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[Treatment] Are these CA's positional or something else? - Printable Version

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Are these CA's positional or something else? - LikeaGlove90 - 11-12-2023

I've been using my CPAP machine for about 2 months now.. I noticed many of my aponeas now in OSCAR are CA's and look very similar in terms of a spike in breathing then stopping.. is this a true CA (TESCA) or is this a positional aponea?

My origional sleep study only have obstructive / hypopneas, no centrals.

How can I address these?

My origional study was 41 AHI, its been down to 2-3 AHI but the last week or so it's elevated to 4-5 AHI

I tape my mouth every night, and wear a soft cervical collar - I wear a medium or a large, when i wear the large I get alot of aerophagia; screenshots below are wearing the medium. I also have a CPAP pillow.. I feel like im trying everything but getting nowhere.

I'm now concerned I've developed an issue here. Really struggling lately with this now and not sure what to do from here in terms of changing settings or other ideas to optimize my therapy.



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RE: Are these CA's positional or something else? - SarcasticDave94 - 11-12-2023

I think there was within another thread you mentioned your sleep test had low to none CA. Having CA myself, I'm sure the CA cannot be positional, so that leaves treatment emergent. You've been on therapy I think 2 months, so they should be getting less with the time involved. If not, with this machine you're in a teeter totter situation, on one side is treating CA, and opposing this is treating obstructive.

If you choose, your only option I'm aware of that can reduce CA on the AutoSet will be reducing EPR. One of those other threads has others mention you should increase EPR. Unfortunately again the teeter totter action means if you attempt to reduce CA, the OA and maybe hypopnea go up, or you may lose comfort.

The reason you've had CA after a low CA sleep study is the increased breath efficiency in exhaling CO2, which drives the desire to breathe. When that drive is paused briefly, you'll have a CA.

RE: Are these CA's positional or something else? - LikeaGlove90 - 11-12-2023

That's really interesting.

Yeh I'm probably more confused now in terms of what I should be doing than before around EPR.

Is treatment enduced CA fixable?

From my sleep study my original oxygen was 88% so makes sense for this to be a factor..

I'm just a bit confused now why these figures are looking how they are.. most of my apneas are CAs now, I'm getting like 5-10 a night of H/OA?

RE: Are these CA's positional or something else? - SarcasticDave94 - 11-12-2023

With treatment emergent CA, they should be diminished within a few weeks to maybe 2 or so months use of CPAP. A few users it may be a bit longer.

The question is are the CA stealing rest and comfort? If they're not, I don't think I would risk obstructive therapy effectiveness.

If you feel you need to address these CA, whatever your current EPR is set to, it would have to be turned down. I'd only try dropping EPR by 1 number, try the AutoSet a night. Then determine did you rest well, did treatment feel good or less good. Next look at OSCAR to see if the CA went down and if any events increased. From there, determine which was better, before or after this edit. Admitted, one night doesn't make a trend, so you may need to try extra nights to decide.

Bottom line though is maximize comfort, rest. If you find the best repeatable good sleep session, I'd probably lock settings there, likely regardless of numbers.

RE: Are these CA's positional or something else? - LikeaGlove90 - 11-12-2023

Good question..
I think In terms of comfort EPR on 1 seems to be fine.. but I guess I'm concerned about potential issues arising from the CA.. I just read a bit about CSR and was concerned maybe that's something I've developed? I really don't understand it much at all.. the issue is outside of a sleep test and some masks and adjusting the pressure a few times I've been on my own so I am really lost with interpretation of my results and what I should be trying In terms of mask tension, cervical collar, mouth taping, positions etc.. I'm just throwing it all at the wall and hoping it sticks

RE: Are these CA's positional or something else? - Sleeprider - 11-12-2023

All cases of CA follow a large sigh or big inhale with a prolonged exhale. This is not CA. I think you should keep questions about your therapy in one single thread, because it gives us a chance to see the other issues that you have dealt with and the history of your therapy, and I also think you need to include the full-night with settings for us to help. In September you had positional apnea and were using pressure of 5-17 with EPR 3 https://www.apneaboard.com/forums/attachment.php?aid=54469. As of this post, we don't know your settings and without the full-night or statistics, we have almost nothing to work from. Please try to keep therapy questions in a single thread and include the left margin statistics and settings information.

RE: Are these CA's positional or something else? - LikeaGlove90 - 11-12-2023

(11-12-2023, 10:14 PM)Sleeprider Wrote: All cases of CA follow a large sigh or big inhale with a prolonged exhale. This is not CA.

What could it be?



I'll have a look when I get home and post the whole nights. Sorry Im new to this so not sure the posting protocol. I'll post on this chain once I get some info. Screenshots of the whole night within the post helpful or is there a better approach to give the information you need to give some sort of feedback/thoughts?

I had a Dropbox I was screenshotting every nights info into, is a link to this helpful?

Thanks

RE: Are these CA's positional or something else? - paulag1955 - 11-12-2023

You said, "All cases of CA follow a large sigh or big inhale with a prolonged exhale."


I'm also interested to know what they are, then, because this is what all of my CA events look like, too.

RE: Are these CA's positional or something else? - SarcasticDave94 - 11-12-2023

You should be able to attach OSCAR images with the button "Choose File" in the new attachment section below the text box when posting.

RE: Are these CA's positional or something else? - LikeaGlove90 - 11-13-2023

(11-12-2023, 11:21 PM)SarcasticDave94 Wrote: You should be able to attach OSCAR images with the button "Choose File" in the new attachment section below the text box when posting.

Thankyou I'll do that. Is a few nights useful or am I better to attach more?