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Re: Complex/Mixed Apnea

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Posted by Sandman on June 20, 2009 at 12:18:07:

In Reply to: Complex/Mixed Apnea posted by SleepyJohn on June 20, 2009 at 11:57:35:

I had a patient once that was post polio. His diaphragm didn't work at all during sleep and all breathing was done with his accessory muscles.

So breathing was pretty bad in NREM sleep and there was no effort to breath during REM sleep, just long central apneas with arousals.

This was many years ago when the only options were cpap or bi-level (bi-pap). We put him on Bi-level in the timed mode with a large swing between inspiration and expiration. The result was his breathing was almost normal in NREM sleep and he was able to maintain SaO2 in REM sleep without arousals.

I'm sure there are newer systems that may work better, however, even with a complete complete lack of effort, bi-level has worked in the past. It would also take care of any obstructions if set to the correct pressures.

The most important part of the setup is it being in the timed mode, where the breathing rate is set in the machine. Typically set to your normal sleeping rate.

Best wishes,
Sandman

Disclaimer, I am not an MD and my opinions should not be taken as medical advice. If you feel that you need assistance with medications and/or diagnosis, you should seek medical advice from a qualified physician.

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PLEASE ONLY CLICK THE SUBMIT FOLLOW UP BUTTON ONCE!!. Thanks, Sandman

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