[CPAP] pwnorris - Advice for Central Apnea Therapy

[dataq1]

I don't suppose you have any technique for safely increasing blood CO2 levels 

Actually, exercise will increase blood CO2 levels..... but I don't imagine that you want to exercise while sleeping!

Now, if the preceding video didn't present respiratory regulation in it's complexities and you want more detailed information on the relationship between blood gases and respiration, I'd suggest this video:
Blood Gasses

Will probably provide more information than you want, but is useful background.

Note that in Respiratory Failure Type 1, the Pa02 is NOT inversely related to PaCO2.  (@4:21 in the video)

Also note that supplemental 02 is discussed (at 2:51 in the video) with some interesting comparison related to the delivery method.  (how you bleed 02 into your cpapmask and mixes with the flow of air (@21%) generated by the cpap)

The whole subject of CENTRAL sleep apnea is fraught with medical complexities. That is why I asked above if your medical professional has diagnosed you with central sleep apnea.

Your OSCAR posts clearly indicate that you have clear airway apneas BUT that alone does not mean that you have central apnea.

Note also that: 

 Moreover, some people hold their breath or under breathe when they are stressed or anxious, which can cause hypoventilation .

Try to breath easy.....

[pwnorris]

Actually, exercise will increase blood CO2 levels..... but I don't imagine that you want to exercise while sleeping!
...
Note that in Respiratory Failure Type 1, the Pa02 is NOT inversely related to PaCO2.  (@4:21 in the video)
...
The whole subject of CENTRAL sleep apnea is fraught with medical complexities. That is why I asked above if your medical professional has diagnosed you with central sleep apnea.

Again, interesting information. Thanks!

Given the episodes of repeated low oxygen which may manifest while I'm awake - in bed but not active, and that they may last for several hours - in conjunction with clear airways, getting up and "exercising" - or at least moving around - may not be as crazy as it sounds. If I knew I could solve the problem with 20 minutes of moving around and therefore normalize the CO2 levels I'd be happy to try.

An item that was interesting was the part on Respiratory Alkalosis. The speaker mentions that while hyperventilation causes low PaCO2, it is generally with high PaO2. My respiration rate can be high, and often precedes the CAs. I have the sense that sometimes I stop breathing, even during the day. I guess the solution is capnography, but that seems to be only possible in a clinical setting.

I had my first follow up study in January after being diagnosed in 2017 with severe sleep apnea, but the clinic that performed the study still hasn't contacted me about the results after 7 months. They are particularly bad and have a lousy rating. I live in Ontario, Canada so don't have much choice about clinic. Ontario's state funded health care can be very good, but sometimes not so much. Not if you want to find out quickly anyway.

All that to say, I haven't been diagnosed with Central Sleep Apnea - or at least - not yet. It may be OA but if it is, it's very sporadic. I can sleep in precisely the same position during the same sleep session, and for 2 or 3 hours I have the CAs at frequent intervals, then sleep soundly for the rest of the night.

[pwnorris]

Earlier in this thread Gideon suggested that my "CA events are mis classified obstructive events".

I guess he's right. I tried a cervical collar and that didn't work for me.

But after a particularly bad series of high AHI values with numerous CA events, I recently bought a CPAP pillow based on the "what is there to lose" approach.

And amazingly my AHI scores have dropped considerably to the point where over the last month I'm on an average score of around 2.5 per night, and the number is slowly dropping. This last week the average was less than 1.

The name of the pillow is: IKSTAR CPAP Pillow for Side Sleeper

No idea why this works for me except it clearly positions my neck differently. Whatever the pillow does works for me. Clearly, others may have other causes for their AHI scores, but if you've tried everything the pillow isn't that expensive

I can recommend the IKSTAR CPAP pillow. The downside is that the pillow is quite firm. But that's probably why it works for me.