[CPAP] what happened to me last night?

[Gideon]

Sounds like you still have the train wreck.
Bump min to 7 and EPR to 1.

[Sleeprider]

As I read your sleep study, you had 67 apnea events, of which 15 were obstructive and 52 were therefore central or unclassified hypopnea. Watchpat is a rather poor substitute for a clinical polysomnograhic study, but I think the next step is going to be a clinical titration test, and hopefully it will include bilevel and bilevel with backup (ASV) based on the apparent CPAP results. If your Watchpat results were purely obstructive, the CPAP results would be more perplexing. Gideon is trying to optimize settings to minimize central events, and is on the right track. If they can be tamed, and you feel you can get restful sleep, that's great. Some people adjust and minimize events, others find a need to move to more advanced PAP therapy solutions.

[Gideon]

To be clear, I am waiting to see the results of attempting to minimize CA events before I too commit to getting an ASV as Sleeprider is suggesting. IMHO if the attempt fails, and it very well might, it strengthens the argument for ASV.

[mallwalker]

ok so here's the last two nights. i don't really see any reduction in the central events, although i'm still relatively new to this. last night it even indicated there was cheyne-stokes breathing, which i looked up and seems to occur if you have heart failure...which i don't think i have, i would think i'd be aware of that? i think tonight i'll raise the minimum pressure to 7. if i really had that many central events during my sleep study... wouldn't the doctor have noticed that? do you think they just threw a machine at me without really examining the results closely (it's kaiser... so i'm guessing its possible) 

   

   

[Gideon]

First ResMed calls any and all periodic breathing CSR, it very rarely is.

Second, other than comfort, there is no reason to raise min pressure. If your EPR was 3vthete would be, but it isn't.
Reduce EPR from 2 to 1 to see if your centrals decrease.

Third, central Apneas are consistently inconsistent, in other words they jump all over the place.

Finally, doctors notice central apnea? Typically not unless you are over CAI > 5.
We have even seen sleep reports with hundreds of events, all but 1 event classified as central and the patient was diagnosed with OSA and given treatment for OSA and not central apnea.
It is one of the reasons we often ask to see the full copies of the sleep studies.

[mallwalker]

here's the last three nights. i thought i was doing better, saturday and sunday looked like improvements when i made adjustments to the machine, although i didn't feel any better the next day. last night apparently i took the mask off again (don't remember doing this) then had some crazy half hour of straight CAs before i woke up. i'm not noticing any difficulty in exhaling with the EPR set to 1, i sort of got used to it (or so i thought) but maybe i should just turn it off altogether?