Lots of Centrals and frequency Cheyne Stokes patterns

[Flex Plexico]

Hey guys,

Out of the blue lately my AHI has gone up to the 10s on average over the last couple weeks, and in general I am seeing a lot of CSR. Please see attached images - any advise or interpretation? No medical conditions at the moment that I am aware of.

Thanks.

[Gideon]

Why are you running with EPR=1?
We commonly recommend low to no EPR to help manage central Apnea.

For now turn EPR off.

Tell your GP, Sleep Doctor and Cardiologist, if you have one,that your CPAP has been showing lengthy periodic breathing of over an hour for several weeks that looks like CSR.
Why, because this has persisted for a period of time and to be safe and cautious.

Because you say no medical conditions I believe this is nothing, but check with your medical team to be sure.



Your periodic breathing is actually long enough to be classified as CSR. It is one of very few that do. It appears to be CO2 based which is what yields the classic pattern you see.

This pattern more commonly occurs from TreatMent Emergent Central Apnea, when your PAP flushes more CO2 from your system than it likes lowering your CO2 concentration to below your your apneic threshold and a central Apnea occurs and you stop breathing. Then CO2 builds up and you build up to heavy breaths once again flushing too much CO2 from your system repeating the cycle many times.

[Zsolt]

Hi Flex Plexico,
I was in very similar situation. I think you need to switch to ASV therapy to reduce AHI events.

[Gideon]

IMHO it is premature to say switch to ASV especially since the CA events have only been present for several weeks. We need to review charts and see what changed to bring these on

ASV is a possibility to be evaluated as we move forward.

[Sleeprider]

Plexico, do you have a copy of a sleep study or titration study? It's clear you are going to need to move to ASV (adaptive servo ventilator) to resolve this, and you will have to have your heart health screened for left ventricular ejection fraction (LVEF) to verify you do not fall into a higher risk group for individuals with heart failure and low LVEF. This is going to require you to contact your doctor. There is simply no way that CPAP or bilevel without a backup function will treat this level of central sleep apnea and periodic breathing/ CSR. The ASV is a high level of positive pressure non-invasive therapy, and this link will help you to understand how it works. Start reading at page 27 - 32 https://document.resmed.com/en-us/docume...er_eng.pdf

If we can look at your sleep study results, we can see if you had CSA before therapy, and were simply prescribed the inappropriate CPAP as a trial. This is a typical approach as CPAP is less expensive and some people respond to it, however, not you.