Central Sleep Apnea-What type of machine should I be on

I was DX with severe Central Sleep Apnea about 11 years ago. I now have both CSA and OSA but CSA is still my primary problem. I woke up the other morning at 5:30 AM and my CPAP was off. It’s set for automatic off and on so it should have been on but wasn’t. I’m thinking I just didn’t breath for too long of a period and the machine shut off. Also, looking back at reports for my Resmed machine (just got a AirSense 10 in July and love that I can see my usage on their app), I never get a score of 100. It shows I take my mask off 2-3 times a night. I never take my mask off as I can’t sleep without my CPAP. I do take a nap most days (also have Idiopathic Hypersomnia, which means I’m sleepy 24/7/365) but usually only one nap. I’m assuming that would mean I took my mask off twice but why are some days showing 3 times taking my mask off? I’m wondering if my CSA is causing me to stop breathing long enough so the machine actually turns off. If this is happening, do I have the correct machine for CSA or do I need an ASV or Bi-Pap? Any advice would be appreciated. I messaged my sleep Dr and he just told me to take the machine to my DME to have it checked.

Wow... great support from the doc! Since I am not a medical professional but have heard that a Bipap is the machine of choice with central apneas and OSA. Not sure why the Resmed daily report card shows your mask off more than you expect but you can turn the automatic on/off (breathing triggered) function and rely on the switch atop the machine to turn the thing on and off. I would turn the automatic off to ensure your breathing patterns don't affect that facet of the machine's function.

Thanks. Actually my Dr is an excellent sleep neurologist for my rare condition (Idiopathic Hypersomnia-IH). He just started taking over my sleep apnea portion. I called the DME and they were very helpful. I have both CSA and OSA and the machine I have is currently managing both. As far as the mask off issue I mentioned, turns out I did take 2 naps on the days listing 3 mask offs. We’re going to wait to see if it happens again. I did have a CSA when my machine turned off.

You are obviously a ResMed equipment user and monitor using the myAir online tool. That is fine for simple issues like mask leaks and AHI but you may want to use a more advance suite of monitoring software. ResMed sells one for clinical use (can't recall name) and you can download a free copy of Sleepyhead software which requires an SD card reader (very inexpensive) and provides more detailed information if you think that might help. Glad to hear you have a concerned MD and a good DME... from comments and personal experience, this is kind of rare!

Thanks for the information. Yes, it is hard to find a good Dr. I found my excellent Dr through a Facebook group asking for recommendations. My son, who works for 3M in tech, just gave me a SD reader Monday. I’ll check into Sleepyhead

If you do have CSA, then CPAP will almost certainly not treat it. You need a Bilevel device of some sort. CPAP holds you upper airway open, but nothing more. When you have central sleep apnoea, the muscles around your lungs aren't pushing the air in and out. It doesn't matter how much you open up your airway if your breathing muscles aren't moving the air. ASV is a subgroup of BiPAP which was designed specifically for treating Cheyne-Stokes respiration (a particular kind of CSA) in the setting of hypocapnia (low CO2 levels).