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Cluster of centrals
#1
Cluster of centrals
    I see issues many nights where I will get a cluster of centrals... last night it was about an hour before waking up.  14 in a row, about 40-50 seconds apart each.  The flow rate has a repeating pattern... where it goes from around +/- 60 slowly decreasing to nothing over about 6-7 cycles... then the CA registers, and 5-10 seconds later the rate goes back up to +/-60, then it happens over again...  during the entire time these are happening, the respiration rate drops from around 16.8 where it was most of the night, down to 13 or so... then back up when the cluster is done.  Just curious if anyone knows if this pattern is mask/machine related or really CAs.  And why it would happen only around the time in the morning... all night I had only a few scattered CAs otherwise.  Thanks!
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#2
RE: Cluster of centrals
The pattern you are showing is CSR, the smoothness of rise and fall with a Central in between is the signature wave form for CSR. I recall that 15 minutes of the pattern is the "flag for action" and your are about 10 at the longest. I'm not saying that you need a change of machine but your Autoset is not the machine that will treat this condition. Look at your other "Periodic Breathing (PB)" and see what they look like. I suspect you may be having centrals that are too short to classify so look at the pattern.

Do you happen to also have a heart condition or a stroke?
[i]Cheyne-Stokes breathing. This type of central sleep apnea is most commonly associated with congestive heart failure or stroke. This condition is characterized by a gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (central sleep apnea) can occur.[\i]


Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#3
RE: Cluster of centrals
Thanks! I don't have heart failure and never had a stroke... I am looking back at my last year of data, and it appears that it happens once or twice a week... and when it happens, just one cluster a night... also looks like it may happen less or not at all when my pressure is set lower. I am going to have to do some more comparisons with past data, and do some research to see if it can be caused by pressure or other factors. I have often wondered if my mask malfunctioned, or my vent was blocked on DreamWear, whether that would cause an increase in breathing old air and rise in CO2 level.
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#4
RE: Cluster of centrals
post similar zooms of the PB at 315 an 400, also the full night for context.  Always include the left sidebar minus the pie chart and calendar.  that is important info.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#5
RE: Cluster of centrals
I have been experimenting over the last week... i set pressure fixed at 6 with no exhale relief to start... and went up 1/2 each night.  I am at 9 now and I definitely see a pattern of more hypopneas at lower pressure and they drop as I go up in pressure.  Same effect with obstructive, but less to start at low pressure... and still reduce with increases in pressure.

The clear airway numbers seem to have NO correlation to pressure... yet... I am assuming that once I get to a certain point, pressure may induce them. On most nights during the last week my clear airway numbers are less than 1/hr.  But on a random night here and there, regardless of pressure, I get around 5-6/hour.

My periodic breathing numbers are usually between 10-15% regardless of pressure.

I am going to keep going up to 13-14 to see how it affects the numbers... and then settle in on a range for APAP.

But I really want to figure out what else might be causing the CA numbers to vary night to night regardless of pressure... I have always wondered if my mattress is playing a role in this all... it is only 8 years old, but has developed depressions that do cause me to move a lot I think.

Any other posts or resources to help me understand what else could be causing variation in CA numbers from night to night?

Thanks!
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