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Confused about CA's
#1
Confused about CA's
My sleep doc believes I need high pressure, be it CPAP or BIPAP however they only prescribe 'suboptimal' treatment of pressure 10 because the sleep tech said the higher pressures were giving me central apneas.
I wasn't feeling better because the low pressure wasn't really helping so I paid for a consultation with Jason at AXG (Youtube Lanky Lefty) who looked at my data on Sleep HQ and told me I needed to go higher. I am currently on pressure 16 and I Have been sleeping better. But my machine data says I have several CA's during the night. 
Are these the same as Central Sleep Apneas? I asked Jason about this and he said the central apneas were false positives.
I really don't know which tech is correct as one says I get them with higher pressure, Jason says I don't.
So if I see CA's on my data could they be false positives? And if they are real, are they really a problem? If so why? 
I guess I'd rather take the risk of having them if I'm overall getting better sleep but I'm not very knowledgable about whether its really bad to have some occurring.
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#2
RE: Confused about CA's
In most cases they are treatment emergent and will lessen with you getting use to the therapy. I would stay on the treatment and reevaluate in 3 to 4 weeks. Also remember that CA are inconsistent - meaning one day you may have a few the next day you will have many more with the same settings.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Confused about CA's
I have used Jason as well and found him to be very knowledgeable. His recommendations were spot on, though his pressure suggestion was higher than I expected. I dialed it back over time from 16/12 to 12/8, and found numbers are still good just a much more comfortable therapy. He has his own view on things and it is another data point to consider. 

There are many of us here with years of CPAP experience, both as users and helping others. Post some charts and folks can dive in with suggestions.
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#4
RE: Confused about CA's
Jason has a lot of experience reading flow rates and likely zoomed in on your "central apneas" and saw it was a position change / breath hold and nothing to worry about.

Are you using EPR? If so, what level?
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#5
RE: Confused about CA's
I did not get to my therapy pressure without Treatment Emergent CAs. Overtime they lessened to where I occasionally get a legit CA about once every third day, The ones you are experiencing may not be real. Post some OSCAR Reports with CAs included. These helpful people will guide you along.
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#6
RE: Confused about CA's
You said you are having several CAs overnight, so am I. The questions are you having excessive CAs?

The simple use of a CPAP, higher pressures, or higher differential pressures may, not will, cause central Apneas. Please post your daily OSCAR charts so we can see.what is going on.
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#7
RE: Confused about CA's
Thanks for your imput. I think I'm overly fixated on this concern. I'm also going to try a cervical collar if I can find one that will keep my chin up
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#8
RE: Confused about CA's
Most people do have a few to some Central Apnea. If it's in the higher count status, or if they showed in numbers equal to 50% or higher of the total events on the PSG sleep study, then it's another issue in my opinion. The latter situation would be like mine I suppose, predominant CA at 124 versus 24 OA, as in lots of purple CA flags in OSCAR.
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#9
RE: Confused about CA's
            Here are a few of my charts
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#10
RE: Confused about CA's
My opinion is your settings are not optimal. If you are willing, try setting your mode to Vauto, EPAP min 8, IPAP max 15, EPR 4 full-time, no ramp. Depending on how that works out you could set your trigger to high, but lets see how CA’s look at those settings.

Give those a try and post some charts. If any issues please let us know right away.
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