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First night on autopap (central apneas)
#41
Ok here's last night. I changed the epr to 1. Lots of leaks and I still have the random centrals. Are some centrals normal?

http://imgur.com/a/dCKA

[Image: dCKA]
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#42
How long are these CA's lasting?  

Also, to  embed an image you can add a ".png" to the end of Imgur link and put it between a "[img][/img]" block.
thus the address would look like this: http://i.imgur.com/QR5PWfA.png. Another way is to right click on your imgur image and select "Copy Image Location".  Then use the "Insert an Image" option from the editor bar and paste the link into it.
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Useful Links -or- When All Else Fails:
Posting SleepyHead Charts in 5 Easy Steps
Robysue's Beginner's Guide to Sleepyhead
Apnea Helpful Tips
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#43
Image embedding just requires image tags around the URL, so [ img] URL [/ img] (without spaces).

Your centrals are not at a level that should be a concern and they are evenly spaced through the night, rather than clustered. All of this points to the likely cause being minor changes in sleep stage, body position and potential arousals rather than a central apnea that is related to a health condition. It is normal for these to diminish in time. CA events can be reduced by using more steady, lower pressure or less EPR if they are caused by excessive ventilation (CO2 washout). I'd rather see you focus on how you feel, rather than the AHI. This is an acceptably low event rate, and very little indication of obstructive apnea, at relatively low PAP pressure. There is no compelling reason to make changes at this time unless you are experiencing discomfort of some kind.
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#44
Thank you everyone for helping so much. This forum is great.

Regarding the length of the centrals, between 10-20 seconds. Total it says I spent 4.xx mins total in apnea.

It seems the obstructives have disappeared completely since you guys recommended the 6 min pressure. I will keep the epr at 1 and see how that goes for the centrals. My leak was 16ml last night with nasal pillows which I thought was odd since it was 1ml the night before. I could've been sleeping face down or something and tilted the mask I guess.

I feel pretty good. I have depression/anxiety/etc, not sure if caused by apnea or life. So not sure what exactly is caused from sleep apnea or life/stress/anxiety but treating the sleep apnea certainly can't hurt the cause. I definitely have felt groggier when waking up before the cpap therapy though so that's a good sign so far.
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#45
This person has a situation similar to yours, if not worse. http://www.apneaboard.com/forums/Thread-...n-yes-down We took out EPR and made pressure fixed...you might find the results interesting.
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#46
(02-22-2017, 12:58 AM)JohnnyGobbs Wrote:
(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.
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.

I don't know why I did not adapt. Perhaps, my CO2 sensors are too sensitive, or not sensitive enough. My sleep doc told me about 10% of his patients have persistent centrals. 

I'm not an expert, but have found some answers about how centrals are caused by PAP therapy. I've found a good explanation at  
freecpapadvice.com/central-sleep-apnea. There are 3 videos on this page, the middle one gives a good overview of how our CO2 sensors are thrown off due to pressurized air flow. 

For me, lowering EPR did not work (tried for 3 wks), and is less comfortable. However, it appears to work for many from what I've read online.

Another thing about Centrals is that they can be falsely flagged... without a detector around your chest to detect movement of your diaphragm, the PAP device uses a less reliable method to pick up centrals. This is why they are labeled "Clear Airway Events" rather than Centrals. Just an extra variable in all this. It is clear in my case that mine are persistent and the vast majority are real. I added a pulse oximeter to my monitoring and found that my centrals typically cause SpO2 level to drop into the low to mid 80s during my first 20 minutes of sleep. Not good, but they bounce back up into the high 90s intermittently (quite a zig zag) with each deep breath following a central. I am completely unaware of all this as it happens.

Hopefully, your centrals will be transient and disappear in a short time.
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#47
Thx for the responses. I've also noticed epr 1 seems a little less comfortable than 2 but will keep trying it for now and see. Also, I don't think I'm having enough centrals for them to be treated, correct? An index of 1 or 2 centrals total isn't enough to warrant treatment from what I've read. But I have to assume they're still disruptive at 10-20 sec breathing pauses.
I will keep monitoring and posting graphs with the epr at 1 and see where it goes.

Also, regarding getting the image to come up in the thread I did [img ] link [/ img] (with no spaces) on the edit of my graph post today and it still didnt show up in the thread. Any ideas what I'm doing wrong? Thx.
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#48
(02-22-2017, 02:32 PM)JohnnyGobbs Wrote: I did [img] link [/ img] (with no spaces) on the edit of my graph post today and it still didnt show up in the thread. Any ideas what I'm doing wrong?

That link is longer a valid address.  You can also use photobucket.  Membership is free and you have a dedicated storage directory for your images.
______________________
Useful Links -or- When All Else Fails:
Posting SleepyHead Charts in 5 Easy Steps
Robysue's Beginner's Guide to Sleepyhead
Apnea Helpful Tips
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#49
(02-22-2017, 12:09 PM)Sleeprider Wrote: This person has a situation similar to yours, if not worse.  http://www.apneaboard.com/forums/Thread-...n-yes-down  We took out EPR and made pressure fixed...you might find the results interesting.

Interesting read. How many nights does it usually take to respond to setting changes? I'm sure it varies but if it doesn't work the first night could it still work the second night or should you keep changing until you see overnight results? Should I stay at epr 1 a few more nights or go to epr 0?
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#50
(02-22-2017, 12:06 PM)JohnnyGobbs Wrote: It seems the obstructives have disappeared completely since you guys recommended the 6 min pressure. I will keep the epr at 1 and see how that goes for the centrals. My leak was 16ml last night with nasal pillows which I thought was odd since it was 1ml the night before. I could've been sleeping face down or something and tilted the mask I guess.

I feel pretty good. I have depression/anxiety/etc, not sure if caused by apnea or life. So not sure what exactly is caused from sleep apnea or life/stress/anxiety but treating the sleep apnea certainly can't hurt the cause. I definitely have felt groggier when waking up before the cpap therapy though so that's a good sign so far.

I think your centrals are pretty low, and some centrals are common. This might be useful: my centrals worsen with increased anxiety. Doesn't mean they go away for me when I'm relaxed, but it does make things worse when anxiety gets high. One of the things I try to avoid is researching sleep apnea late in the evening because it often creates some anxiety for me given that I'm still not being effectively treated, although I'm confident I will get there. Our mindset definitively influences outcomes.
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