My Experience So Far (and thoughts on changes to therapy)

[Esq.]

It helps to look a bit closer at the event duration and even the flow chart detail to see if respiration tails off and back on which is more characteristic of CA, or if the transitions are more abrupt.  The machines are less than perfect in their interpretation of apnea as compared to more sophisticated PSG.  In your case the CA seems to correlate with some flow limits and leaks, so this might point to some lighter sleep, movement and other causes than a central respiratory failure. We can look at a closeup of the flow rate wave form if you want.  For the most part your respiratory and pressure statistics look pretty good.

What SleepyHead data is helpful for this and how far should I zoom in on each episode?

[Hojo]

With the cursor hovering over the graph side of the screen, start taping your mouse (for me on my Mac Lap top), its the mouse (pad).  Tap it several times, the more you tap, the more it zooms in.  You will notice on the top of the screen under "Events Flags" the screen will go darker to the events that you are 'blocking' out, while the inner portion turns white, to the event you are zooming in.  The more you tap, the more defined the area (10 min, 5 min, 2 min).

To reverse it, put the cursor on the left side of the Events Flag, click on it and drag the cursor to the other side.

[Esq.]

So here are some zoomed in SleepyHead shots showing some clusters of CA events. I've moved the respiratory rate and tidal volume graphs to the top (letting snore fall out of view). Anything noticeable here?

[Sleeprider]

I have never paid much attention to resp rate and tidal volume charts. I was looking at my data and I don't even chart it, but yours do look like some kid scribbled outside the lines.  I don't see anything too alarming there, and really don't even know what to expect.  Median rates are good.  

[Esq.]

I have never paid much attention to resp rate and tidal volume charts. I was looking at my data and I don't even chart it, but yours do look like some kid scribbled outside the lines.  I don't see anything too alarming there, and really don't even know what to expect.  Median rates are good.  

Ahh my bad. I read your earlier quote as wanting to see resp rate. Is flow rate what you wanted to see?

[Sleeprider]

like this



or this, depending on how messed up you are...

[CTcentrals]

Sleeprider: I've got to ask. Is that top graph one of your personal samples?

[Sleeprider]

  Yes it is.

[Esq.]

I see. I'll focus way in on a few individual CA events and post the data this evening.

I turned EPR off last night, and it was a horrible night. My AHI was up close to 5 (highest it's been in over a month), I had bad leak issues, and I think I experienced my first night of significant mouth breathing, because my mouth felt like it was full of sand mixed with glue (concrete, perhaps) this morning (which might explain the leak issues). And that was with a chinstrap and cervical collar. It might be 100% unrelated to turning off EPR, but it was the worse night I've had in some time. I feel pretty terrible today.

[Sleeprider]

Actually it is good news that EPR is not a contributor to centrals and higher apnea. I think it points to the potential for bilevel, with even more pressure support,to resolve many of your issues without making centrals worse. Set your pressure and EPR where you find the most comfort and best rest.