ResMed - CSA during CPAP therapy: first insights from a big data analysis

Holger Woerhle, MD, explains the main findings of a big data analysis on CSA during CPAP therapy. The analysis was able to identify 3 categories of CSA during CPAP therapy, all of which negatively affected CPAP therapy compliance and increased therapy termination risk. A second analysis performed on the same database found that switching patients with persistent or emergent CSA from CPAP to ASV therapy may improve compliance.
Holger Woehrle, Head of the Lung Center Ulm, Germany - Sleep and Ventilation Center Blaubeuren

[abdulkarimsaleh]

i have central sleep apena please help

[ktxh]

I have been using cpap and apap for about 7 years, but was recently able to get an ASV covered by Medicare. It has reduced my sleep apnea, which consists of both obstructive and central events, from an AHI of 7-15 to less than 2.5. ASV has been wonderful. I sleep much better and do not feel tired during the day anymore.

[benttranberg]

I was told after the sleep study that my apnea was 10 seconds stop and 25 seconds of breathing through the night. I got an Airsense 11. Now I'm using OSCAR, and see that the reality is quite different from what I've been told. They only look at summary data at the hospital, and not graphs. I see that I have CSA (stops of 10 s to 55 s, mostly 15 s to 25 s) in a few periods of CSR (Cheyne-Stokes Respiration) through parts (1.5 h +- 1h) of the night. This is worse the higher the max pressure is. Lowering the pressure to 5 typically give me a mix of events through considerably more of the night, and higher AHI, but it helps me stop my bad aerophagia. I can't get consistently below AHI 15 or 20 or thereabouts, no matter the setting. I will ask for an ASV.

[DDDarray]

Doctors need to stop prescribing CPAP and auto-PAP, so the machine makers will stop making them. The hardware is the same for CPAP, auto-CPAP, bilevel CPAP, and they cost the same to manufacture. Perhaps ASV has a more expensive flow sensor or something. The difference in cost is only the firmware. If all machines were bi-PAP or ASV, treatment success would improve, popularity would increase, and the machine manufacturers would sell more machines and make more money.

[CSIS-Spy]

I have complex sleep apnea. I am on a trail CPAP for the past 2 months awaiting insurance coverage for new CPAP. ASV is unfortunately not covered by insurance, so I need to depend on CPAP or APAP. I have done my own research and experimented with settings and anylized data with Sleepyhead software.. CPAP has improved my AHI from 26 to 8. The problem I have is the fine line is an increase in pressure by 0.5 cmH20. At 8cmH20 Hypopnea's increase and clear airway are low, and at 8.5 Hypopnea's decrease and clear airway increased. Its almost as though the algorithm for this CPAP (ResMed Competition) increases pressure for Obstructive or Hyponea's but does not take into account reducing pressure for clear apnea. Before I make the final decision, does a Resmed 10 autosence algorithm take into account central apnea? Unfortunately the model I have can only adjust in increments of 0.5 cmH20 for either fixed CPAP or APAP modes.