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Best machine for reducing central apnea?

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soundsleeper +0 points · almost 6 years ago Original Poster

I have been using a Respironics System One BIPAP machine for 4 years. It is much more comfortable than my old CPAP machine. I have it set up for 13 on inhale and 8 on exhale. After raising the head of my bed, my AHI is down to around 6-8 each nite. Recently, I notice that my central apnea in my Sleepyhead reports is the major part of my AHI. Are there some types of machines (APAP or ASV) that are better at reducing central apneas? Or are there other methods than a new machine that will reduce my number of central apneas? Does anyone know what causes them?

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Sierra +0 points · almost 6 years ago Sleep Patron

You are asking a very basic question that is very difficult to answer. The question really generates a bunch of other questions. On average what is your ratio of obstructive apnea index to AHI ratio, what is your central apnea index to AHI ratio? If your obstructive and hypopnea component is still significant, then you may have some opportunity to reduce AHI without changing machines. If central apnea is the large component then it becomes more difficult.

So what are your OSA index values on average? If less then 1.0 you may be looking at a another machine. If it is significant then you may have improvement opportunities without changing machines.

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Sierra +0 points · almost 6 years ago Sleep Patron

You may find the article at the link below helpful in understanding CSA.

Central Sleep Apnea

In treating CSA with a CPAP there are two basic machines used beyond the basic CPAP. One is the BiPAP or two pressure level machine, which you already have. They can help a little bit with the pressure support feature (5 cm in your case). It provides a minimal improvement in your breathing efficiency. I am not familiar with the Respironics machines, but the ResMed AirCurve 10 VAuto machine has some additional features which allow you to fine tune how the machine switches from IPAP to EPAP pressure (13 cm and 8 cm in your case). If the machine switches quickly and at the right time, it can also help your breathing efficiency. Not sure if your machine has those features, but it would be worth discussing with your sleep technician. The next step is an ASV machine or Adaptive Servo Ventilation. Those machines monitor and lock on to your breathing pattern. When they detect shallower breathing they provide forced ventilation to compensate on a breath by breath basis.

Hope that helps some,

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wiredgeorge +0 points · almost 6 years ago Sleep Enthusiast

Perhaps reducing central apneas might be more appropriate discussion with the sleep physician who prescribed the set up. The tech at the current machine configuration and tech at a DME just sets up the machine per that prescription and may not (probably doesn't) have the training to prescribe a different set up in the event one is needed. While education is essential when discussing your current situation with your sleep doctor, in the end, that doctor is paid to make a diagnosis and best judgement.

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Sierra +0 points · almost 6 years ago Sleep Patron

The system must be different in the US compared to Canada. I'm not even sure there is really any such thing as a "sleep doctor" here. Typically the general practitioner approves getting the sleep study which is typically done at home. This is done through a sleep clinic that as far as I can see only employs sleep technicians. The sleep test results are read by some phantom doctor who is apparently independent from the clinic. The results are sent to the GP who rubber stamps the prescription. From there the sleep tech sets up the machine, and does all the adjusting. They are the ones who in theory monitor the results through the cell phone system used by the newer machines. It sounds like you get more service provided in the US.

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sleeptech +0 points · almost 6 years ago Sleep Enthusiast

The simple answer is that it's not really about the brand of machine as it is about the settings. How well a machine will treat central apnoeas is down to it being set appropriately for you, and the brand name written on the outside is basically irrelevant. ASV is a specialised form of BiPAP which was invented to treat Cheyne-Stokes respiration in hypocapnic patients, something which normal BiPAP is not great at. Which machine is best for you depends entirely on your specific condition and what your requirements are. You need the one which treats your particular problem.

Why do you have BiPAP? Do you have something other than OSA? If not, and you were given BiPAP simply for comfort, then it may be CAUSING the central apnoeas.

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Sierra +0 points · almost 6 years ago Sleep Patron

Does the Respironics bipap machines have the equivalent of ResMed's Triggering and Cycling adjustments; TiControl and Rise Time?

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