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Poll: Have you messed with your settings within the first month of treatment?
This poll is closed.
yes
36.36%
20 36.36%
no
63.64%
35 63.64%
Total 55 vote(s) 100%
* You voted for this item. [Show Results]

Advice for new users wanting to "tweak" settings
#11
(09-26-2012, 09:43 AM)SuperSleeper Wrote: Until someone, somewhere does a comprehensive study proving that higher CPAP pressures actually induce true central events

I am also skeptical of the theory that higher pressures actually induce centrals.

Does the higher pressure actually induce Centrals OR does it merely sufficiently treat the OSA & therefore leave the already existing Centrals?

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#12
It makes the number of central apneas increase. By quite a large amount in some cases.

A few months ago someone posted an article about BiPAP-induced CSA. It was real, as confirmed by sleep studies, not just by a PAP machine that records clear-airway events.

The next time I see that article I'm going to save it. I don't recall if any of the CA events were accompanied by oxygen desats or how long they lasted.
Sleepster
Apnea Board Moderator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
Had a recent full night sleep study which found only obstructive and not central apnea.
Started on APAP at min 7, max 12 cmH2o pressures.
Immediately took care of almost all obstructive issues,
and generated consistent and significant (AHI 12.9) central apnea events
(or at least what the machine calls central apnea).
I conclude that excess pressures (for a given individual) can indeed induce central apnea,
or what gives every appearance of being central apnea.
I am frankly too spooked to continue at the same pressure settings,
(as I'm not too keen on waking up dead...)
though I do not know what setting might be both safe and effective.

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#14
(09-24-2012, 07:48 AM)jdireton Wrote: Your profile says you have an S9 Escape Auto. This machine doesn't collect efficacy data, only usage (compliance) data, so what are you basing your decisions on?
The S9 Escape Auto does score AHI but not the breakdown. No central apnea detection or leak and no mask fit or smartstart features either
Basically its a brick that does auto and report AHI and how many hours used each night

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#15
Follow up report: changed settings to max 8 min 4 cmH2O last night.
Brought AHI down to 6.3, of which 5.6 is still central...so I will set the max pressure even lower tonight.
But the key point is this: lower pressure = less central apnea (for me).

Excess O2 saturation is one pathway to central events....where the CNS is actually doing what it is supposed to do.
And then there is another pathway to central events due to a CNS malfunction.

So I am tweaking settings in the first month...out of sheer necessity.
And I might (or might not) take some heat for this from my doc.
Safety trumps protocol.

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#16
Actually, a true central apnea is a non-obstructive hypoxic event, where not only is there a total cessation of breathing for at least 10 seconds, but along with that there is a drop in the oxygen saturation of at least 10 percent of the baseline saturation. In order to know if the "clear away or open airway" events that your machine records were significant, you would need to have simultaneous pulse ox data. That isn't wouldn't be that difficult to do, especially with SleepHead software and an inexpensive CMS50 D+ pulse oximeter. Frequent significant drops in your pulse ox, whatever the cause, obstructive or central, aren't good for you.
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#17
Here's my notes in the med history I keep for myself.

CPAP level 5 resulted in 97% O2 saturation, breathing stopped 13 times an hour
CPAP level 7 resulted in 90% O2 saturation, breathing stopped 36 times an hour

Nearly all of the 36 AHI were central events while the 13 were obstructive.

My O2 dropped quite a bit at the higher pressure.

However, the doc set the machine to 8 then, 3 months later, raised it to 10.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#18
(09-28-2012, 12:42 PM)Remfan Wrote: Follow up report: changed settings to max 8 min 4 cmH2O last night.
Brought AHI down to 6.3, of which 5.6 is still central...

The thing is, there's no way to safely draw the conclusion that the change in pressure caused that drop in your AHI.

It's more likely you adapting to the therapy. It's very common for the AHI to just drop like that on its own.

Quote: so I will set the max pressure even lower tonight.

Not a good idea, in my opinion.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#19
Especially if you are going by just one night of data.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#20
Thanks for the guidance,
and even more, for the goodwill behind it!

I gather that:
we are working with a non-linear system - output is sometimes not proportional to input;
and the system takes a while to come to dynamic equilibrium.
Furthermore, there are hazards of excess as well as hazards of deficiency with respect to treatment pressures.

I'm trying to thread a moving needle,
and will proceed with these provisos in mind.


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