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First night on autopap (central apneas)
#31
Okay here's the data from last night (have no idea what the hell i'm looking at and hopefully I have the graphs right). Not a very eventful night like the others. I received my p10 nasal pillows and have been using them the past 2 nights.


http://imgur.com/a/vSFtY    (can't figure out how to embed image in thread)
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#32
Johnny, your machine is setup with pressures 5 min to 18 max with 2 EPR.  Your pressure was mostly under 7.5 and averaged 5.5 for the night. Your AHI is acceptable, but would be improved if you increased the minimum pressure to 6.0.  There s a lot of little pressure changes, and the higher minimum pressure would stabilize that and be less disruptive.  We can see some snores and flow limitations that line up with the hypopnea and obstructive apnea, and the CA (clear airway) appears to be more related to sleep disturbance or moving, rather than anything to be concerned with.  There is some leak, but not very large.  Your respiratory rate, tidal volume and minute vent are normal or slightly above average, so this part looks really healthy.

No recommendations other than to increase minimum pressure by 1.0 to 6.0.  If you have questions how to do that, let me know.


[Image: l5Ml1fd.png]
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#33
(02-19-2017, 03:51 PM)Sleeprider Wrote: Johnny, your machine is setup with pressures 5 min to 18 max with 2 EPR.  Your pressure was mostly under 7.5 and averaged 5.5 for the night.  Your AHI is acceptable, but would be improved if you increased the minimum pressure to 6.0.  There s a lot of little pressure changes, and the higher minimum pressure would stabilize that and be less disruptive.  We can see some snores and flow limitations that line up with the hypopnea and obstructive apnea, and the CA (clear airway) appears to be more related to sleep disturbance or moving, rather than anything to be concerned with.  There is some leak, but not very large.  Your respiratory rate, tidal volume and minute vent are normal or slightly above average, so this part looks really healthy.

No recommendations other than to increase minimum pressure by 1.0 to 6.0.  If you have questions how to do that, let me know.


[Image: l5Ml1fd.png]

Thank you. I will adjust to 6 minimum pressure tonight and post the results. Also, The ramp feature is on auto. Should I use that? I assume it's just a personal preference but just wondering if it could effect anything. Thx.
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#34
I would turn off ramp unless you really need it. In default mode it delays therapy up to 45 minutes. Otherwise, increase the pressure to a comfortable level, and use Auto ramp to allow it to start therapy upon detection of sleep onset.
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#35
Okay this was last night. It seems changing the pressure to 6 (good call) totally took away the hypopnea and the apneas but what's with the clear airways here? 

http://imgur.com/a/gvjMA
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#36
Try EPR at 1. I bet you improve.
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#37
I've been using APAP since October 2016 and while my obstructive apnea and hypopnea has been controlled nicely, APAP therapy created a problem with central apneas for me. (In my original sleep study, only 10% were central apneas, since starting therapy, its 70-90% centrals). Early on, my sleep doc reassured me the centrals would likely go away after an adjustment period (2-3 months at most), but in my case they did not.

If you are just starting APAP, it makes sense to see if you adjust. SleepyHead will allow you to monitor your centrals in greater detail - like how they cluster and when they occur throughout the night. Mine cluster as I fall asleep and wake up (which I do a couple of times each night). My CA index runs close to 10 each night, and there is great variation from night to night - sometimes closer to 20, and rarely below 5. After all these months, I am returning for another sleep study, which will confirm the high number of centrals, and will provide the next step to treat centrals - an ASV machine that will replace my APAP. 

Good luck!
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#38
(02-21-2017, 10:00 PM)Sleeprider Wrote: Try EPR at 1.  I bet you improve.

What exactly is the epr doing and how does it cause centrals?

Some of these centrals are 15-20 secs long btw. That has to be disruptive.
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#39
(02-22-2017, 12:02 AM)tiredDogs Wrote: I've been using APAP since October 2016 and while my obstructive apnea and hypopnea has been controlled nicely, APAP therapy created a problem with central apneas for me. (In my original sleep study, only 10% were central apneas, since starting therapy, its 70-90% centrals). Early on, my sleep doc reassured me the centrals would likely go away after an adjustment period (2-3 months at most), but in my case they did not.

If you are just starting APAP, it makes sense to see if you adjust. SleepyHead will allow you to monitor your centrals in greater detail - like how they cluster and when they occur throughout the night. Mine cluster as I fall asleep and wake up (which I do a couple of times each night). My CA index runs close to 10 each night, and there is great variation from night to night - sometimes closer to 20, and rarely below 5. After all these months, I am returning for another sleep study, which will confirm the high number of centrals, and will provide the next step to treat centrals - an ASV machine that will replace my APAP. 

Good luck!
What was the reasoning behind it? That your brain just didn't adapt to apap therapy? My index isn't 10 (which seems pretty high) but the majority of my disruptions tends to be centrals. Hopefully they'll go away.
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#40
(02-22-2017, 12:53 AM)JohnnyGobbs Wrote: What exactly is the epr doing and how does it cause centrals?

Some of these centrals are 15-20 secs long btw. That has to be disruptive.

The EPR feature reduces the exhale pressure in centimeters by the value indicated by a number, 1 through 3.  However, the lowest the CPAP will reduce pressure to is 4cm.  So if you had the EPR set to 3 and a pressure set to 7 or below, it would only go to 4cm.  Using the EPR feature can cause a CO2 washout in the body causing Centrals.

Centrals may be also caused by an increase in pressure that your body isn't use to. All these should eventually go away. If your CA's persist they may be from another underlying ptroblem and you should keep your doctor informed.

I hope this may help.
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