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Central Apnea or Not?
#1
Central Apnea or Not?
The only test I could afford was a $180 home sleep test using the Philips Alice NightOne device, and it showed an AHI of 18.7 with a prescription of 4 - 20 pressure range for an APAP machine.  I received an ResMed AirSense 10 AutoSet for $100 as I couldn't afford the price of a new one and I'm looking to understand the charts from ResScan.  Also, I don't have a sleep doctor thus I have no one to talk about this with. 

Is there anything that can cause a false Central Apnea event, like a mask leak?  Can you have Central events some days and not others?


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#2
RE: Central Apnea or Not?
Centrals are often caused by holding your breath whilst rolling over. Your number of events over the night are not enough to worry about. I suggest you download OSCAR there is a link in my signature. It’s easier to use than rescan and the graphs are easier to see what’s going on
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#3
RE: Central Apnea or Not?
(10-17-2019, 12:40 AM)jaswilliams Wrote: Centrals are often caused by holding your breath whilst rolling over. Your number of events over the night are not enough to worry about. I suggest you download OSCAR there is a link in my signature. It’s easier to use than rescan and the graphs are easier to see what’s going on


Thanks for the reply jaswilliams, I'm going to try OSCAR out now.
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#4
RE: Central Apnea or Not?
G'day xXZexxMooreXx. Welcome to Apnea board.

While a few centrals might be caused by rolling over I doubt that's the case when there are 8 or 9 clustered together as you have on 15/10/2019. First we need to know what the sleep report showed - can you post a copy please? Make sure you erase anything you don't want to share with the public, but make sure you include the charts and tables. Its important to know what the mix of apneas and hypopneas was before treatment.

A lot of people get "treatment emergent" central apnea, as the therapy changes the CO2 concentration in the blood, causing the brain to "forget" to initiate a breath. (That's a crude simplification but it will do for now). In the majority of cases the emergent apnea will fix itself over a period of weeks. In a few cases it is particularly stubborn and needs special attention but I don't expect that will be a problem here.

I agree with jaswilliams that OSCAR is a far more useful program than ResScan for looking at your data - it's easier to use and presents the information in a more coherent format.

Edit: I should also mention that a pressure range of 4 - 20 is not really a prescription - it's how the machine comes from the factory. Most people do a lot better on a narrower pressure range, especially raising the minimum a few cm to aid inhalation.
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#5
RE: Central Apnea or Not?
I agree with the others; let's see what OSCAR shows along with that sleep study info. Then we can work on making therapy the best possible for your success which will include narrowing the pressure settings to something specific for your needs. And, welcome to the Apnea Board.
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: Central Apnea or Not?
A very notable feature of your Resscan charts is Flow Limitation. It is persistent through the night and is driving your pressure changes. I think you need to abandon your default settings of 4-20 and consider a minimum pressure of 8.0 and turn on your EPR (exhale pressure relief) full time to a setting of 3. While EPR sometimes will increase CA events, it will reduce the flow limitations and should feel comfortable. I look forward to seeing your OSCAR charts in the near future.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#7
RE: Central Apnea or Not?
(10-17-2019, 01:57 AM)DeepBreathing Wrote: G'day xXZexxMooreXx. Welcome to Apnea board.

While a few centrals might be caused by rolling over I doubt that's the case when there are 8 or 9 clustered together as you have on 15/10/2019. First we need to know what the sleep report showed - can you post a copy please? Make sure you erase anything you don't want to share with the public, but make sure you include the charts and tables. Its important to know what the mix of apneas and hypopneas was before treatment.

A lot of people get "treatment emergent" central apnea, as the therapy changes the CO2 concentration in the blood, causing the brain to "forget" to initiate a breath. (That's a crude simplification but it will do for now). In the majority of cases the emergent apnea will fix itself over a period of weeks. In a few cases it is particularly stubborn and needs special attention but I don't expect that will be a problem here.

I agree with jaswilliams that OSCAR[url=https://www.sleepfiles.com/OSCAR][/url] is a far more useful program than ResScan for looking at your data - it's easier to use and presents the information in a more coherent format.

Edit: I should also mention that a pressure range of 4 - 20 is not really a prescription - it's how the machine comes from the factory. Most people do a lot better on a narrower pressure range, especially raising the minimum a few cm to aid inhalation.

I sent an email requesting my sleep data and will post when I receive it.  I'll run my data through OSCAR as well.

(10-17-2019, 08:28 AM)SarcasticDave94 Wrote: I agree with the others; let's see what OSCAR shows along with that sleep study info. Then we can work on making therapy the best possible for your success which will include narrowing the pressure settings to something specific for your needs. And, welcome to the Apnea Board.

Thanks Dave!  I never new my prescription wasn't even a prescription at all, nor that you could change it.  And even if I did, I would have never expected help optimizing it.
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#8
RE: Central Apnea or Not?
(10-17-2019, 08:38 AM)Sleeprider Wrote: A very notable feature of your Resscan charts is Flow Limitation.  It is persistent through the night and is driving your pressure changes.  I think you need to abandon your default settings of 4-20 and consider a minimum pressure of 8.0 and turn on your EPR (exhale pressure relief) full time to a setting of 3.  While EPR sometimes will increase CA events, it will reduce the flow limitations and should feel comfortable. I look forward to seeing your OSCAR charts in the near future.

I had no idea mine were just default.  I was never told that by the sleep people.   You guys are really showing me things I never knew about.  Also, I'll upload the OSCAR charts soon.  Thanks for all of you by the way.
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#9
RE: Central Apnea or Not?
May I ask if my previous experiences may or may not have been from sleep apnea? I've had some weird things happen that led me to going out on my own to get a home sleep study test and I'm really curious if it could potentially all be related.
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#10
RE: Central Apnea or Not?
Maybe I'm missing some part involving what you're asking, if so I'm sorry. Can you elaborate a bit on previous experiences and/or weird things that happened? Is this maybe odd things happening during sleep or sleep attempts?
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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