[Treatment] How to reduce central apnea?

[cyjatoronto]

For years my AHI has ranged from 6/7 (seldom) to 10-12 (typical), mostly central. I awaken maybe 1 morning a month feeling refreshed. Until a month ago I had left my Dreamstation Auto CPAP at the store-set prescription 7.0 cm, no ramp, no flex. About a year ago I cracked open the clinician manual and added ramp and flex. Not much difference.  EXPERIMENTS: (1) A month ago I set Auto 5-15 cm. Seemed a bit better. (2) For 2 days I tried fixed 5.5 cm. Worse-ever AHI. (3) For 2 days I tried fixed 8.5 cm. Results: AHI similar to best days historically.

The 1 page summary below (click to enlarge) compares (1) and (3). For (1) those 2 days of the 1 month auto 5-15 happened to be exceptional - AHI in the 6 range. For (3) AHI also in the 6 range but strikingly, very little OA and HA.

Observation: In Events Flags there appears to be a significant co-incidence of CA, PP, and VB.

QUESTION: Do the charts indicate other adjustments I can try to reduce central apneas? I intend to stay on (3) 8.5 cm fixed for 1 week, then move on to settings (4?), (5?) .... Grateful for any help, and ready to send more charts/info as needed.

   

[PeaceLoveAndPizza]

Please read the link in my signature “Formatting OSCAR Charts” and repost individually. We use those specific charts to make recommendations.

[SarcasticDave94]

Welcome to Apnea Board,

It does appear the CA will be an issue. Given that they're still present, it's possibly a pre-dominant Central Apnea issue. Without the sleep study info would be the main reason I say possibly.

What you'll need to try is very little variables, flex to minimum, probably no pressure variable along the lines of this 8.5. The bad news about it is it may not get better than this with the machine you've got available here.

With Central Apnea, expect it to be consistently inconsistent, that variable up then down thing you've noticed on CA.

Your best answer is if you're able to get either a ResMed AirCurve 10 ASV or similar. Philips Respironics has the SV Auto, others might have something similar, but I know the most about these 2, with having used the ResMed ASV myself.

I'm saying this due to your statement that CA have been the issue for a year plus. This might have been your Apnea issue all along.

[cyjatoronto]

Really appreciate the info and the insights. Last night the 3rd at 8.5 cm. Three AHI in a row around 6 is unprecedented in the 4.5 yrs I've been on CPAP! Averaging 1 OA/HA per hr, 5 CAs. I will post new charts tomorrow as recommended. I will continue 8.5 cm for the planned week. If a solid week I'm thinking of trying 8.0 cm for a week, maybe Auto 7-8.5. Other recommendations welcome.