Looking for Advice [Erratic results, many centrals]

[snoopj123]

I'm going to preface this by stating that I've been using my BiPAP for about 14-15 months now.  The last few months, I've been getting consistent numbers in the 1-3 AHI range.  However, something has changed and I'm not sure what's going on.

I travel quite frequently.  That means different hotel beds with different pillows and such.  However, I've had pretty good luck keeping the numbers pretty good.  As an example, I traveled to San Francisco for a work conference last week.  My numbers were pretty good, as seen here:

   

At home, it's starting to be a completely different story.  My numbers are now all over the damn place, as seen here:

   

I did get a new batch of supplies recently.  I'm using the Dreamwear Full-Face Mask.  Up until this newest batch of supplies (new headgear, new face mask, new hose, etc), I was perfectly fine bouncing between the house and hotels.  Now, when I'm at home, I'm getting double digits when I should be getting between 1 and 5 for the AHI numbers.  I am a side sleeper and I know Dreamwear isn't exactly the best, but again, up until this last batch, I was doing fine.  I also feel like I'm not getting as much pressure, even though my leak numbers don't seem that bad.  I'm just wondering if I've ran into a bad batch of equipment or my body is in full revolt of the bed/sleeping arrangement at home.  The road, I don't seem have nearly as bad of problems with getting rest.

At a loss, folks.  I guess I could ask about pressure adjustments, but something seems off here and I can't quite put my finger on it.  I'm also wondering if my numbers are artificial due to potential of fighting with equipment.  I've seen that happen before (I switched from a F&P mask because of this).  I've thought about starting to add more things like a cervical collar when at home, along with looking into what sort of options for better side sleeping pillows with masks.

--j

[srlevine1]

You may wish to space out one of the areas of interest ( large number of CA's) so greater detail can yield a better analysis by the community.

Also, although there were no "large leaks" indicated it does appear in the statistics that there may be significant leaking.

Are you continually adjusting your mask? When I got a new mask, I kept moving it around for a more comfortable fit (I have a moustache and beard) and found out that I was holding my breath during the adjustments.

Best wishes for a resolution to your question.

[DeepBreathing]

G'day snoopj123.

Could I ask you to reformat your charts so we can get a better view of what's happening please? In particular, turn off the calendar and pie chart, and re-order the various graphs. See the instructions here: http://www.apneaboard.com/wiki/index.php...ganization

As srlevine1 said, it will also be useful if you could zoom in on a short (~3 minute) section so we can see those events in detail.

[Gideon]

Also need more history, how often are the numbers similar to 1 Sep? A 1-off is not worth chasing.
That said Centrals are often consistently inconsistent. A look at your Overview page will help with the history.

[snoopj123]

My numbers started going erratic over the last 3-4 weeks and only when I'm at home. And yes, I do find myself adjusting things a bit. I'm going to downgrade the mask from a M to a S to see if that can help as I feel like I might be getting leaks around the nostrils with the current masks. The weird thing is that I've been using a M for about a year, but who knows if they resized something somewhere.

I'll get some more data and drill into some of those areas here tomorrow morning for folks.

[snoopj123]

Here's probably the worst cross section of a three minute period from Sept 1.  It's one of the most clustered sections of the whole night.

   

[DeepBreathing]

Your leaks aren't terrible by any means - certainly not enough to cause that dramatic up-tick in central apneas. I'm wondering if there are any personal / environmental factors at play - do you take medications at home but not when travelling? Do you have a drink or two at home but not when travelling? Any exposure to chemicals, gas leaks etc at home? Difference in altitude?

<Edit> Thanks for posting the updated chart. The zoom-in shows they are definitely central apneas and not misdiagnosed obstructives. I'm not convinced that your mask or leaks have anything to do with this - I'm pretty sure it's either an internal health issue or environmental factors. Have you had a medical checkup lately? Have centrals always been part f your apnea history?

[snoopj123]

As far as history, here's the last quarter, starting on June 1st, ending with my most recent data.  I received my new equipment around July 21st and have essentially fought with it since.  It should be noted that all instances where the numbers fell back down again, I was on the road, including my most recent trip to SF (that I mentioned in the first post) from Aug 24 through Aug 29.

   

[snoopj123]

Your leaks aren't terrible by any means - certainly not enough to cause that dramatic up-tick in central apneas. I'm wondering if there are any personal / environmental factors at play - do you take medications at home but not when travelling? Do you have a drink or two at home but not when travelling? Any exposure to chemicals, gas leaks etc at home? Difference in altitude?

No.  The only difference I can think of is that the bed at home is much different than those on the road.  My wife insists on her Temperpedic bed, but I've shown to be able to stay below AHIs of 5 as part of my history.  My medications are the same (only an allergy med) and altitude shouldn't be an major issue between my usual travel destinations.  In fact, I do have some history showing when I camped at elevation (7600 ft) and it's some of the best numbers I've ever had.  The only thing I can point to is that I've grown to hate the bed/pillow at home and I've been fighting with the new Dreamwear equipment I received in the last 45 days.

[Gideon]

Your charts show a fairly solid history of Centrals and they are , as expected, quite variable to the point of being essentially non-existent. Your current machine ca.nnot treat it. It is unlikely that these are treatment emergent Central Apneas.

Let's try to avoid the Centrals, set you PS to 2, possibly going to zero. Yes, I know, a big change, but it should knock down the Centrals.