(05-19-2015, 10:27 PM)gbesq1 Wrote: Here is my situation.
I was intermittent but no longer. I know I need CPAP and have been using it every night for several months and will continue. My 2007 Remstar recently conked out and I replaced it a week ago with the 550.
I tried APAP (8-20L/min) and got AHIs from 16 to 29 (the high ones using a nasal mask, the lower using a nasal pillow). Obviously no good. Since I was originally prescribed 8L/min CPAP with a recommendation of 10L/min if I could tolerate it (which I can), I switched to 10L/min on my new machine and got a much better (but not great) AHI. However, when I was using APAP, my median pressure was around 13.
If a pressure of 13 is what you need at least half the time, maybe you can slowly work up to using 13 or 14?
Not sure why you are using 10, except maybe just to proceed cautiously?
Do your centrals increase excessively at pressures above 10? Changing from C-Flex+ to standard C-Flex may make treatment less comfortable (C-Flex+ provides 2 cmH2O greater exhalation pressure relief, compared to standard C-Flex) but some patients have fewer centrals when using C-Flex compared to when using C-Flex+.
In general, I think central apneas (in themselves) are not worse than obstructive apneas. Central apneas can lower our blood O2 and can cause arousals, just like obstructive apneas do, but I think centrals (especially if fairly short) can sometimes be far less troublesome than obstructive apneas.
With central apneas, as soon as we try to breathe again, we are breathing again. With obstructive apneas, I think often more stress is caused, because we are trying to breathe but can't, and a strong arousal is needed before we manage to start breathing again. All the adrenalin and stress hormones caused by strong arousals from obstructive apneas have got to be more stressful on the heart and whole body, I think, than an equivalent number of short central apneas.
But some patients do get a completely excessive and serious amount of long centrals at higher pressures, so it does not hurt to proceed cautiously.