Titration Question

[retired_guy]

That could just be because you are shaking the tree a bit with the new machine and settings. As long as you're under 5, you're good to go. I'd try it again tonight and see where you're at. Your max may need to come down a little, but I wouldn't do that just yet.

[Stargazer]

Well, after further evaluation of the data, I have noticed for the first time I have been having central apneas with the new auto setting. Never had them w/straight cpap at 11 cm.

Also, much more apneas in general with longer duration vs hyponeas. I've had 8 and 9 apneas on consecutive nights now with at least 7 hrs of sleep where on straight cpap, I only had one or two per night.

Is that a cause for concern or just bc I need to get used to the new pressure range setting? AHI is still well under 5, however.

CORRECTION: The first night w/the AutoSet, it was set back to cpap mode at exactly what my Elite was set at (same EPR, ramp, etc). I went to apap mode for the first time last night with what the doc set; 10-15.

Still, with the new machine, central apneas have shown up both nights where on the Elite, I've never had them. Not sure why this machine has registered them and the Elite did not.

[PaytonA]

Did the data from the Elite distinguish between OAs and CAs? I ask because my machine was invented around the same time retired_guy invented dirt. ;>)

Best Regards

PaytonA

[Stargazer]

Did the data from the Elite distinguish between OAs and CAs? I ask because my machine was invented around the same time retired_guy invented dirt. ;>)

Best Regards

PaytonA

I'm not sure if it was capable, I guess that's my question as this is the first time I'm seeing them. First night with the auto was identical setup in cpap mode to the Escape settings yet saw the central apneas.

[zonk]

Did the data from the Elite distinguish between OAs and CAs? I ask because my machine was invented around the same time retired_guy invented dirt. ;>)

Best Regards

PaytonA

No. This is the first time seeing them. First night with the auto was identical setup in cpap mode to the Escape settings yet saw the central apneas.

Both S9 Autoset and S9 Elite distinguish between obstructive apnea and central apnea, S9 Escape Auto don't

[retired_guy]

That could just be because you are shaking the tree a bit with the new machine and settings. As long as you're under 5, you're good to go. I'd try it again tonight and see where you're at. Your max may need to come down a little, but I wouldn't do that just yet.

You may have missed this earlier Star, because you and I were posting at about the same time.

The biggest thing is don't stress about the CA's at this point. See what happens tonight.

[Stargazer]

Both S9 Autoset and S9 Elite distinguish between obstructive apnea and central apnea, S9 Escape Auto don't

Well, that's a bit puzzling then. The only variable was the new AutoSet. I used the same exact settings as I had on the Elite the very first night. Double checked everything and yet still, the CA's showed up. Went to auto mode the next night and they showed up again. Very strange!

AHI's still held firm at <2 with both machines so, I have no clue!!

[vsheline]

Well, that's a bit puzzling then. The only variable was the new AutoSet. I used the same exact settings as I had on the Elite the very first night. Double checked everything and yet still, the CA's showed up. Went to auto mode the next night and they showed up again. Very strange!

The only variable? Many things can affect the frequency of our central apnea events.

For example: sleep position, pillow position, temperature, how many hours we are sleeping, what time we go to bed, stress and anxiety, common non-prescription medications, what time caffeinated drinks taken, changes in consumption of alcohol, changes in vitamins and supplements, changes in diet and exercise, developing or recovering from anemia, developing or recovering from heart or lung conditions, etc., all these things may have an influence.

There is some anecdotal reports that having a little coconut oil with the evening meal reduces central apnea in some patients. It depends what the causes are. In my case I think I have slow blood circulation from bradycardia. Others may have other conditions.

But in most cases patients simply need a few weeks or months to adapt to being under pressure while asleep, and the central events will eventually become rare, a couple per hour or less.

Yours are only a couple per hour or less now and will likely become less frequent within weeks or months. By the way, most insurance companies in USA do not upgrade a patient to a machine capable of treating central sleep apnea unless the number of central apneas per hour is at least 5 or 10 or 15, depending on insurance company.

Take care,
--- Vaughn

[Stargazer]

The only variable? Many things can affect the frequency of our central apnea events.

Yours are only a couple per hour or less now and will likely become less frequent within weeks or months. By the way, most insurance companies in USA do not upgrade a patient to a machine capable of treating central sleep apnea unless the number of central apneas per hour is at least 5 or 10 or 15, depending on insurance company.

No, I definitely get that about the variables. In my case, it's not about frequency, it's about centrals or "clear airway", showing up for the first time with the new machine. For all intents and purposes, the main variable was the new machine. My AHI's have stayed at or below 1.5 consistently with both machines. However, hypopneas have all but disappeared with centrals taking their place in the new AutoSet.

I have since learned that the AutoSet has an advanced central apnea algorithm. So, it now finally makes sense as to why the CA's have been showing up with the AutoSet where they never had before.

No worries, it was just more of a curiosity. I hate unsolved mysteries!

[vsheline]

I have since learned that the AutoSet has an advanced central apnea algorithm. So, it now finally makes sense as to why the CA's have been showing up with the AutoSet where they never had before.

Sorry to keep that unsolved mystery alive and well, but although only the S9 AutoSet has the new Enhanced AutoSet Algorithm (introduced around 2010) for automatically adjusting the pressure, actually both the S9 Elite and S9 AutoSet share the same Central Sleep Apnea Detection algorithm.

This info can be found on the ResMed website, but you can also call ResMed Customer Service line to talk to a technical representative to confirm both machines report central apneas using same detection algorithm.