Central apneas - Resmed S9 autoset

Hello,

Some years ago I stopped CPAP due to various compliance issues, I now need to go back on it. But way back then I had started with a Resmed 9 autoset, but had a ton of central apneas even though I never tested positive for them.

Could the reason be due to incorrect calibration of the S9, can this occur with any cpap machine?

Thank you all

Mike

summer wrote: ↑

Sun Dec 12, 2021 10:41 am

Could the reason be due to incorrect calibration of the S9, can this occur with any cpap machine?

No...it's not the calibration of the machine that is causing centrals.
And the AutoSet model was never designed to treat/fix central apneas anyway....it reports them and ignores them because it can't do anything about them.

Can cpap itself, no matter which machine, actually cause centrals to happen when they didn't happen prior to cpap use???

Most definitely it can happen and it is called treatment emergent central apnea.

It can happen with any pressure and isn't limited to just higher pressures over 10 cm (this used to be the thought to be cause) and it can happen with as little as 4 or 5 cm pressure.
Now there are some people who find that if they use exhale relief, which creates a bilevel situation in terms of pressure, that the bilevel pressures can actually trigger central apneas and if/when that has happened we can usually help reduce the number of centrals by either reducing or turning off the exhale relief.

A few centrals happening...entirely normal...they are only a problem if present in large numbers causing desats or disturbing sleep markedly.

I don't know your definition of a "ton" but most usually doctors won't even bat an eye about the central numbers until someone has over 5 per hour average...every hour...every night.

If you still have the S9 AutoSet available...use it and use OSCAR and lets see what is going on. Then decide if anything can be done or even needs to be done.

OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

Post a detailed nightly report...see this thread for examples of what we like to see
viewtopic/t158560/How-to-post-images-for-review.html


Also....don't panic if there indeed is a "ton" of centrals that can't be reduced in numbers with minor tweaking of the settings. Centrals can be dealt with if they are a real problem simply by a different type of cpap machine.

I just wanted to note that summer tried a self-funded ASV earlier out of concern about centrals:

https://www.cpaptalk.com/viewtopic.php? ... 27#p734727

She is, or at least was, in the UK.

Summer, it is really important for you to provide an Oscar chart, as Pugsy has suggested, or at the very least your index for central apneas. (That will be the total number of CAs divided by the number of hours you used the machine.) I see that you used to use Sleepyhead. It isn't supported any longer, but I think you'll find Oscar very easy to install and use.

[/quote]
If you still have the S9 AutoSet available...use it and use OSCAR and lets see what is going on. Then decide if anything can be done or even needs to be done.[/quote]

Hi Pugsy,

Thank you very much for a comprehensive supportive reply

I don’t have the S9 Autoset anymore or the ASV version, I have been using a AveoTSD, nasal dilators, Spo2 monitor, pillow wedge and sleep position to reduce the nightly events.
I do have silent reflux that does affect my breathing if my control lapses. I am finding that I have tight chest in the morning, most mornings now, I think due to hyperventilating and probably refluxing as well. That is my main issues as I am able to mostly control my apneas, but it is getting inconsistent during a given week.
So I am just looking to going back on cpap, but I had a torrid time on it and I also tried the ASV version for a while which did control the central apneas though.

I need have think and reflect on your post.
Kind regards,
Mike

Miss Emerita wrote: ↑

Sun Dec 12, 2021 12:38 pm

I just wanted to note that summer tried a self-funded ASV earlier out of concern about centrals:

https://www.cpaptalk.com/viewtopic.php? ... 27#p734727

She is, or at least was, in the UK.

Summer, it is really important for you to provide an Oscar chart, as Pugsy has suggested, or at the very least your index for central apneas. (That will be the total number of CAs divided by the number of hours you used the machine.) I see that you used to use Sleepyhead. It isn't supported any longer, but I think you'll find Oscar very easy to install and use.

Hi Miss Emerita,

Thank you very much for replying .

Yes, I am in the UK and I did try the ASV version after being prescribed the S9 autoset.

I don’t have the machines anymore and don’t think the ASV machine would be the right way to go as it was breathing for me. So I thought it a good idea to get some views on central apneas.
Kind regards,
Mike

Summer, sorry about the wrong pronoun. Any chance you can provide an Oscar chart?

summer wrote: ↑

Tue Dec 14, 2021 4:57 am

I also tried the ASV version for a while which did control the central apneas though.

ASV are typically the way to treat centrals.

summer wrote: ↑

Tue Dec 14, 2021 5:07 am

I don’t have the machines anymore and don’t think the ASV machine would be the right way to go as it was breathing for me.

Central apnea occur when your body doesn't make an effort to take a breath.
You DO want the machine to breathe for you when that happens.
When there are no events, it lets you initiate inhalation and exhalation.

Although the ResMed ASVs have a default 15 BPM backup rate, it continuously monitors your breathing pattern in a rolling 3 minute window and tries to match the pattern.

But it may had become out of synch.

OR your breathing pattern may have changed from the last 3 minutes while trying to fall asleep.

Here's the technique to deal with the problem if you get the ResMed ASV again.

Slow and easy breathing is the key for the first 3 minutes of the session.

But if you feel that the machine is not matching your breathing, blow back hard against the pressure for 3 seconds.

The machine will go into recalibration mode.

Breath slowly and regularly for the next 3 minutes while it recalibrates.

The post below has some ResMed marketing material explaining how their ASV work.

https://www.cpaptalk.com/viewtopic.php? ... &#p1398953

Good luck