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[Equipment] CSA #'s that require BPAP or BPAP-SV?
#11
(03-12-2014, 07:03 PM)WakeUpTime Wrote: It's another night of the persistent Central Sleep Apnea events (5/hour) on a regular CPAP machine.
Just wondering if they're part of "getting used to the new CPAP machine" or perhaps I really
do need an AutoSV machine to get rid of them altogether.

I wouldn't be overly concerned. They are part of the adaptation to CPAP therapy for many of us.

If you'd like, you can use SleepyHead to see how long these CA events last. They have to last at least 10 seconds to count as a CA. If they last significantly longer, or if you are concerned for any other reason, you can ask your doctor about it.

If I were you I would NOT adjust your pressure. Your CA index is very low and will likely drop as you adapt to CPAP therapy. If it doesn't your doctor might want to lower your pressure temporarily, but I doubt it's necessary, and it will likely raise your OA and H indices, so it's a dodgy business.
Sleepster
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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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#12
Looks like you are on the cusp of an abnormal amount of central events which is usually accepted as 5 central events an hour when asleep and not in wake/sleep transition when central events are regarded as normal. You may well end up needing an ASV machine to completely stabilise your breathing. However I would recommend trying switching off the CFLEX/AFLEX if it is not too uncomfortable or at least substantially lowering the level. This has been shown to reduce central events in certain individuals (such as myself with full Complex sleep apnea). In my opinion it is certainly worth a try.
Ian
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#13
(03-13-2014, 07:30 AM)igdoc Wrote: Looks like you are on the cusp of an abnormal amount of central events which is usually accepted as 5 central events an hour when asleep and not in wake/sleep transition when central events are regarded as normal. You may well end up needing an ASV machine to completely stabilise your breathing. However I would recommend trying switching off the CFLEX/AFLEX if it is not too uncomfortable or at least substantially lowering the level. This has been shown to reduce central events in certain individuals (such as myself with full Complex sleep apnea). In my opinion it is certainly worth a try.
Ian

You understand my situation very well. I'll try exactly that. (Much appreciated.) It's either a transitional thing (only 2 mo. of CPAP) or the "Complex" part of CSA (CSA during CPAP). [No significant CSA was detected during the sleep study; only with CPAP.]

I'm just curious how much time to give it before being convinced it's CSA. Perhaps somewhere in a 6-12 month window I suppose. I really seem to be stuck on that 5 CA events/hour number. I don't know if that's the cause of the ongoing crummy sleepless nights on CPAP. (It's not a tolerating thing.) The OSA is down to a low 2, but sleeplessness continues (awake every 1.5 hours last night).

The machine's set at a constant 12 at the moment rather than variable, which seems to be the number that almost ends the OSA. The pressure doesn't really bother me, but my stomach each morning is sure ballooned/bloated/cramped.
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#14
(03-13-2014, 07:55 AM)WakeUpTime Wrote: The pressure doesn't really bother me, but my stomach each morning is sure ballooned/bloated/cramped.

Turning off or lowering the EPR will likely make that problem worse.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#15
The papers I have read suggest that 80% of people who initially have large numbers of CPAP induced central events will improve by 2 months. That is not to say that after 2 months no one will see improvement but it may be less likely to happen. The improvement is due to the body potentially readjusting the Carbon Dioxide apnea threshold level.

The important thing is why you are sleeping badly as a few central events are not likely to be the cause unless they are prolonged. Lowering the EPR/CFLEX/AFLEX will certainly not help aerophagia causing your bloating but it will probably not make it significantly worse.
Ian
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#16
(03-11-2014, 03:29 PM)WakeUpTime Wrote: I get a good sleep until about 3am with CPAP but the rest of the night is just awake but somewhat paralyzed.
Can you think of any reason, why you cannot go back to sleep?

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#17
(03-13-2014, 03:49 PM)Sleepster Wrote: Turning off or lowering the EPR will likely make that problem worse.

I'm still relatively new at this, so please pardon my ignorance... Turning off the Exhaust Pressure is the same as making the Exhaust Pressure the same as Inhale Pressure yes? Therefore, turning it off would make the bloating (from air) worse. That part I think I get. It would make the BPAP behave like a CPAP.

However, "lowering the EPR" in BPAP makes it easier for the Exhaled air to escape, and therefore would reduce air in the stomach wouldn't it?

(03-13-2014, 04:15 PM)zonk Wrote: Can you think of any reason, why you cannot go back to sleep?

I do stay in bed, but don't go into anything that I would describe as a comfortable deep sleep. It's a "surface resting state" with an exhausted body. No, there's no big worries, or high stress, or heavy alcohol use (everybody eventually asks). I suppose there could be some subconscious frustration of "here we go again, day number 212 of 4 hours of sleep".
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#18
(03-13-2014, 04:15 PM)WakeUpTime Wrote:
(03-13-2014, 04:15 PM)zonk Wrote: Can you think of any reason, why you cannot go back to sleep?

I do stay in bed, but don't go into anything that I would describe as a comfortable deep sleep. It's a "surface resting state" with an exhausted body. No, there's no big worries, or high stress, or heavy alcohol use (everybody eventually asks). I suppose there could be some subconscious frustration of "here we go again, day number 212 of 4 hours of sleep".
Check Robysue profile, she have blog titled "adventure in hose land" which include chapter about insomnia among other useful stuff
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#19
Don't worry we have all been new to this at some stage. EPR is Resmed's CPAP/APAP version of exhalation pressure relief and CFLEX/AFLEX is Phillips Respironics version. There are technical differences but essentially they both reduce the pressure during exhalation compared with inspiration to increase the ease of breathing. Switching them off could potentially increase the aerophagia but the pressure change is relatively small compared with your inspiratory CPAP pressure of 12 and therefore any effect on this should be small. Hope I have understood and that this helps.
Ian
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#20
(03-13-2014, 04:40 PM)zonk Wrote: Check Robysue profile, she have blog titled "adventure in hose land" which include chapter about insomnia among other useful stuff
You're right. Robysue is an amazing resource with great help. I'll follow some of these ideas.
(If she offered a course, I'D TAKE IT!)

Insomnia is an interesting subject. For me, it's hard to just get up and do something else. Why? The brain is wide awake (the heart too sometimes) but the rest of the body is in a near-paralyzed tired state. My eyes are burning, etc. To do something else is sometimes even harder. I have to experiment with an audio book sometime to see how that might work out.
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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