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+--- Thread: Newbie, Treatment Emergant Centrals and Cheyne Stokes?? (/Thread-Newbie-Treatment-Emergant-Centrals-and-Cheyne-Stokes)
Newbie, Treatment Emergant Centrals and Cheyne Stokes?? - zees - 01-22-2023
Hello Everyone,
I am in my third week of treatment, diagnosed with mild obstructive apnea, 9.0 AHI. In home study with WatchPAT showed no centrals.
The Oscar data is showing Centrals and Cheyne Stokes,
I have since learned that this is not uncommon, well the centrals anyways. I am otherwise healthy (could stand to loose a few lbs.), no medications or injuries. No heart issues, thankfully. No drugs or alcohol...
I am looking for some help interpreting the Oscar data (this is an awesome program, I have so much to learn)!
Unless I am reading this incorrectly the flow limit does not seem to indicate a tucked chin, but I could be wrong...
Any recommendations or pointers would be welcomed.
Doctor didn't seem too concerned about the CA's.
Basically he said that we would look at it in 3 months, after I have had time to adjust to the APAP.
What are your thoughts about the data? I have posted 3 images, in increasing zoom, first is the whole night, second is the CA's and third is a more detailed look at the CA events.
Thanks for your input and I really appreciate the forum, I have learned a great deal already!
Thanks again,
Zees~
[attachment=47252] [attachment=47254] [attachment=47253]
RE: Newbie, Treatment Emergant Centrals and Cheyne Stokes?? - Melman - 01-22-2023
Your data looks pretty good with the exception of the cluster of CAs near the end of the night. is that a recurring pattern or a one time event? Increasing your minimum pressure to 7 may be an improvement since most feel starved for air at 4. Please replace the tidal volume and mask pressure graphs with machine pressure and leak rate, Those data are usually more helpful. Flow limits could be a little lower. You may benefit from using EPR,
RE: Newbie, Treatment Emergant Centrals and Cheyne Stokes?? - zees - 01-22-2023
Hello Melman,
Thanks for your review of the screens, new ones attached with the graphs that you requested.
Unfortunatly this is not a one time event. It also seems to be happening only at the end of the night.
Not sure if that is a factor.
The centrals were more prevalent during the first 2 weeks of therapy and my therapist recommended that I take EPR to ramp only in an effort to eliminate the centrals. That is why it's at 2 and ramp only at the moment. Sorry I didn't mention that earlier.
I did have a few good nights with no centrals after setting the EPR to ramp only, but they returned after 3 nights.
Hopefully the new graphs give better insight.
Good to know that the numbers look good, still hoping to feel better as treatment progresses. Still foggy and tired during the day, although it's better, just too soon, I suppose.
One thing I have noticed is that my sense of smell has returned, not sure if anyone else has experienced that, but for years I have not been able to really smell (pre - covid). Now I can!
Thanks again,
Zees~
RE: Newbie, Treatment Emergant Centrals and Cheyne Stokes?? - Gideon - 01-22-2023
Your Ramp is set to 4cmw meaning that your EPR is totally off, never on.
For most users 4cmw is too low of a pressure.
Turn Ramp off.
A zoom, no more than 10 minutes, showing your breathing before and for the first of the CA events would be helpful.
What is happening is you are jumping into cyclic breathing including over recovery all of which is centered on your CO2 apneic threshold. Our main drive to breathe is, simply put, the need to remove CO2 and its byproducts. You see the CA events at the nadir where your CO2 levels drop below your apneic threshold. These typically go away over 2-3 months as your body adapts. In the meantime we want to stop that cyclic patter from starting.
Set min=max=8, EPR=Off ( or Ramp=Off as mentioned above)