Sierra

Complex (both central and obstructive but with central dominant) sleep apnea is difficult to deal with. Here is a link to a good discussion about Complex Sleep Apnea. An ASV is a probable solution providing you do not need more than 20 cm of pressure to deal with obstructive apnea. They are expensive if insurance is not covering it though.

Are you using SleepyHead to monitor your apnea? If not it would be a good idea to get a better understanding of what is going on. An APAP can aggravate central apnea. Even when the machine does not increase pressure to a central apnea, it may respond to a central hypopnea because no machine that I am aware of can distinguish between a central and obstructive hypopnea. About the only way of dealing with it is to limit maximum pressure to the level required to deal with obstructive apnea and no more. You could also try with and without EPR.

Insurance companies can be difficult. To date the APAP has not worked, so that is the first step. Next they may insist on a BiLevel machine which does have a bit more capability, but in most cases it cannot deal with central apnea very well either. You may want to think of it as step you have to go through to get them to approve the ASV.

The other thing to check out with your doctor and heart specialist are other issues. Some heart issues can cause central apnea, and some drugs as well. If you live at high altitude that can aggravate central apnea as well.

Keep in mind that if they cannot get total AHI under 5 the treatment is not successful.

Hope that helps some,

The thing to watch for on minute ventilation is the amplitude of how much it fluctuates. It is kind of like a measure of your car speed when the cruise control is not working properly. The car goes too fast then too slow, and the cycle continues without stabilizing. The underlying issue with central apnea can be this inability to stabilize the breathing rate and depth. You don't really see it in the graphs until you expand the scale in the area where you are having centrals. MV cycling up and down tends to be a precursor of central apnea.

All I can say is that I have not had a problem (yet!) with my A10, and my wife after 4+ years has no problem with her older S9.

This said, I have had problems with my wife's S9 12 volt to 24 volt converter. Two have failed now. Defective from the factory.

I don't think that many try to sleep with their CPAP mask in their pillow.

You might want to consider converting it to the Swift FX Headgear.

This is how I did it.

This is the one you want if you follow my method for conversion.

I would suggest using SleepyHead to look at the detailed data, but I don't think Luna is supported by SleepyHead...

Some report success with keeping their tongue at the top of their mouth with it behind their teeth. Did not work for me though. I now use mouth taping.

Sorry, but no experience with LPR.

Sorry, but I have been away. The lowest price, actually only price I have seen is at the link below - $5000 CDN. I recall they used to be closer to $4000 but the price seems to have increased over the last year or so.

AirCurve 10 ASV