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I'm following up on this from post back at the end of the year. CAs tend to dominate my score, but they occur between 3:30 and 5:00, just when I am starting to wake up. I'll stay in bed for another hour, but just dozing on and off - never in a deep sleep. I've heard about something called "false CAs" but I can't tell if this is what I am experiencing. My sleep lab is useless as a source of advice. I have attached a screenshot from last night.
Overall, therapy looks good with one cluster of CA in the morning ahead of what looks like the best sleep of the night. We would need to take a closer look at how those events initiate to understand what is going on. Your median pressure is 10 cm, and I think if you can tolerate setting the minimum pressure equal to the current median actual pressure, you might get less disrupted sleep. Your pressure pretty much moves between 10 and 12 all night. If you are using a ramp from 4.0 cm, that seems a bit low, but at least it doesn't last long.
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.
First thing I will do is start increasing the minimum pressure to 10 in small increments.
In terms of ramp. would you suggest (1) moving it up in tandem with the increase in minimum pressure, (2) leaving it at 4, or (3) turning off the ramp entirely?
As you gain experience with the therapy, you will eventually find you don't need ramp at all. Increasing the minimum pressure is a good way to wean off of ramp. We want you to be comfortable, but ramp often interferes with getting a good mask seal or appropriate therapy while it is in use. That does not seem to be a problem in your case, but try some higher starting pressure and see what works best for you.
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.
I have been incrementally increasing both the ramp pressure and the minimum (toward 10) as you suggested everything seems to be going well. Each morning I have been shutting down the machine and unmasking when I wake up between 4-5 am. Last night I tried something different. After waking up around 4-4:15, I kept everything going until about 5:30. The attached Oscar chart shows what happened. Overall my AHI was 4.04, with 27 CA events. If I had stopped treatment at 4:15, my AHI would have been approximately 0.5, with 2 CAs. Any ideas as to what's going on here?
Most likely those centrals are you tossing and holding your breath which is common while awake. This is a guess because you have not provided the detailed screenshots Sleeprider requested to make that determination.
I don't know about you but I hate guessing on my therapy and really hate it on someone else's therapy.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter
SingingWolf, I'm satisfied you have reached a good pressure setting and no need to move higher than 9.2 minimum. The pressure has stabilized and it's fine to hold here for a while.
As Gideon said, we can't tell much about the centrals without a closer view of the respiratory flow. I agree this could be a series of breath-holds or unstable respiration due to transitional sleep. We're not really concerned that you are developing a serious central apnea syndrome as it is not present most of the night.
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.
