centrals, advise please.

[leadslinger]

Hi all, been using cpap for 5 weeks now and after reading alot of info I have come to the conclusion I require a little help from my fellow aflicted. I have a airsense cpap with data but what has hindered me really seeing whats going on is the lack of auto. Sinse starting treatment I have always had more CA's then OA's but never ALOT just enough to make me think that I maybe complex apnea on a small scale. I have tryed various things, epr on/off, more pressure, etc, but still have the same outcome. When I cranked abit more pressure (12) I was having aerophagia problems, but not really anymore CA's as I was expecting. Have hovered from AHI 1.6- 9.8 and was diagnosed at AHI 38 with not alot of mention of CA's. Alot of the time I'm within <5 but still feel washed out and fatigued. The reason for asking now is that I'm thinking of buying my own airsense autoset ( one at the moment is NHS supplied) but dont want to waste money if I really need ASV, just not sure on the data to make a rational call. I'm not over weight for my height (6.3) and the sleep nurse even remarket that I wasn't a typical 44 year old apnea patient, should of taken that as a bad sign lol.

what do you think, thanks for looking.


I've tried to get the graphs working in imgur but not computer savy, so if they dont come up I'll have another go.  

http://imgur.com/a/xiRJz

[Beej]

If I understand what I've read, generally you do not want to increase pressure as it may generate more CAs.

There is some leaking going on which aligns with some (not all) of the events, so those events may not be completely accurate.

Can you take a zoomed in screen shot (worked just fine, by the way) of that section towards the end of your night with all the CAs? Might give some of the more knowledgeable some ideas.

And, just checking - do you sleep on your back or your side? Side sleeping may help a lot with any obstructive events. Do you tuck your chin down towards your chest? Keeping the airway straighter with a soft cervical collar or pillow may help.

[Gideon]

I read what you said about your sleep study, but do you have a copy, can you get a copy. Because your question is about centrals and because of the limited info we get on CA with our machines what was said on your study, however little, could be important. So if possible post a copy of your study.

You need 4 posts to be able attach links but nice start on your chart data.

[leadslinger]

thanks Beej, I think the main problem I'm having is the cpap verses apap, in that I can see I would be more comfortable with higher pressure if it only kicked in when needed and was around 10 for the steady parts, its just wheather my CA's are true and may benefit from AVS ( I know I dont have that many compared to alot of folks ) and can see I need more pressure then 12, probably closer to 14 or 16 to knock the OA's out.
I generally have a mix of sides, front and back when asleep and as far as I know I'm not a huge chin tucker but do have an slight overbite which the sleep nurse also noted as a partial cause. I just dont want to spend £700 on an auto if increasing the pressure is going to make CA's worse and have to go bilevel or asv. I do have a tendansy to hold my breath or pause breathing naturally which does make me think that some of my CA's are turn overs in position and wake junk. Will sort some closeup ca's now.



http://imgur.com/a/D2sF4

[Beej]

The almost flat line and then inhalation does support the CA identification. Be sure to take in these kind of graphs to support

Initially, when I was diagnosed a couple decades ago, I was told I had a mixed apnea and was prescribed protriptyline. It helped a great deal for a long time. Might be something to discuss with your doc if they won't step up the machine to what you need - which may be an ASV.

[leadslinger]

I'm not able to get a copy of my sleep study at the moment as can't get hold of sleep nurse, I didnt even meet with a specialist afterwards. NHS is very underfunded especially in the sleep apnea dept and the poor nurse covers a 30 mile square patch. Only had the basic explanation when I was given my machine and left to get on with it. Bit like alot of you as long as I stay <5 its fine in their eyes.

thanks for the replys tonight, its 1am here and I'm struggling to keep my eyes open, so time for the hose. night.

[leadslinger]

ok last night I thought about the pressure problem and decided to try cpap 12 with epr 3 to see if I could tolerate the pressure better. Well I fell asleep quickly with no ramp and had a reasonable nights sleep but I guess the graph says different. There is another cpap 12 graph to compare to above and that was with no epr. I know the epr causes more CA's but without it I cant tolerate the higher pressure needed to deal with the OA's but will try again tonight with epr2 and cpap14 to see what happens. I feel this is adding up to be an ASV in my future.

going to ring resmed uk on monday and see if I can buy an autoset, try it and return after a week, just want to try an auto machine before going further, have already asked the question to the NHS and was told that all their machines are cpap and can't supply an apap. This does change per region, I just happen to be in an underfunded one. Havent asked about ASV route yet as wanted enough data to prove the need first.
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http://imgur.com/a/eCqAn