New to Airsense 10 and OSCAR from NEPA

[sfwood]

Hi, and thanks in advance for advice! 
Diagnosed with mild to moderate apnea not quite 10 years ago. Prescribed 7 psi. Don't have sleep study available. I used a Respironics REMstar, most recently with a Quattro FX mask, since diagnosis. The machine in recent months has reported nightly AHI of around 4-5. Having lost about 30 lbs a year ago and wanting better reporting, last December I upgraded to an Airsense 10 Autoset and Airtouch F20 mask. I set it on fixed 7psi for a couple of weeks and then switched it to auto 7-9psi where it has been since. I can't say I love the F20 which I can't seem to get to fit well, but leaks seem under control most nights. My OSCAR reports seem to be telling me that over the 2-1/2 months I've been using the new Airsense 10, my AHI has been steady at 2-3 but obstructive apneas have decreased while central apneas have increased. I have attached OSCAR reports from 3 nights, one with expanded views of some centrals. Hoping for any insights. Should I go back to 7psi fixed for a longer period (the two weeks being, admittedly, a bit short) to see if the centrals abate? And, are a few to a dozen centrals of 10-12 seconds per night something to worry over such that I should subject myself to a visit to a sleep doctor?
Thanks, Steve

recent OSCAR reports showing increased centrals and details:
   
   
   

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two older OSCAR reports with fewer centrals:
   
   

[sfwood]

Should also have mentioned, I turned off EPR (from 3 to off) when I first noticed centrals seeming to increase--shortly after switching to auto.  Thanks

[Gideon]

Any changes in your heart health? Any tendency toward SHF?
The last of the centrals show a CSR pattern BUT they do not have sufficient duration. They are telling me that you are near your apneic threshold on your blood CO2 levels.

What is odd in you comparison is that the old examples have a EPR=2m the new ones EPR=Off. Usually higher EPR lead to a higher level of centrals because it "washes out" the CO2, lowering the concentration of CO2 in your blood, removing a primary driver ("high" CO2) to your breathing.

To prove or disprove this theory, and to compare apples to apples, set EPR=2 for 1 night only and post your results.

[Osiris357]

wrong thread

[Gideon]

Your numbers, centrals included, are such that it would unusual for your doctor to say anything more than great job, awesome numbers.
Assuming these centrals are CO2 based, which I think they are, you have a few options.

1. EPR= 0 to avoid them and continue.
2. ASV, the traditional, and most expensive solution, your numbers say you do not qualify for this, so you would have to goo rouge
3. EERS, a method of rebreathing a little CO2 to raise the CO2 level in your blood above the apneic threshold. Most doctors will be unaware of this option. It require a mask modification This allows a higher PS/EPR to be used to treat hypopnea, flow limitations, RERAs, UARS

[sfwood]

Any changes in your heart health?  Any tendency toward  SHF?
The last of the centrals show a CSR pattern BUT they do not have sufficient duration.  They are telling me that you are near your apneic threshold on your blood CO2 levels.  

What is odd in you comparison is that the old examples have a EPR=2m the new ones EPR=Off.  Usually higher EPR lead to a higher level of centrals  because it "washes out" the CO2, lowering the concentration of CO2 in your blood,  removing a primary driver ("high" CO2) to your breathing.

To prove or disprove this theory, and to compare apples to apples, set EPR=2 for 1 night only and post your results.

No heart issues whatsoever (that I am aware of). However, I am nearing 60 and it's not like the good old days.  Have been fighting type 2 diabetes with diet and in the past couple of months have become aware of some nephropathy presumably from diabetes.  

I chose the details with the grouped centrals to show more of them in one screenshot.  Centrals are as likely to be scattered through the night as clumped, though clumping isn't uncommon, either.  What I do see pretty consistently is a change in breathing preceding most of the centrals (easier to see in the first detail with two centrals), which I hoped suggested I was just fidgeting. :-/  The second detail is the 20 mins before getting up, for what that may be worth.

I will try the EPR experiment and report back. Thanks.

[sfwood]

Well, here is a night's sleep with EPR turned back on at 2.  Centrals not noticeably increased, in fact are fewer and less clumped. Probably random changes from other nights.  The detail shows two more of my typical centrals preceded by a spike or blip or whatever it is.  Also included the overview page showing the trend over the 2-1/2 months.  Unless somebody thinks different, I'm ready to set it back on fixed 7 psi for a couple of weeks to see if that reduces the centrals back to the level they started out at.  Thanks.