I am aware of this link about the causes and possible solutions, but that is about it. I have not suffered from it so have no personal experience.
thanks I did find that in a search that you had posted and have read it.
Have you talked to your sleep specialist about it, and asked if there is anything that can be done to reduce it, such as limiting the base and IPAP pressures?
not yet I have a follow up in two days and will see what they say
What kind of machine is it? ResMed? If so you may want to have a read of the document at the link below, pages 27 to 31. The AirCurve ASV has two modes, ASV and ASV Auto. The ASV Auto mode may result in lower pressures.
Sierra you are definedly a wealth of knoledge on all this. i have been reading over other subjects and you information is always very thought inducing. lol. dont go anywhere, there are alot of people that you can pass this info onto.
I am using a Phillips Bipap Autosv I am running 12 cm as a base and have had it ramp up to 22 during a central apneas. This happened the first night with it and i called in to my sleep clinic and they advised that if the pressure was too high and it woke me up after a centrtal apnea to hit the ramp button, that has worked since then but the aerophagia started a few days after, but today it was better, mainly just two bad mornings. I have started having a cup of pepermit tea for breackfast before my coffe and that seems to get a start on the feeling that i have had the air forced down my throut all night, a few more days in and hopefully i will have some more luck.
The Phillips may be possible to set up in a similar way. You could ask them about it. If it can, then it may be possible for the base to be set lower and then have the machine increase it as necessary to address obstructive apnea, and also increase the IPAP pressure to address any central events.
Doctor has done exactly what you had said Sierra. lowered base pressure and we are going to monitor till my events start to rise or I stop getting the discomfort in the morning, I have gone from 22.7 to 5.2 events per hour a night but the asv machine is still breathing 10% of the time while I am having central events. so go news so far I will say I am happy with the 5.2 but not so happy with only breathing 90% of the time on my own. Maybe the machine will be able to magiclly train my brain to do it on its own but I don't expect that to happen.
Do you have a breakdown of the obstructive events you are having compared to central events? At least in theory the base EPAP pressure should be dealing with the obstructive events, while the pressure support should be dealing with the central events. If your residual AHI of 5 is mainly central events, then you might even gain by lowering the base pressure and giving the pressure support more range. Just my thoughts based on using an APAP and trying to use it to control mixed apnea. My central events are like 2/3 or so of the total, but I do not have an ASV machine to deal with the central events. But, I can generally average under 3 for AHI, so probably not time to consider an ASV necessary.
Downloaded the sleepyhead program and it does not like me. says my machine is too new? Sierra as you seem to be good at this stuff what do you make of this.
Sounds like you and I are in a similar boat. I was put onto an ASV machine for central apneas also. I ended up with the ResMed AirCurve 10 ASV which works with SleepyHead. My numbers may not have been as severe as your. I think my AHI was closer to 13.3, with 10.5 being centrals. With the ASV treatment I'm down to an average AHI of less than 1.0. However, that being said, a couple times a week I wake up in the middle of the night very bloated, after an hour or so, I manage to relieve that pressure and fall back to sleep. Just this last week, my Doc lowered my EPAP from 10 to 5 and while it helped a little with the bloating, my AHI went up between 1-2 every night. Also after a week, I noticed I was more tired at work, and had a harder time getting up in the morning. Even with the bloating and waking up at night, my old settings helped me more than I realized. Tonight I'm setting my EPAP back to the old settings and will talk to my Doc about using the ASV Auto mode instead of straight ASV once I'm back to my new normal.
Here's hoping that we both find a solution to this problem and get some good sleep.