[CPAP] Is this healthy sleep?

[lucky474]

Is this considered healthy sleep? AHI under 5...

My original at home sleep test gave me an AHI of 8...But I think I only got a short amount of sleep that night, definitely not a good sleep.

When I use the CPAP for 4 hours a night my AHI is always higher. I wonder if I even have obstructive sleep apnea now. Surely they would have known, or can they not differentiate between all the different sleep disturbances?

Basically is this healthy sleep or should I be aiming to get rid of those central apneas? and how would I do that?
Have had days where i've felt a lot better since cpap use but then days where I am still very anxious and down like the last couple of days (sleep screenshotted)

I'm in the UK

[G. Szabo]

Apparently, changing your EPR from 3 to 1 did not decrease the number of CAs, which is a bit unexpected. Try to turn it off entirely; if you still have CAs, post a few magnified (3-4 minute window) ones to ensure these are real CAs.

[Deborah K.]

Yes, you are having healthy sleep,  Did you have a lot of CAs in your sleep study?  I'm guessing not, in which case your CAs are treatment-emergent and will lessen on their own as time passes.  Don't worry about them.  You are doing very well.  

P.S.  Leave your EPR set at 3.  Changing EPR does not have any effect on CAs; it is used to tame flow limits and to make breathing more comfortable.

[G. Szabo]

 Changing EPR does not have any effect on CAs 

OpalRose wrote:
03-27-2018, 06:38 AM
RE: Can EPR use cause Central Apnea Events? 
"With that said, if you spend enough time on this forum, you would quickly notice that when we see a high CA count, the first thing we look at is if the person is using EPR. At that point, we most always recommended that they lower it or turn it off completely to see if that helps."

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Sleeprider wrote
03-27-2018, 05:00 PM

RE: Can EPR use cause Central Apnea Events?
"higher EPAP or positive end expiatory pressure (PEEP) improves oxygenation. Individuals who have a tendency towards central apnea need steady fixed pressure without pressure support or EPR." 
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These are just two comments among the many similar ones. 

[Deborah K.]

What you say is true, but unless Lucky's CAs were high in his sleep study, they are likely treatment-emergent, and there is no need to worry about them.  That is why I advised him to stay with EPR 3 since that setting is more comfortable for most folks.  If it turns out that he had a lot of CAs in his sleep study, then it's a different matter.

[OpalRose]

G. Szabo,

You took two quotes from a different time, a different situation. What I'm saying is that the advice we may give to one member may not be the same advice we'd give to another.

There are too many variables in our sleep that cause what we see on our charts.

I have seen the use of EPR have absolutely no effect on CA's one way or another....
yet another person clearly will see relief from CA's if EPR is lowered. Also, EPR affects more than just CA's, like Flow Limitation and Hypopneas. It can also give relief to folk that suffer from Aerophagia.

The bottom line is... there is no one size fits all when advising the use of EPR,
you have to look at the total picture.

[G. Szabo]

OpalRose,

Am I mistaken in thinking that it is a common practice that "when we see a high CA count, the first thing we look at is if the person is using EPR. At that point, we most always recommended that they lower it or turn it off completely to see if that helps"? (This is a pretty general statement without specifics mentioned. I can provide you with a few dozen similar general statements within and outside this forum, a few of them delivered by advisory members). I was precisely advised that.

I do not think it is wise to discredit someone's suggestions, which are in line with the general consensus, and deliver such a sweeping statement as "Changing EPR does not have any effect on CAs," which is clearly false, because, as you admit yourself, " yet another person clearly will see relief from CAs if EPR is lowered."

I agree with you that "The bottom line is... there is no one size fits all when advising... you have to look at the total picture." But it this case we have not seen a bit yet about the total picture. This is why some wise considerations should be made before discrediting helpful suggestions.

I understand that you feel obliged to defend your team, which I acknowledge and respect.

[OpalRose]

OpalRose,

Am I mistaken in thinking that it is a common practice that "when we see a high CA count, the first thing we look at is if the person is using EPR. At that point, we most always recommended that they lower it or turn it off completely to see if that helps"? (This is a pretty general statement without specifics mentioned. I can provide you with a few dozen similar general statements within and outside this forum, a few of them delivered by advisory members). I was precisely advised that.  

I do not think it is wise to discredit someone's suggestions, which are in line with the general consensus, and deliver such a sweeping statement as "Changing EPR does not have any effect on CAs," which is clearly false, because, as you admit yourself, " yet another person clearly will see relief from CAs if EPR is lowered."

I agree with you that "The bottom line is... there is no one size fits all when advising... you have to look at the total picture." But it this case we have not seen a bit yet about the total picture. This is why some wise considerations should be made before discrediting helpful suggestions.

I understand that you feel obliged to defend your team, which I acknowledge and respect.

I'm not defending anyone.... you can send me a PM if you wish to discuss further.  I don't think hijacking this thread with disagreements is fair to the O.P.