(12-12-2019, 06:32 PM)Sleeprider Wrote: I don't see a central. I see increasing flow limitation leading to a RERA with an open-airway apnea that looks for all the world obstructive based on what is around it. I completely agree with the direction from Bonjour to start treating flow limitation and not be concerned about what is flagged as a CA.
Yes that's what we are doing (flow limitation and RERAs et al).
You'd need to go back to the chart (attached) to see why we are being cautious about the possibility of re-triggering CAs.
I am hoping (and starting to believe) that I may have crossed the acclimatization threshold and that treatment-emergent CAs may now be a thing of the past. If true.. that's a fairly recent transition.
The centrals were previously triggering with EPR 3 (worst-case nightly CAI 32.7 and worst hour clustered CAI rate of approx 94.0 per hour)
In the past couple of days we stepped back to EPR 0 to fix the CAs ...then creeping back up to give RERA support with EPR 1 last night .... EPR 2 tonight ... tomorrow (maybe) back into the EPR 3 realm
We are going slow to try to avoid repeating the treatment-emergent CAs that were seen previously in the attached chart on Nov 28th when EPR was 3.
If I'm hearing you correctly... It's interesting to hear you say that you disagree with the CA flag...is that what you are saying?
I previously asked my Sleep Doc if she had seen any peer-reviewed papers she could point me to that measure how RELIABLE those CA flags are. Sending ripples or pulses down the pipe to try to guess is a cute idea but I've not seen any papers measuring just how ACCURATE these flags are. We can't know for certain unless we have a study that compares the flags against readings from chest bands to truly measure if the muscles are working or not. Unfortunately she did not know of any such studies and just believes the flags because Resmed marketing tells her to. I am a more skeptical audience... maybe you are too (if I'm reading your response correctly).