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Having Centrals but not Diagnosed with Centrals, also having CSR's
#11
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
same night with Vitaom data
#12
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
There are zero obstructive events, and pressure settled in at the minimum pressure of 11.0 for most of the night. I'd like to see the flow limits chart moved above the respiration rate, because that is what drives pressure. I honestly think a minimum of 9.0 and maximum of 11.0 might produce fewer CA events and will limit the pressure fluctuations which are meaningless for therapy. Your issues are all central, and it is low, steady pressure that has the best chance of minimizing it. If you want to minimize CA, we need to drop pressure and find where the airway is most stable. As I have already said, CA events will be consistently inconsistent, so expect some event rate variation. Until we see some real obstructive apnea, we should focus on reducing pressure.

As your oximetry data shows, CA events are rarely significant for oxygen desaturation.
Sleeprider
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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.
#13
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
@Sleeprider

I have added flow limitation as requested & added in the first night I tried having a pressure (top pressure) of 15 instead of 20

With Flow Limit

[attachment=24922]

First Day

[attachment=24923]
#14
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Turn off your EPR It is set to 1 and Ramp only. and the Ramp off too.
#15
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(07-23-2020, 08:30 PM)bonjour Wrote: Turn off your EPR It is set to 1 and Ramp only. and the Ramp off too.

I tried ramp off and EPR off and, I lay there for 4 hours with the machine on unable to get to sleep. I need to practice that setting to get used to it, because I’m not and I felt like I was choking, I thought I’d use the ramp with EPR to get to sleep and then have it turn off once I’m asleep and hoped for a good / better result than previously.

But I take that advice onboard thank you
#16
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
(07-23-2020, 07:27 PM)Sleeprider Wrote: There are zero obstructive events, and pressure settled in at the minimum pressure of 11.0 for most of the night.  I'd like to see the flow limits chart moved above the respiration rate, because that is what drives pressure.  I honestly think a minimum of 9.0 and maximum of 11.0 might produce fewer CA events and will limit the pressure fluctuations which are meaningless for therapy.  Your issues are all central, and it is low, steady pressure that has the best chance of minimizing it.  If you want to minimize CA, we need to drop pressure and find where the airway is most stable.  As I have already said, CA events will be consistently inconsistent, so expect some event rate variation.  Until we see some real obstructive apnea, we should focus on reducing pressure.

As your oximetry data shows, CA events are rarely significant for oxygen desaturation.

I’ll give those settings a try tonight, I’ve got nothing to loose.

So pressure of 9 to 11, because the pressure is lower I’ll put Ramp Off and EPR off and see how I go.

Thank you for the advice

I might struggle to get to sleep as I found it hard with EPR off but we will see.
#17
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
If you feel like you are choking, that is usually a sign of CA events kicking in at sleep onset. There is little difference in EPR at 1 or off in terms of efficacy. I normally agree with Bonjour, and know he will recommend a user to keep EPR at a low level if EPR off is not tolerated as you describe. We have been in this rodeo before. If your CA events continue or increase, we are going to pursue a different therapeutic path. Meanwhile we try to optimize as much as possible, and take a conservative course that usually works. Your objective other than that is to make therapy as comfortable as possible.

Recall that the first set of changes was to "tame the chaos". We found that those changes resulted in an effective pressure to address obstructive events, however central events were inconsistent. We will refine those changes with the last set of recommendations to minimize the chance for CA, then observe what we have. So 9-11 EPR 1 for comfort.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
#18
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
I'll make it official, I concur.
#19
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
So glad I checked this thread before bed, will adjust those settings and post in the morning; thank you for trying to help.
#20
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's
Correct me if I am wrong, the night it sat at 11 EPR was off; so shouldn’t the top pressure be 12 as the EPAP is therefore 11 the magic number?


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