[Health] Central apneas can depend on the sleeping position?

[kurata]

Hello

In my sleep study i had a AHI of 47 (around 39 obstrutive, 6 central and 2 mixed).

Then i started using an APAP. My AHI now varies from 2-18, 99% of them central. I watched some videos and
seems like that some of them may not be real, but anyway most of them are.

After some tests, I have the strong impression that when I sleep on my back the AHI rises. 

Does this make any sense? For central apneas the sleeping position should make any difference? If so, why? 
If not, what else could be causing such variation?

And an AHI <=5 is a good number? Or maybe should I replace my APAP with an ASV? 

[TimelyComics]

Welcome!

[Sleeprider]

We learn a lot more about your therapy from a couple OSCAR charts. You seem to be using the program, take a look at our wiki on Organizing your Oscar Charts, and we can perhaps connect the dots.

[Gideon]

This does happen and while I, and I'm sure Sleeprider both have ideas, it is always much better to base suggestions on the detailed OSCAR data than it is to guess.

[SarcasticDave94]

Welcome to Apnea Board. Yep we need to see some data to help us give the right suggestions. This is where OSCAR comes in.

Did the doctor tell you anything about your Apnea? Did you discuss test results, anything of that sort?

[kurata]

Thanks for your feedback.

I'm attaching 2 days: a good (with AHI=2.82) and a bad one (AHI>13).

I started the therapy on last 02/09. My preferred sleeping position (specially with a mask) is on my back, so in the first days
I normally slept in that position. Then I had the insight to try to sleep on my side to see if could help and it did (at least apparently).

I think it's important to say that my sleep is still very fragmented (even more than before, actually). Curiously, 
i feel my dreams are better now, but didn't notice any other visible improvement so far. 
My BMI is 22 and I'm physically active (I run 30km a week).

I read another post and then tried to lower my EPR to 1 cmH20, but didn't notice a meaningful difference. If you have any 
opinions on how to minimize the fragmentation it will be great.

I haven't discussed yet with my doctor (next appointment is only one month from now). 

Thank you very much.

[Sleeprider]

Part of the problem is that with a pressure range of 4.0 to 13.0 with EPR 1, your pressure is constantly changing. At 4 cm you don't get any EPR until pressure rises. When you used EPR to 3, your central apnea definitely increased a lot. I think you need to move your minimum pressure to 6.0, dial back the EPR to 1 and set a maximum pressure of 8.0. This is going to significantly reduce pressure fluctuation and disruption of your sleep, and keep you in the effective therapy zone longer.

[sheepless]

given the relative proportion of apnea in your sleep study, you might have mixed apnea, which requires a different machine. otoh, you had a lot more obstructives and many newcomers to cpap get pressure induced treatment emergent centrals that will dissipate in 1-3 months.

sleeping supine frequently worsens obstructive apnea and it's possible you're experiencing them on your back. however, I think it's quite possible that ca may be worse on your back but I can't say why. just my experience that when trying to nap without cpap on my back or in a semi reclined position like in a car or airplane, I have terrible ca, at least at during sleep onset since I'd be unaware in a deeper sleep.

but again, if you're new to cpap, give it some time before worrying too much about the centrals. meanwhile see if the guidance you get here improves things.

[SarcasticDave94]

I'd consider getting rid of the 45 minute Ramp that locks you to a pressure of 4. Even more important to nix it with the concern of the elevated Centrals. And not to be forgotten is the edits Sleeprider mentions.

[kurata]

I already set the new pressure range as suggested. First night was a bit more comfortable. I'll keep you posted.

Thank you so much for all the responses.