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Is this Cheyne-Stokes? Should I be worried?
#1
Is this Cheyne-Stokes? Should I be worried?
Are these photos concerning? Are they Cheyne-Stokes? This pattern appeared a few times in my Flow Rate. 

While we are on the topic, some of the flatter parts of the pattern didn't get flagged as CA, I know it's because they're not 10 seconds long. This leads me to ,y next question, is it possible for there to be central hypopneas? I get a good amount of these a night. I know they could be treatment emergent. But if they do not go away in some months, should I be concerned and consider an ASV?

BTW: I do experience chest pains, that are worse when I don't use my machine. Im about 1.5 weeks into treatment. I have flow limitations so EPR is on 3. And I have mild OSA.  Sleep study results = 9.4 AHI 17.7 RDI. Thanks.            
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#2
RE: Is this Cheyne-Stokes? Should I be worried?
BTW here is a screenshot of the whole night.


Attached Files Thumbnail(s)
   
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#3
RE: Is this Cheyne-Stokes? Should I be worried?
Likely not CSR. Resmed tends to call periodic breathing CSR.

Your numbers look really good. How is your sleep quality?
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#4
RE: Is this Cheyne-Stokes? Should I be worried?
Ironically, this wasn't flagged as CSR.
My sleep is ok but could be better.. feeling a little human today for the 1st time.
Do you think these periodic breathing patterns are causing me any harm? These centrals are worrying me.
And as I asked in my OP, can these technically be hypopneas as they are short periods of central apneas? How do I treat them besides lowering EPR?
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#5
RE: Is this Cheyne-Stokes? Should I be worried?
There is nothing in your OSCAR charts to be concerned with right now. Some arousals going on, but they and your CA’s may settle down over time. Your CA’s are likely TECSA, so just keep an eye on them. It can take a month or two for them to go away as you get used to therapy.

I do suggest turning off ramp as it is not doing anything. Also consider turning min pressure up to 9 so your settings would be 9-15. You may have to increase EPR to 3 (it is on 2 in the posted chart) with the pressure increase, but see how it goes first.

Things are looking really good. Keep at it, you are doing quite well.
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#6
RE: Is this Cheyne-Stokes? Should I be worried?
What should I do about my CA’s if they don’t go away? Btw this photo is some days old. I’m now at EPR 3 with a pressure of 10. Somehow I snored last night, leaked a bunch, and had way more flow limitations.
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#7
RE: Is this Cheyne-Stokes? Should I be worried?
Please post the new chart. I can only comment on ones that are posted.

If the new settings give similar results to the posted one, do nothing. It is fine. Now, if you start seeing a consistent increase in CA/AHI, then we have to deal with it.
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#8
RE: Is this Cheyne-Stokes? Should I be worried?
            Here is my report from last night. My AHI went up from the previous day (0.8) largely due to centrals. I had more centrals last night since my first day of therapy, but I’m not sure why, as my EPR has been on 3 for 3 nights now. Also my 99.5% flow limitations aren’t looking good. Will up pressure for that, but am worried about the centrals.
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#9
RE: Is this Cheyne-Stokes? Should I be worried?
First, I don’t think you have anything to be worried about right now with CA’s. You are not even two week into treatment and still settling into the new routine. Give it time. Things will vary nightly. Different sleep times, napping, alcohol, recreational drugs, eating late, etc. It all affects sleep. 

Any nasal congestion when you go to bed? How about your pillow, is it causing a neck kink laterally? That big jump at 04:45 may be as simple chin tucking. A soft cervical collar may be of use. Before tweaking things too much, pay attention to your sleep hygiene. No eating a few hours before bed, relax, no TV or phone, etc. A simple thing like laying off caffeine after lunch can make a big difference.

Once you get settled into the new routine, we can address the arousals. Big things first like sleep hygiene and chin tucking, then zero in on playing with pressure, EPR, response. Don’t shoot for AHI 0.0. It is made of that rare metal unobtanium and will rarely be found. Focus on sleep quality.

Give it a few more days then post a chart. You are doing fine.
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