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+--- Thread: Advice wanted for CPAP settings & central apneas (/Thread-Advice-wanted-for-CPAP-settings-central-apneas)
RE: Advice wanted for CPAP settings & central apneas - SarcasticDave94 - 05-02-2024
Agreed with above, just adding in you should always request your full diagnostic reports, as detailed as possible. Home tests, lab overnight PSG sleep study, titration. Doc, I want my full detailed reports, thanks. The acceptable answer is yes, because in the US, HIPAA says that you are going to get it.
RE: Advice wanted for CPAP settings & central apneas - EnigmaticToad - 05-03-2024
Here are results from last night with min 9 / max 12 and EPR 1. My untrained eye does not see much of a difference from the norm, unfortunately.
I will look into giving a soft cervical collar a try. Unless you have any additional thoughts based on these results, tonight I will try a fixed pressure of 11 and EPR off, as suggested.
Thanks!
RE: Advice wanted for CPAP settings & central apneas - Dormeo - 05-03-2024
Looking at the snippet, I'm not sure what the story was with that first CA, but the rest are all sequalae to arousal breathing. The CAs themselves are not a problem, unless you're experiencing low O2 as a result, but the arousals are.
I also see a lot of FLs before the cluster of CAs. They may have caused the initial arousal. This makes me wonder whether you'd do better to use EPR of 2 to try to reduce the chances you'll experience FLs and hence arousals.
I realize it's tough to get conflicting advice and perspectives. We're in the territory here of delicate balances in the pros and cons of various changes to your settings, and ultimately what's best is what WORKS best for YOU.
Do try to give each change at least several nights before making another change. Sleep is highly variable from one night to the next, so a single night's experience isn't going to be much to go on, unless it's a total disaster.
You might try changing the scale on your flow-rate graph. Try +60 to -60. That will provide a little more detail in the FL trace when you zoom in.
RE: Advice wanted for CPAP settings & central apneas - EnigmaticToad - 05-04-2024
Attached results from last night. As requested, I kept the same settings as the night before.
RE: Advice wanted for CPAP settings & central apneas - SarcasticDave94 - 05-04-2024
I missed the study chart from earlier. You did have a few Centrals mixed in with the Obstructive Apnea. However the current CA are very likely Treatment Emergent Central Apnea, due to the CPAP and its bit of pressure on the lungs causing a little extra CO2 to be exhaled than your body is used to. This new imbalance will self correct over time, and manifesting itself by not having enough CO2 in your system which in turn delays the breath signal. This delayed breath is similar in looks to any CA, and the machine interpreted it as such.
RE: Advice wanted for CPAP settings & central apneas - Dormeo - 05-04-2024
Well, your CAs are settling down some, but your OAs seemed to give you some trouble. Were you on your back between 3:30 and 4:45, do you think?
I'd suggest another night with these settings; then we might all be able to give you some thoughts about tweaking them.
RE: Advice wanted for CPAP settings & central apneas - EnigmaticToad - 05-05-2024
Results from a short session last night. If this isn't enough to get any useful information from, I'll try the same settings again. I should have put the mask back on during one of my awakenings but never did.
@Dormeo - I'm pretty firmly a side sleeper, so I doubt that I was on back during that time, though I can't say for sure.
Again, huge thanks to all of you for the advice and help so far.
RE: Advice wanted for CPAP settings & central apneas - EnigmaticToad - 05-06-2024
Attached last night's results.
RE: Advice wanted for CPAP settings & central apneas - EnigmaticToad - 05-07-2024
Attached results from last night. Since I haven't heard anything, I followed the most recent suggestion of increasing EPR back up to 2.
In terms of AHI, the results look better than usual. However, I was unable to get back to sleep after the 3h30m mark despite being very tired, so that is all the sleep I got. I will have to find some time to take a nap or it is going to be a very rough day.
Honestly, I wonder if my problems have anything to do with sleep apnea / machine settings at all, or if there is just something else wrong with me.
RE: Advice wanted for CPAP settings & central apneas - EnigmaticToad - 05-10-2024
Results from the past three nights. The last two in particular show a notable increase in obstructive apneas.