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Are these false centrals
#1
I had a sleep study in March of 2015. I had an AHI of 15.1 made up of 4 OA, 58 H, and 88 RERA's . I also had 116 periodic leg movements . The report says the PLM  appear to be related to airflow restriction.  I had no CA's in my sleep study. I was not given a titration study. The sleep doctor recommended settings of 15 for IPAP, 8 for EPAP and 4 for PS . Since I have had insomnia for many many years I was given 5mg of zolpidem prior to my sleep study. I slept for 4 hours. I continue to use 5mg of zolpidem each night.

I use an Aircurve 10 vauto and I use the amara view minimal face mask. From the first day I started on my bi-pap I have had Central apneas recorded by my bi-pap. However, I had no central apneas in my sleep study. I do not believe that the CA's recorded nightly  are true centrals. To prove my point I purchased a camera and recorded my sleep for a few nights. The first screenshot shows my flow rate when I am sleeping normally. The second screenshot shows my irregular breathing followed by a CA being recorded. In almost all instances such as this when a CA is recorded my video recording shows me as rolling over.

My question is am I right in assuming that these are not central apneas but instead are just arousals from rolling over ?

As for the PLM's, I get anywhere from 20 to 30 a night as revealed my my camera. Since my sleep study stated that they appeared to be related to airflow restriction I'm wondering if I should be adjusting my EPAP or IPAP or both.
 Any suggestions ?
 Almost all of the UF #1 & UF #2 are recorded when I have a leg movement as revealed by my camera .

My present settings are : IPAP 13, EPAP 7, and PS 3.0. I had adjusted the original settings over time due to a problem I was having with the machine not being in sync with my breathing, but that problem has been resolved over time .


I might add that I am 76 years old and in good health,walk 3 miles a day, and take medications for allergies for my eyes and nose as well as taking 5mg of zolpidem each night to get me to sleep as I have had insomnia most of my life.

Due to the number of times I roll over and also due to the number of PLM's , I end up with a very fragmented sleep. My AHI has been good at an average of 1.8 for the last 6 months with 1.4 of that being CA's(which I doubt are really CA's).  Due to the fragmented sleep I am always yawning after about 11:00 a.m.

 Any suggestions as to pressure adjustments

            
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#2
I agree with your conclusion that these irregular events are from arousals or small sleep disturbance. There is nothing you should change to try to treat or change this. Your results are excellent, and disregarding a few centrals indicated by the machine is easy to do when you feel good otherwise. I experience the same thing from time to time. You have no snores, a very low leak rate, healthy respiration, and nothing to worry about from what I can see.
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#3
Thanks for your advice Sleeprider. I will continue with my present settings as you suggest.
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#4
If the PLMs make it difficult to feel rested, there are some medications which might be tried.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#5
Are there any that you can recommend ?
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#6
Check this info from Web MD.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#7
Thanks Beej for your helpful information.
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