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[CPAP] 0 OSA, High Central Apneas
#1
0 OSA, High Central Apneas
    Hi everyone,

I received my Airsense 10 about ten nights ago and have been using it religiously ever since. I find it pretty comforting to sleep with and have adjusted relatively well. Since using it, my OSA events have been close to 0 every night, while my clear airway apneas have been around 4 per hour, with last night being over 7. I'm having the typical sleep apnea symptoms today, however, on the nights with ~4 AHI, I've felt pretty good the next day (likely not 100% though). Here is my OSCAR data from last night.

I have an appointment with a respiratory specialist next week who will look at my CPAP data and give advice, but am wondering if anyone here has gone through similar circumstances or has any advice. I've also shared my initial sleep study results. Thanks!


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#2
RE: 0 OSA, High Central Apneas
OK, let's turn back EPR to 2 and see if the CA drop. EPR may need to drop to 1 or off if we don't see these CA dropping. I'd also consider a second separate edit, bumping 5 to 6 on your Min pressure.

I'm not sure if these are treatment emergent Centrals meaning just because you're on PAP, your breathing gets more efficient at flushing out CO2. Or that these CA are your main issue, called pre-existing.

I'd suppose this test was a home version. Did you wear a chest effort belt? That's the way a home test can measure centrals. If it did not, and dependant upon your CA in the meantime, you will want to highlight these CA to your RT at that upcoming meeting. Keep notes of how well you sleep each night to report that too.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: 0 OSA, High Central Apneas
Those are very similar to my results, please keep us posted with what steps and result or any other update.

Thank you
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#4
RE: 0 OSA, High Central Apneas
Thanks for the reply. I forgot to mention that I turned off EPR this morning. I believe I can fall asleep without it with no issue, but is a 3 -> 0 too drastic of a change?

My sleep study was at home, and I did wear something on the upper part of my sternum. I’m going to request an in lab study if that is possible / helpful.

I’ll document how I feel each day

I’ll let you know!

Have you tried turning off EPR? From what I’ve researched, that is the only thing that can provide quick results. I’m going to start sleeping with 0 EPR starting tonight
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#5
RE: 0 OSA, High Central Apneas
EPR is technically a Comfort feature, but we've noted that the number of EPR equal a BPAP pressure support setting and EPR is measured in cmH2O just like pressure. Given what's seen a lab test may be a good idea.

You handle EPR however you feel for Max comfort, but my edit was to attempt to manipulate the CA numbers. You can drop EPR by 1 or go all the way to 0, or in between. Eventually you might try all 4, 0-3 setting levels.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: 0 OSA, High Central Apneas
Hi moogcity3, just quick one off of a thought, Maybe or Not ! if worth Trial/Error in turning down the Max pressure to present 95% @ 7, then continue in Baby Steps, as go, reducing down then each few nights of the Max pressure by .2 % increments. Noting presently well in control of "H or O" as last @ AHI .44,  But not yet in control of CA's @ 7.24AHI, with fingers crossed by reducing max may possibly? assist, with the prevent higher pressure will not flushing out then to much CO2? if that is what is possibly contributing to the CA's?  As by reducing max, then also comfort will benefit as compensated or balanced in sort, your exhaling against pressure as have from reduced EPR," or turned off" but then is just only my thoughts, and follow in line with Dave, in which most my Learnings and understandings CO2 etc from Dave and others in this forum.
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#7
RE: 0 OSA, High Central Apneas
High pressure is not the problem. EPR is for now. As your body gets accustomed to the therapy the central should be reduced. As they reduce reintroduce EPR 1 increase at a time until you are at 3.

Why do you want EPR to 3? 2 reasons first exhale comfort but two is flow limits. Flow limits are apnea just like O and H events. They cause sleep disturbances and can wake you up.

So reduce EPR until your body adjusts to CO2 lower levels then increase them.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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