Central vs Obstructive Apnea

[ChadBSr]

Unfortunately autoset, EPR, ramp, anything with variation increases centrals. I know my post is questioning the validity of some of those but I know that I'm having at least some actual CSA caused by the machine. Really I'm trying to get to a point I can more accurately look at the chart and decide which is happening because at this point I'm trying to balance OSA and CSA. I think you're right that the false ones are probably me awake.  What did you see that lets you know about the swallow?

I think I need to be around 10-11 cm for effective therapy, but anything around 10 I have more centrals reported than I had OSA with no therapy at all. I'm experimenting with EERS soon to hopefully be able to handle a higher pressure and maybe autoset and EPR.

[srlevine1]

@ChadBSr

A few words of caution.

When experimenting, change only one variable at a time, keep meticulous records, and look at a trend before changing settings. Do not overlook underlying medical issues, medications, supplements, or other confounding variables.

While Enhanced Expiratory Rebreathing Space may be useful for certain respiratory conditions, it is important to be cautious of its potential adverse effects, particularly on the cardiac and pulmonary systems.

The technique should be used under medical supervision, especially for patients with cardiovascular or pulmonary diseases, to minimize the risks of complications such as increased blood pressure, arrhythmias, air trapping, and hypoxia.

[ChadBSr]

Yes, I've been through all different settings. I don't have any underlying conditions except vitamin d deficiency, and very slightly elevated blood pressure and cholesterol.  I have a BMI at the upper end of "normal". 

While using CPAP my tidal volume is low. My pulse is always low.   I expect EERS will only raise these to "normal". I'll be wearing an o2 monitor when I use it. To your point though, I probably should also monitor blood pressure.

I'm also due for a physical checkup in about 6 weeks. But as far as someone monitoring me, I'm on my own with therapy. 

If I don't see immediate results with EERS I will likely be buying a bipap. Its either that or just live with whatever balance I can find between OSA and CSA.

[Deborah K.]

It would be best if you listened to Sleeprider. He knows sleep apnea inside and out and has enormously helped many people.

[ChadBSr]

It would be best if you listened to Sleeprider.  He knows sleep apnea inside and out and has enormously helped many people.

I'm sure that's true, but as I've said I've already been at a similar pressure as suggested and both autoset and EPR increase reported CSA.  The settings he suggested, while probably exactly what I need for OSA will result in an AHI worse than pretreatment.

[Jay51]

Another option to consider might be to make a push for either ASV (specifically for CSA - It treats OSA as well)) or ST (treats CA's - and OSA as well), but is for patient's with lung diseases, neurological conditions, etc.  Showing you Dr. evidence of all the CA's you are having would be a great 1st step.  

You could even explore the 2nd hand market for one of these machines (ASV) if you don't want to use your insurance.  

Just a suggestion is all that this is.

[ChadBSr]

Another option to consider might be to make a push for either ASV...

Yes if EERS isn't helpful I will look for another machine. I'm considering buying the ibreeze ST30

[SarcasticDave94]

The ResMed machines will be better for you in therapy. Have you searched for DotMed? They sell new and used machines.

[ChadBSr]

I have experimented with a makeshift taped together EERS. I started with autoset with EPR on 3. I found it interesting that my tidal volume increased and I had similar AHI to when I was using a set pressure, no EPR, and vcom. The second night I dropped EPR to 2 and last night I dropped it to 1.

Last night is the first time I have ever had ZERO spo2 drops greater than 4% or 3% and no pulse increases over 73. AHI was under 1

My tube and valve has arrived so I can lose the taped together mess tonight and probably turn EPR off but keep autoset on.

EERS is looking very promising so far

[Sleeprider]

I don't know how you came up with EERS, but it sounds like a great idea. I assume you have seen our wiki. https://www.apneaboard.com/wiki/index.ph...ace_(EERS) Once you get things sorted out, I'm looking forward to your feedback and perhaps some images of your EERS construction.