VAuto Journey

[lbl82]

My AHI was a little worse last night at 3.1. I increased my PS from 3.0 to 3.4. What should I do? I’ve also noticed that since being on the VAuto that my centrals have been better. The average is around 1 to 1.5. If the VAuto doesn’t help with centrals why are my centrals so low?

[Sleeprider]

You are on the right track assuming you need to treat hypopnea. It might be worth taking a closer 2 or 3 minute view of events.

[Gideon]

The trigger sensitivity helps with centrals, and your body could be somewhat adapting. That and we always see some differences between machines.

[lbl82]

The trigger sensitivity helps with centrals, and your body could be somewhat adapting.  That and we always see some differences between machines.

My Central to Hypopnea ratio has changed since being on VAuto. My AHI is low, but my hypopneas are more than my centrals. How do I lower my hypopnea while keeping my centrals low? Also, what do you mean by my body may be adapting? I’ve been on VAuto for 27 nights with an average AHI at around 3. I also average 8.5 hours of sleep. I should be feeling awake when I wake up. I still don’t and my sleepiness has actually increased over the last couple days!

[SarcasticDave94]

For some/most PAP users, the body can adjust its own sensitivity to the CO₂ washout scenario that occurs and causes treatment emergent centrals. That adjusting or "adapting" is very likely what bonjour is referring to.

[Crimson Nape]

To reduce hypopneas, try increasing your EPAP pressure. Looking at your graphs, I'd try 10 cm to see what happens.

[sheepless]

I suppose increasing pressure will tell us or at least give us a hint, but has anyone had a close look at the hypopnea to try to determine if obstructive or central? it kind of sounds like the very high trigger setting may have reduced his ca to central hypopnea.

[lbl82]

I suppose increasing pressure will tell us or at least give us a hint, but has anyone had a close look at the hypopnea to try to determine if obstructive or central?  it kind of sounds like the very high trigger setting may have reduced his ca to central hypopnea.

What is central hypopnea?  What can I do about that?

[sheepless]

just as there's obstructive and central apnea, hypopnea can be obstructive or central. or mixed. raising pressure helps obstructive but tends to make central worse and vice versa. as you know, neither cpap/apap nor bilevel is designed to treat central events. if central events are your dominant apnea type, not treatment emergent, and you aren't satisfied with how you feel, the next step would be asv. but that's a bit premature yet. your under 5 ahi is quite reasonable for vauto so you won't get much assistance from the system.

[Sleeprider]

Please see my post#82 asking for a closer look.