TreatmenT emergent central apnea

[Stracky]

I have been using the resmed 11 for approx 3 months for moderate obstructive  apnea *26ahi .  I got used to machine very quickly although it hasn’t seemed to improve my sleep.  I am now waking almost every hour and it seems I now have Central Apnea’s .  Oscar is telling me some are 29sec and my arms and hands get pins and needles when I wake.I also have heaviness in my chest (have been checked by cardio /X-ray/ct scans/heart monitor) he doesn’t think it’s heart related.  Last night was terrible , barely slept 2 hours & machine tells me 5.9 central’s.  I feel exhausted very sore and at my wits end.  I asked my sleep doc if I should try BiPap and he said he didn’t want to complicate things.  My whole quality of life is affected and not sure what to do next.  The only sleep I get atm is with a sedative.  Any help would be appreciated,,!

[Deborah K.]

It looks like you have already downloaded Oscar, our free apnea reporting program.  Post a couple of night's charts if you have been recording your sleep, and we will probably find information that can help us help you.  If you haven't used Oscar yet, put a 32GB or less SD card in your machine tonight and then post a chart tomorrow.  Oscar will tell us a great deal about your sleep and hopefully, we can offer you good advice.

Again, welcome, and good luck!  

[Stracky]

       

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Thanks Deborah - I think I have attached the last 2 days charts.  Both nights I had awful sleep but seems the numbers are quite different - would appreciate your comments as I'm ready to toss the machine out of the window!

[Crimson Nape]

I would turn the ramp off, set the minimum pressure to 9 and the maximum to 10. This is a narrow enough range not to disturb you on pressure changes. This is not the final settings, but just a start. See if you feel any better, first.

Also, why are you reporting data for a year from today (09/25/2025)?

- Red

[Stracky]

thanks Red - do you think it could be the change in pressure that could be causing the Centrals?  (I am very new to all this and my doc is away) I Had no centrals on both my sleep studies and they have gotton worse since CPAP started 

The date issue may be cos I'm in Australia and we have a different format ie today is 26.09.24

[Crimson Nape]

They could be treatment emergent. Have you ever been riding in a car and stick your head out the window and couldn't breathe at first? The same effect is true when first starting CPAP.

Sorry about misreading the date. I didn't pay attention to your location.
- Red

[Deborah K.]

As your CAs are treatment-emergent you can ignore them. Turn your EPR up to 3 and you will be more comfortable.

[Stracky]

Thanks Deborah - difficult to ignore as I am waking up so often Grrrrrrrr

I did read somewhere on this forum that EPR should be switched to off for CA -its all so confusing.............

[Phaleronic]

Hi Stracky, the narrower band of pressure will help you sleep as you'll have less arousals and microarousals, also the other issue with turning up EPR especially straight to 3 is that you will lose some apnea (and have potential increase in CA events) control unless you ratchet up your minimum pressure, so for now I'd stick with what CN suggested, give this change a few nights then see how you feel and if you may want to try EPR (on 1 at first)-and what the charts show us.

[staceyburke]

And I disagree. EPR moved to 3 does in some people give them some central until they get use to it.  The ResMed finds a Flow Limit and raises the pressure.  That is why your pressure chart looks like a mountain range.  That type of raises in you pressure makes it much harder to keep a good seal and stops you from getting into a deep sleep.  It also can wake you up.  This is something you need to try and see how EPR effects you.

There are always people who differ on how to help.  Unfortunately he did not have a good experience with a ResMed pap and  that seems to color his suggestions.  I owned a dream station bipap and it is NOT as good as a machine as the ResMed.    But as always you need to choose who you want to take advice from.

Leave the pressure where it is, set EPR for full time EPR set to 3