I have ph due to severe central and obstructive sleep apnea. i use an asv machine and oxygen 4l. what other treatment(s) are available?

Alternatives for OSA: Although there are other options available, you are limited with the diagnosis of central sleep apnea. This typically does not respond to other modalities such as CPAP or bipap. Surgery is an option with respect to the obstructive component, though many variables can affect the success rate, which is typically quite low. If you look at all comers for obstructive sleep apnea, success rates are typically in the 50% range, though this is defined by a reduction in the apnea by 50%. This may still, and often does leave you with residual apnea if you are starting in the severe range. I would recommend that you see an ENT if you are considering surgery, but realize this will not treat the central component of your apnea.

Sleep apnea: Depending on the level of your sleep apnea an oral mandibular advancement appliance can be used instead of the cpap. Appliances do not treat central apneas. Look for a dentist in your area that treats sleep apnea for a consult

Heart OK?: Your question seem to suggest at least two things that need to be addressed. Central sleep apnea is usually caused by heart problems. Check with a cardiologist about this matter. The fact that you need additional oxygen suggests that obesity might be a significant modifiable factor.

ENT consult: Alternative therapies may include surgery to either remove excess patulous ( flabby) posterior pharyngeal tissue, reduction of the size of the uvula ( uvulectomy ),possible removal of tonsills/adenoids. I suggest a comprehensive ENT exam and evaluation as well as pulmonary function and sleep studies.

Other options: Other treatment options you may consider include mandibular advancement devices (MAD) or a variety of surgical procedures. Discuss this with your sleep MD>