Recent increase in Central Apneas and AHI

[Colt45CCG]

Hello, I'm hoping for some feedback from the experts here.  1) Does anyone have any thoughts on why my central Apneas are way up? 2) Any ideas on how I can improve the treatment?

I've been using my Dreamstation APAP 100% for about 3 years with an average AHI of 1.6 (its been great) with an average of .27 OA, .7 CA and .8H.  

For some reason over the last couple of weeks I have seen a huge increase in central apneas (on the order of 30-50 a night) with very poor sleep, a lot of wakeups, etc.  I'm seeing AHI all over the place 1-9, I'm waking up constantly, I'm dead tired, its almost worse than it was before treatment...

I have lost about 10 lbs this year, but it seems odd that it would culminate so suddenly last month and then fluctuate between great nights and poor nights.  I cant think of anything that would be causing this variance in my daily routine.

I have a sleep consult & study scheduled for late June, but hoping you may have some ideas or tips for the interim.

I've included two samples:  4 May = great sleep night and 8 May = bad sleep night.

Good Sleep Night
   

Bad Sleep Night
   

Any help or thoughts would be greatly appreciated.  I've already learned so much from this board, I had no idea there was a community like this!!

--Colt

[Gideon]

Welcome to the forum.

Based on your bad night I'd turn off your Flex. Higher values of Flex will tend to increase Centrals.
Why the difference between good and bad nights? Central Apnea is consistently inconsistent. In other words, it can unpredictably jump all around.

[Colt45CCG]

Thank you Gideon - I was hoping you would have time to take a look at this!

I thought the EPR might be a factor, but had no clue if more or less was needed. I will turn it off for a few nights and report back.

[Sleepinwell]

I don't see your APAP ramping up during the multiple events.... regardless of flex.

gradually raise your pressure above the minimum to prevent events. APAP is really worthless.
Flex is comfort... as long as you're comfortable with it turn it off. Flex will be a problem. Your leaks aren't good...

[SarcasticDave94]

Actually, the OP leak rate isn't bad. Respironics units you need to gauge leaks by the lower trace line.

[Sleepinwell]

This is more like it, and the Vitera is the answer. Leaks mean less therapy. Lower trace line? What is the upper one for? I'll say it again as I said numerous times...... scrap APAP's.



   

[SarcasticDave94]

And again please note that your ResMed leak graph versus the original posters Respironics will look quite different. Your ResMed shows a single trace line while Respironics DreamStation shows two trace lines.

[Sleepinwell]

what's the second trace line represent?

[SarcasticDave94]

Respironics upper leak line is total leaks while the lower one is what I call unintentional. That would be mouth or mask leaks.

[Sleepinwell]

so the upper graph is the one that counts then ! LOL