auto BiPap SV, which are the only machines for Central Sleep Apnea. If they can do half a night with each, great, but they will probably choose only one. The Respironics is more user-friendly, in my opinion.

The ResMed Adapt SV gave me 100% correction in overnight titration study, and the Respironics gives me 99%. I had to switch from ResMed to Respironics because of specific problems I have with fitting, facial contours, etc., but most people could use the masks that the ResMed accepts and don't have my issues.

It will take some time to find out what works for you, and what you are comfortable with.
Vicki

*****


Jan said:

Vicki E Jones said:

Jan -
Hard to say if you need CPAP or the more complicated machines for Central Sleep Apnea.

With that high a level of obstructive sleep apneas, correcting the obstructive with CPAP, or
with an oral appliance that advances the lower jaw, or both may get rid of the Central events.
You won't know until they decide what to do for the obstructive events.

They should do an overnight titration with whatever machine they feel is appropriate, to see
what air pressure you need, and whether it corrects the obstructive and the central.

There are many different machines, masks, little nasal masks that just go around the nose or
end of nose, nasal pillows that go under the nostrils (soft silicone), many different headgear
systems - some simple, some elaborate, brands, styles.

For the more complicated machines for the Central Sleep Apnea, there are only two machines,
but it seems to me they should first try an oral appliance, or oral plus CPAP. There are some
very small CPAP machines out there, and some fairly comfortable face masks and nasal pillows.
I have problems with allergies and facial contours, but you are not likely to have that.

Vicki
******

Jan said:

Hi-- I took an overnight sleep study last week and am scheduled to go to the lab again tomorrow night to be fitted with equipment. The results of the test were that I have severe sleep disordered breathing. During the 172 minutes I actually slept, they recorded 20 central apneas, 94 obstructive apneas, 93 hypopneas (???), and 12 respiratory effort related arousals. (I don't rven know what the last two things are but will continue to research)

What is scariest to me is the large variety of equipment available and the number of stories I have read on here and other sites about the difficulties in figuring out the right equipment and making sure that technicians/insurance companies don't short change you or steer you to cheaper equipment.

Frankly, if need be, I can pay for the equipment out of pocket.

Given the variety of issues I have going on-- I am wondering if anyone is able to narrow down to several models the very best equipment I should be looking at? I do travel some, but that needn't be the main consideration.

Thanks for your help, I do feel under some time pressure given tomorrows scheduled visit to the sleep lab.

Jan

Thanks, Vicki, for your quick reply. I had some serious TMJ treated a number of years ago, so I am probably not going to be very happy with any oral device that moves my chin forward....but I'm receptive to anything that will work. I received a two page report from that initial test and the lab said "The patient has mixed apnea. A CPAP titration study shoudl bbe performed to determine the efficacy of this devive in treating the patients sleep related breathing disorder and to determine the correct pressure blah blah...

I've read about "automatic machines" and also BiPap machines and was wondering if anyone had a view on whether these are features I should be looking at...

Vicki-- thanks so much for all of your help. I leave for the sleep lab in about 30 minutes. One thing I keep hearing is to make sure that I get a machine that is completely data capable. I don't exactly know what that means or what to watch out for-- any quick tips there in terms of what to ask about and the language to use with the tech so that they know what I am talking about?

Once again-- appreciate all the tips. Mostly, I am glad to hear that eventually I will find something that works and that I will start to feel better.

Best
Jan

• ▶ Reply

Permalink Reply by Vicki E Jones on October 7, 2009 at 8:59pm

Jan -
Don't know if this will reach you in time.
Yes, you want a machine that records data or has a smart card for data
and records data that can be downloaded, if possible.

Good luck!
Vicki

***

Jan said:

Vicki E Jones said:

Jan -
It sounds like they want to do an overnight CPAP titration first, to see if it corrects both obstructive and central sleep apnea. If it does not, they should schedule an overnight study with either ResMed VPAP Adapt SV or with Respironics Auto BiPap SV, which are the only machines for Central Sleep Apnea. If they can do half a night with each, great, but they will probably choose only one. The Respironics is more user-friendly, in my opinion.

The ResMed Adapt SV gave me 100% correction in overnight titration study, and the Respironics gives me 99%. I had to switch from ResMed to Respironics because of specific problems I have with fitting, facial contours, etc., but most people could use the masks that the ResMed accepts and don't have my issues.

It will take some time to find out what works for you, and what you are comfortable with.
Vicki

*****


Jan said:

Vicki E Jones said:

Jan -
Hard to say if you need CPAP or the more complicated machines for Central Sleep Apnea.

With that high a level of obstructive sleep apneas, correcting the obstructive with CPAP, or
with an oral appliance that advances the lower jaw, or both may get rid of the Central events.
You won't know until they decide what to do for the obstructive events.

They should do an overnight titration with whatever machine they feel is appropriate, to see
what air pressure you need, and whether it corrects the obstructive and the central.

There are many different machines, masks, little nasal masks that just go around the nose or
end of nose, nasal pillows that go under the nostrils (soft silicone), many different headgear
systems - some simple, some elaborate, brands, styles.

For the more complicated machines for the Central Sleep Apnea, there are only two machines,
but it seems to me they should first try an oral appliance, or oral plus CPAP. There are some
very small CPAP machines out there, and some fairly comfortable face masks and nasal pillows.
I have problems with allergies and facial contours, but you are not likely to have that.

Vicki
******

Jan said:

Hi-- I took an overnight sleep study last week and am scheduled to go to the lab again tomorrow night to be fitted with equipment. The results of the test were that I have severe sleep disordered breathing. During the 172 minutes I actually slept, they recorded 20 central apneas, 94 obstructive apneas, 93 hypopneas (???), and 12 respiratory effort related arousals. (I don't rven know what the last two things are but will continue to research)

What is scariest to me is the large variety of equipment available and the number of stories I have read on here and other sites about the difficulties in figuring out the right equipment and making sure that technicians/insurance companies don't short change you or steer you to cheaper equipment.

Frankly, if need be, I can pay for the equipment out of pocket.

Given the variety of issues I have going on-- I am wondering if anyone is able to narrow down to several models the very best equipment I should be looking at? I do travel some, but that needn't be the main consideration.

Thanks for your help, I do feel under some time pressure given tomorrows scheduled visit to the sleep lab.

Jan

Thanks, Vicki, for your quick reply. I had some serious TMJ treated a number of years ago, so I am probably not going to be very happy with any oral device that moves my chin forward....but I'm receptive to anything that will work. I received a two page report from that initial test and the lab said "The patient has mixed apnea. A CPAP titration study shoudl bbe performed to determine the efficacy of this devive in treating the patients sleep related breathing disorder and to determine the correct pressure blah blah...

I've read about "automatic machines" and also BiPap machines and was wondering if anyone had a view on whether these are features I should be looking at...

Vicki-- thanks so much for all of your help. I leave for the sleep lab in about 30 minutes. One thing I keep hearing is to make sure that I get a machine that is completely data capable. I don't exactly know what that means or what to watch out for-- any quick tips there in terms of what to ask about and the language to use with the tech so that they know what I am talking about?

Once again-- appreciate all the tips. Mostly, I am glad to hear that eventually I will find something that works and that I will start to feel better.

Best
Jan

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