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Backstory: I am Canadian and got a diagnostic after doing the a complete home test (2 nights, oxymeter, chest strap, nose sensor...) 19 AHI on my side 29.9 on my back. The Somnos team sold me a SleepStyle Auto CPAP Machine By Fisher & Paykel. I hate this machine, I have very bad result with it (12-30 AHI with the machine). The Somnos team tried to help, by swapping mask, switching from APAP to CPAP. (Pressure 12) Nothing is working, they said I am a difficult case and that they don’t have any doctor because of the Covid so they don't help me anymore. I was stuck alone without help, and without data, thanks to the SleepStyle. I found this forum and bought myself a new Resmed 10 airsense for her and punched settings myself. The Resmed is so much smarter than the Sleepstyle, first night my AHI dropped near 5, my sleep was better and the pressure in APAP lower than expected. This is the result from last night, if you can help me improve my result, I am open to test your settings recommendation. Thanks to this community, you’re help is beyond measure.
Your numbers are mostly central and all the common machines do absolutely nothing when central are present. Central Apnea is treated by avoiding central apnea.
Also be aware that Central Apneas are consistent, that is they are consistently inconsistent, they tend to bounce around.
We only need to see these charts, we will ask to see more if the need is there.
Left sidebar (without calendar and piechart.
Events
Flow Rate
Pressure (not mask pressure)
Flow Limit (these drive pressure)
Leaks
Let's look a 10 minute view of a couple of your central apnea events. This will let us evaluate the character of them. It is likely that your central apnea is treatment-emergent as you flush CO2 out of your system to below your apneic threshold resulting in a central apnea. This is what I will be looking for. Treatment-emergent central apneas ten to diminish to completely go away over a 2-3 month period as you body adjusts to pap treatment.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
Welcome there are a lot of very smart people on this site that can help
The first thing I saw was the looong ramp time that was used 2 times. While you are on ramp you are NOT getting therapy. It would be best if you could turn it off but if you don’t think you can do that reduce the length of time of the ramp. Most people just leave it off here.
2nd your main problem are centrals. Most of the time they are treatment emergents that go away after your body become adjusted to pap therapy. It happens because the pap therapy is working well and eliminating CO2 much better than without pap. It should get less and less as you continue with therapy.
We can try to make them less frequent by narrowing the difference between exhale and inhale pressure. To do that I would eliminate EPR and see if that helps.
Thank you for your help!
I will shut off the ramp and EPR tonight.
I am already amaze by the results of the Resmed vs the Fisher. I am already doing better. Is this normal going from one machine to another one ?
I understand that the central will tend to go away.
You are the best, I am kind of mad at my local sleep clinic. They sold me a 2000$ package without result and locked me without help.
I attached two 10 min slice of CA event, thanks again for your help.
Yes changing to ResMed makes a large difference. I moved from a Phillips dreamstation about a year ago and I had excellent results. I see Gideon has posted, he is outstanding I read but not post.
Those look to be CO2 driven breathing which is what I expected.
Any CPAP or variation will "improve" for breathing. In the case of Treatment-Emergent Central Apnea what happens is too much CO2 is flushed from your system. To understand this you must realize that while our breathing is complicated, with many different factor, The drive to expel CO2 from our system, not 'low' oxygen concentration, provides our main drive to breathe. When this level goes below the apneic threshold a central apnea occurs and we stop breathing. Not surprising is that now that we are not breathing the CO2 concentration builds back up and we start breathing again. The breathing, both the stopping and starting happens gradually, with successive smaller or larger breaths resulting in the typical waxing and waning of the flow rate. As CO2 goes high the body once again fluches CO2 out, again to below the apneic threshold as the cycle repeats.
Treatment with CPAPs and BiLevels without backup rate (forced breaths) is to avoid the central apneas which we accomplish lessening the efficiency of your breathing initially by lessening the difference in pressure between your inhale and exhaling by decreasing EPR in your case or PS or Flex on other machines.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
(04-29-2021, 01:19 PM)Gideon Wrote: Those look to be CO2 driven breathing which is what I expected.
Any CPAP or variation will "improve" for breathing. In the case of Treatment-Emergent Central Apnea what happens is too much CO2 is flushed from your system. To understand this you must realize that while our breathing is complicated, with many different factor, The drive to expel CO2 from our system, not 'low' oxygen concentration, provides our main drive to breathe. When this level goes below the apneic threshold a central apnea occurs and we stop breathing. Not surprising is that now that we are not breathing the CO2 concentration builds back up and we start breathing again. The breathing, both the stopping and starting happens gradually, with successive smaller or larger breaths resulting in the typical waxing and waning of the flow rate. As CO2 goes high the body once again fluches CO2 out, again to below the apneic threshold as the cycle repeats.
Treatment with CPAPs and BiLevels without backup rate (forced breaths) is to avoid the central apneas which we accomplish lessening the efficiency of your breathing initially by lessening the difference in pressure between your inhale and exhaling by decreasing EPR in your case or PS or Flex on other machines.
I just want to say thank you again. I donated to the board as a big thank you.
This is the best explanation I ever got, long live to this board.
