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90 day update
Just have some questions and observations. So my pressure started at 5-18 initially and I eventually narrowed it to 7-12 (it's never gone over 11) and 95% it's like 8.5-9. I have the machine on auto ramp (6) and soft response. I've tried all the epr settings to see if they would effect the ca's and found no correlation so stuck with epr 1 as I find it to be the most comfortable. 


I would say my average ahi is 3-3.5. My cai avg is 2.5-3.0. Hyponea index avg is 1. Obstructive index .5

I've been using a chinatrap and my leak rates are pretty good. I feel like I'm as dialed in as I can get with this machine.

Regarding the ca's, I have about 25-30 of them scattered throughout the night, half are prob sleep junk lastingly under 15 seconds but the other half will have some 18-25 second ones. The only time they go down to like 1 index is if I take a Xanax/ativan some time in the evening. That's it. That's the only time my ca index will be 1 and not 2.5 or 3. 

So my first question is I'm wondering if my ca's are just spontaneous arousals (I had a lot of these on my sleep study) that the xanax helps me sleep through. Is there anyway to tell by the flowrate graphs an arousal vs a central?

And also, if I am having 25-30 scattered but legit centrals throughout the night. Should that be treated? (I know it doesn't meet the 5 threshold but just wondering).

I have my required doctor compliance check up tomorrow so I'm curious about the centrals/arousals and what to talk about. I don't think I can dial in my machine anymore though. I think the settings are perfect.

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I recommend you download SleepyHead software from here: https://sleepyhead.jedimark.net/ and post some of your data in the forum. The links below tell how to organize and post your data. There are experts here who can analyze the data and help you better undersyand your CA events.
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ĒHey Melman,

I've been using and analyzing sleepyhead since week 1 and have posted graphs in other threads. I've figured out most of the software and graphs except for some of the intricate flowrate stuff. I know that the machines can't truly detect a central but I was wondering if examining the flowrate could help determine an arousal vs central.
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I would certainly bring in several days of Sleepyhead charts that show the Centrals as a concern. I only get 2-3 a night and that is on a BAD night, so 25-30 seems like a lot to me.
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One clue on CA vs OA is the flow around the event. When breathing ends on an inhale, it is almost always a SWJ change in position or CA. Most CA events terminate with normal breathing restarting, not a strong recovery breath(s). Events beginning in a flow limitation (down-sloped peak inspiration) and especially when followed by recovery breathing are clearly OA. It's not possible to accurately know what a CPAP flagged event 'really' is, but you can second-guess them pretty well.
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When you removed your EPR entirely (I assume you've already tried that) did you leave it off for a week to see if made any difference? It took a couple of days but for me removing EPR entirely quite reduced my CA events. If you haven't left it off for an extended period of time I would try that. Especially now that you are more used to the treatment. You may end up being pleasantly surprised. Or not. Either way, worth a try.
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