Central apnea and high pressures?

[esaulcatnas]

Are CSA events more prevalent at higher pressures? (Perhaps due to more frequent arousals?)
I'm thinking of using an MAD device simultaneously with CPAP. This should allow me to reduce the pressure, and I'm wondering if the reduced pressure would also mean a decrease in the CSA events that I get. Currently with CPAP all my events are CSA now.

[Gideon]

It depends on the cause of the central.

If you know, without question, that high(er) pressures are causing your centrals then a reduction in pressure should reduce the centrals.
IF increased pressures are causing centrals it is likely because of increased flushing of CO2 and byproducts from your system resulting in centrals. (Simply put, Our main drive to breathe is to remove CO2 and its byproducts.) This is what occurs with TECA, Treatment Emergent Central Apnea, too much CO2 is flushed from our system removing our drive to breathe and showing as a central apnea

.

[esaulcatnas]

https://i.imgur.com/D6t1Xlq.png
https://i.imgur.com/SJBSL2y.png

[SarcasticDave94]

Your thread from I think 2021 you'd mentioned the sleep study had almost equal Obstructive and Central Apnea. And again I'm thinking the titration reduced Obstructive but about doubled CA.

As for cause of CA, I'm not certain, but you had them back then.

You might want to stick to one thread. There's no historical context for members to help.

[esaulcatnas]

Ah gotcha. I was mostly trying to make the post subject match the discussion, but you're totally right that historical context is more important.
Would CO2 flushing be increased by pressure alone? I.E without EPR. I was under the impression that CO2 flushing was primarily caused by high EPR.

[esaulcatnas]

Some more context..
First sleep study (5 years ago): 3 obstructive, 4 central, 2 mixed, 106 hypopnea in 5:45 hours. AHI 20, RDI 20.1,
N2 sleep 66%, REM sleep 26%, with no N3 sleep, spontaneous arousal index 15.5/hour

CPAP titration (5 years ago): 2 obstructive, 10 central 6 mixed in 5 hours. AHI 6.8, RDI 7
N2 sleep 77%, REM sleep 16%, with no N3 sleep, spontaneous arousal index 13.1/hour

Repeat sleep study (more recent after losing 20lb): 4 obstructive, 6 central 1 mixed in 4 hours. AHI 6.6, RDI 6.6
N2 sleep 77%, REM sleep 16%, with no N3 sleep, spontaneous arousal index 7.5/hour

Repeat CPAP titration (more recent after losing 20lb): 3 obstructive, 36 central , 0 mixed in 5:43 hours. AHI 8.4, RDI 8.4
N2 sleep 70%, REM sleep 9%, with 16.4% N3 sleep, cortical arousal index 4.7/hour

According to my muse headband I'm currently getting an OK amount of N3 sleep

[SarcasticDave94]

Possibly with higher pressures, more likely with EPR or a bilevel PS. This is if the centrals are caused by CO2 flushing. At least as I'm understanding it.

[Sleeprider]

You pretty clearly have some variable or periodic breathing near the apneic threshold, but in no way do you suffer from Cheyne Stokes. Are these results typical for you? The session in these graphs is only 4.5 hours in duration and the central apnea index is high enough to be of concern, but not serious. Have you discussed your concerns with your doctor. Your Muse headband aside, how do you judge your therapy efficacy?

[esaulcatnas]

I often find I get clusters of these CSA events, and I notice it when I wake up extremely fatigued.
Overall I'm not sure how much CPAP has helped my sleep quality and daytime fatigue, maybe not at all to be honest.

[Sleeprider]

It's not out of the question to move to a more advanced therapy like ASV. I think it might be helpful to look at more examples of your typical sleep and therapy. Meanwhile, I have merged your two current threads. They both deal with your therapy and are very much related. Please try to keep your therapy inquiries in this thread.