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11-02-2023, 08:51 AM (This post was last modified: 11-02-2023, 08:54 AM by Kathy14225.)
Can you tell if these are true CAs and OAs?
This is a typical night. I usually have centrals towards the end of the night and wondering if I'm just holding my breath while tossing and turning? I don't know how to tell. Also I know OAs can be flagged incorrectly. Is this how they are suppose to look so I can tell in the future? Also included is the full night. I know my flow limitations are above .10 but changing the EPR hasn't helped. Wondering if it may be because I sleep on my back? It is an adjustable bed. Also I know my leak rate is from opening my mouth but I'm satisfied with it as I do not want to use tape for this small amount.
Based on the events shown in closeup, I suspect most events are related to change of position or sleep stage transition. Centrals at the end of the night are commonly associated with wake/sleep cycle and nothing to worry about, particularly at these levels. Your therapy seems to be working well, and I would suggest increasing EPR to 3 to reduce flow limitations, along with an increase in pressure of 1-cm (9.4) or use of Autoset pressure in a range of 9 to 11.
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you can't always tell for sure. Most machines will send an air pulse down the circuit, which is pretty reliable in determining if it's a CA but for both Resmed and Phillips algos, they struggle to get it right at higher pressures, but you're at 8.4cm, relatively low.
The events in the two pictures you attached look properly flagged to me, but the OA one is questionable and might be a CA. It starts on an inhale and there isn't any flow limitation quantified in the flow-limit graph below; however, it does end on a large recovery breath and the pressure profile is not what we would expect. Look how the CA one terminates with normal breathing, that's a giveaway. There's no hunger for air.
Try sleeping on your side and see if you're flow-limit profile changes noticeably.
Thank you so much, I have more tools to look at this data now. I have a spinal disorder so have to sleep on my back on an adjustable bed so I can't sleep on my side. I don't think the mouth leaks far enough to worry about? I'm not waking up and I'm getting sleep, which hadn't been happening the first 10-11 months of therapy. Usingably dream way so I think that's been the game changer. I was giving it a year or so without it I think I would have quit. I didn't know any symptoms to begin with so this past year has been surprisingly awful. Now I'm just fine tuning and wanting to know what I'm looking at if things go south.
11-03-2023, 11:28 AM (This post was last modified: 11-03-2023, 11:33 AM by Kathy14225.)
RE: Can you tell if these are true CAs and OAs?
I've been changing my EPR, from 1 to 2 to 3 and back down to 2, flow limitations haven't changed. With each level they vary between .07 and about 0.16 and so many times up and every day occurrence up and down. I did have my pressure at 9.2 and then the doctor changed it to 10 but when I went on the bleep mask the air was blowing my mouth open, chipmunk cheeks for sure. The founder told me that often people need to lower their pressure. I can raise it a little bit and see what happens, thanks for that. I sleep on my back because of a spinal disorder but it is an adjustable bed with my head up a little bit. The best I can do. I had no symptoms before CPAP I was referred for the study because of the medication I'm on. As needed and I've kept track and taking them or not doesn't seem to make a difference either.
I would be willing to put it on auto 8 to 10 and if I put the EPR on 3 the pressure could go from 5 right on up to 10? I've been on auto a couple times just to see where to set the pressure. I haven't slept well, I was having RERAs seemingly when the burst of air went up but at that time I'm not sure how well I was reading data. I would have to look back since I know more now but I would be willing to try that.
Consider a simplified approach of increasing pressure by 1 and adding EPR of 1. See how you react before going further. Basically a mix of what has been suggested with a fixed pressure of 9 with EPR, or even a range of 9-11 with an EPR of 1. You can always add more pressure or EPR later if needed.
11-04-2023, 11:48 AM (This post was last modified: 11-04-2023, 11:51 AM by Kathy14225.)
RE: Can you tell if these are true CAs and OAs?
Just changed the EPR to 3 last night and much more comfortable. I was having centrals at the end but look at all these! There was also a lot of mouth opening which is very unusual, looks like I went backward instead of progressing!
Do you know what's causing all the centrals at the end of the night? I sleep on my back in an adjustable bed, no negotiating that since I have a spinal disorder. When I had my pressure at 9.2 the air was blowing out my mouth like crazy. Until last night I had the mouth leaks under control. It may have been I took a muscle relaxer. I'm not willing to go back to taping, it's been since July that I trained my mouth to stay closed. I can try to go up .2 at a time but what difference will that make? Centrals can't be controlled by the CPAP anyway?
