How to optimize my AHI, mixed results so far

[Gideon]

That seems to be a good balance. Based on that 10 min zoom most of your CA is CO2-based/Treatment-Emergent and as such over time should diminish as your body adjusts to a new normal.
How do you feel?

[turk0ZzZz]

That seems to be a good balance.  Based on that 10 min zoom most of your CA is CO2-based/Treatment-Emergent and as such over time should diminish as your body adjusts to a new normal.
How do you feel?

Yesterday I felt really good... Today not so great. Will keep these settings and hopefully they CA is treatment emergent. How can you tell this from the chart? As I did have about 30+ CA events in my sleep test. Wouldn't that indicate I had them pre treatment?

[Gideon]

The pattern of successive breaths gradually rising and falling, waxing and waning with many of these sets having a CA at the nadir. That is what you see when your body does not see the need to breathe because the concentration of CO2 is decreasing so the depth of your breathing lessens, sometimes to the point where your stop breathing (a CA event) and your CO2 is below your apneic threshold.  When you are not breathing your CO2 levels build and breathing resumes, slowly at first but building, frequently getting too deep and on\ce again flushing too much CO2 out repeating the cycle.

Yes you had centrals pre CPAP of an unknown character, here assuming the bulk of the others you have show the same pattern, treatment-emergent is a better explanation.  If I was reading the raw data, which we never see, from your diagnostic test I could render a more specific opinion on that.  We do generally assume that CA on the diagnostic test are idiopathic since they cannot be, by definition, Treatment-Emergent.  And they are idiopathic for us simply because we have no way to evaluate them beyond the fact that they occured.

[staceyburke]

I will let Gideon give you an explanation on determining emergents but I will say that a central can just be you holding your breath when changing position, pulling up covers. Sometimes we have quite a few centrals when we are in a sleep study and are restless.

[turk0ZzZz]

The pattern of successive breaths gradually rising and falling, waxing and waning with many of these sets having a CA at the nadir. That is what you see when your body does not see the need to breathe because the concentration of CO2 is decreasing so the depth of your breathing lessens, sometimes to the point where your stop breathing (a CA event) and your CO2 is below your apneic threshold.  When you are not breathing your CO2 levels build and breathing resumes, slowly at first but building, frequently getting too deep and on\ce again flushing too much CO2 out repeating the cycle.

Yes you had centrals pre CPAP of an unknown character, here assuming the bulk of the others you have show the same pattern, treatment-emergent is a better explanation.  If I was reading the raw data, which we never see, from your diagnostic test I could render a more specific opinion on that.  We do generally assume that CA on the diagnostic test are idiopathic since they cannot be, by definition, Treatment-Emergent.  And they are idiopathic for us simply because we have no way to evaluate them beyond the fact that they occured.

Ahh. I see what you mean. Thanks for the explanation. Would a "true" CA event just happen suddenly with a normal pattern of breathing before it?

[Gideon]

These are "true" CA events.
Idiopathic basically means for unknown reason.

Our main breathing cycle, to breathe or not to breathe is driven by CO2 levels and blood acid levels which are driven by CO2 levels. Not by the need for oxygen which simply makes you breathe faster.

[turk0ZzZz]

Would you characterize the CA events the same as the first set in the other 10 min view? To my untrained eye they look different, but would like to know what you see. I'm just trying to learn to interpret my own charts/events.

[Gideon]

All of these are arousals and most likely breath holding while tossing/moving.

There are hints at CO2 impacted breathing following the CA events, but I see 8t because of knowledge of the other previous. It is very subtle here. I would class these as SWJ,sleep wake junk

[turk0ZzZz]

Thanks for taking the time to explain it all. I will keep on keeping on and, hopefully, with time, the CA events will subside.

[turk0ZzZz]

What can one tell from this RERA? I remember waking up and looking at the clock on my nightstand.. It was exactly 3am. So I changed positions and then it was followed by a series of hypopnea events.