Central Apnea question

[Sleepster]

The CA's being reported by the S9 are actually hypopneas that the theory is the pressure is too low and not treating them fully so the s9 is reporting them as CA events.

In my opinion, and I'm just saying this based on my understanding of the situation in an attempt to help you, that the CA's being reported by the S9 might actually hypopneas.

This is a dilemma, because if you're having CA's the rememdy is to lower the pressure, and if you're having hypopneas the solution is to raise the pressure.

I have tweaked my settings in an attempt to resolve dilemmas like this. I would adjust the pressure by 0.5 cm one way or the other, and then collect data for a month to gauge the effect.

I have another issue to contend with, though, which is aerophagia. When the pressure is too high it gets worse. I was titrated at 13 cm, but I've found that 12 cm is the highest I can handle. Next year I may try to get my insurance company to pay for an auto-BiPAP to see if we can get the the AHI lower than 2. My sleep doctor seems to think that it may be worth a try to do that to treat my fragmented sleep.

[jbuchanan6196]

Great responses everyone! Looks like I started a pretty good conversation. Sorry I have not been on here sooner, it hasn't notified me of the new replies! Whats new:

I upped my pressure from 7 to 8 the last two nights and got these results:
Night 1: 1 obstructive, 2 central, 1 hypopnea, max leak only 10.8
Night 2: 1 central, 2 hypopnea, max leak only 9.6

Compared with the night before I changed pressure, which was:
1 obstructive, 6 central, 4 hypnopnea, max leak 26.4

Coincidence or did I make a difference changing pressures? I will keep a close eye on the data the next few nights and see what it reveals. Keep up the great work friends and

[retired_guy]

Those are all excellent numbers. Now, don't futz with anything for awhile, say at least 2 weeks and see what happens. As a matter of fact, with these numbers you really don't need to futz with anything anymore. But especially for awhile.

[Peter_C]

I agree with retired_guy

[retired_guy]

Now here's the thing: Yeah, jbuchanan6196 is getting great numbers and should not futz with them anymore. I know that, he knows that, all us guys know that. But that's the problem: We're guys! Futz is what we do best! Our truly really secret motto is "If it's NOT broken, break it so we can figure out how to fix it."

All of that is really exceedingly complicated by our tendency to have models of these machines that have so many options. So much to futz with, so little time. There are literally zillions of possible combinations of dial settings that we can experiment with.

I'm thinking maybe we need a 10 step program here........... "Hello Barney? Sorry to wake you up at 3:00 am, but I'm having a tremendous urge to futz with my dials...... Can you come over?"

[jbuchanan6196]

Now here's the thing: Yeah, jbuchanan6196 is getting great numbers and should not futz with them anymore. I know that, he knows that, all us guys know that. But that's the problem: We're guys! Futz is what we do best! Our truly really secret motto is "If it's NOT broken, break it so we can figure out how to fix it."

LOVE this post! It's very true

[Peter_C]

Now here's the thing: Yeah, jbuchanan6196 is getting great numbers and should not futz with them anymore. I know that, he knows that, all us guys know that. But that's the problem: We're guys! Futz is what we do best! Our truly really secret motto is "If it's NOT broken, break it so we can figure out how to fix it."

All of that is really exceedingly complicated by our tendency to have models of these machines that have so many options. So much to futz with, so little time. There are literally zillions of possible combinations of dial settings that we can experiment with.

I'm thinking maybe we need a 10 step program here........... "Hello Barney? Sorry to wake you up at 3:00 am, but I'm having a tremendous urge to futz with my dials...... Can you come over?"

(INSERT LIKE BUTTON HERE)

[WakeUpTime]

AHI has been low, like around 0.5, I don't think its ever gotten up to 2.0 which I know is great. I'm fairly new to therapy.

An AHI of 0.5 is terrific! I've been on CPAP/BiPAP for about 5 months and I've never been able to get my Central Apnea Index below 5.0 and it's a struggle to even get my overall AHI below 10.

Sometimes but not always, experimenting with EPR or turn off if you can live without it, may helps.

I'm intrigued by your comment about turning off (or reducing EPR) as a way of reducing central events. I suppose "EPR" is "C-Flex" or "B-Flex" in the Philips Respironics world.

Are you new to CPAP therapy? Your body is not used all the extra oxygen you're supplying, and those elevated oxygen levels trick your brain into thinking you don't need to breathe.

That's a great point about the body's reaction to getting more O2. I'm beginning to think though that there are some that just can't get fully cured by CPAP alone. I had hoped that the body would settle after a few months of CPAP, or at least be on an ever-improving line. I read about a doctor that was diagnosed with severe SA that did everything (CPAP, surgery, dental appliance, etc.). Five or ten years later, she was finally able to throw away her CPAP machine.

Nothing is causing this, it's just a natural variation. It's like asking why it rains more on some days than others. That's just the way it is.

You're probably right, however I'm not sure if I'll ever give up the idea that there's something that can be done to improve poor sleep nights. The problem is that we're all in a new sleeping paradigm (as a result of being diagnosed with SA) where so many variables are in play (internal sleep clock, food sensitivities or consumption time, alcohol or other prescriptions, stress, exercise, etc.) in addition to the common fixed variables (throat/mussel/jaw/teeth design). Before Sleep Apnea, and when we were younger, lighter, healthier (or whatever), these weren't significant factors. Narrowing down which of those variables contributed most to a reduction in sleep quality for a particular night does seem extremely difficult though.

[Bama Rambler]

You can make the BiPAP act like an APAP. Just set the IPAP and EPAP to the same number and set the Mins and Maxes where you want them.

[WakeUpTime]

You can make the BiPAP act like an APAP. Just set the IPAP and EPAP to the same number and set the Mins and Maxes where you want them.

Thanks for that Bama. I had mistakenly initially thought EPR was referring to the exhaust pressure (EPAP in a BiPAP). I understand now that he was referring to the Philips equivalent C-Flex/B-Flex setting.

Regarding your solution, setting IPAP and EPAP to 11, with min. PS at 0 and max. PS at 6 (for example) would work? That's exciting. Many thanks for that tip! I'll try that tonight.