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My first days of trying
#1
My first days of trying
I noticed i do have Central sleep apnea as following pictures show, when i am using Full Face Mask, but when using Nasal Pillow  Mask, there is no CA showing.

It seems that the AHI with the Full Face Mask are higher than with Nasal Pillow Mask.

What can I do, do i really have CA's? I am 34 years old.

I have attached the screenshots of OSCAR here.

[Image: f5z9vdkg.jpg]


[Image: 8l29ntvn.jpg]

[Image: fg5nw9z9.jpg]

[Image: wqhlellc.jpg]
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#2
RE: My first days of trying
What did your sleep study show?

You only have a couple of central events, so no, I wouldn't say you have central sleep apnea. The odd event or two is probably nothing to worry about. It could be sleep-wake junk around times you're falling asleep or waking up, or it could be you rolled over and held your breath while doing so, or took a deep breath, and then didn't need to breathe for a little longer.

Looking at your charts in particular, the first one shows that you took a huge breath right before the CA, so that's the cause of that. Probably rolled over or something, I would guess. The second one has some flow limited breathing immediately before but I can only see one breath on picture 3, but I imagine that maybe you partially stirred because of the flow limits and that triggered the second CA.

In other words, within normal limits.
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#3
RE: My first days of trying
(01-01-2022, 09:08 AM)Ratchick Wrote: What did your sleep study show?

You only have a couple of central events, so no, I wouldn't say you have central sleep apnea. The odd event or two is probably nothing to worry about. It could be sleep-wake junk around times you're falling asleep or waking up, or it could be you rolled over and held your breath while doing so, or took a deep breath, and then didn't need to breathe for a little longer.

Looking at your charts in particular, the first one shows that you took a huge breath right before the CA, so that's the cause of that. Probably rolled over or something, I would guess. The second one has some flow limited breathing immediately before but I can only see one breath on picture 3, but I imagine that maybe you partially stirred because of the flow limits and that triggered the second CA.

In other words, within normal limits.

My sleep study showed that i have a lot of OSA distruptions during REM sleep, almost every minute is an arousal, so the total AHI over entire 8 hours was 6.

It was not recorded with WatchPAT, so it was not arrucate.

The doctor said, the result of AHI 6 was "very good results", i dont need CPAP, he said. I didnt trusted him and i brought the AirSense device myself.

Yes, i do roll myself a lot in the sleep.
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#4
RE: My first days of trying
An AHI of 6 generally only needs treatment IF you are symptomatic, according to guidelines, but there are plenty of people here who experience symptoms below an AHI or RDI of 5, and need to get below 1 or 2 to feel okay. So if you feel unwell, with an AHI of 6, and this helps you to feel better, then your doctor is wrong.

But yes, don't worry about the odd central. Looking good.
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#5
RE: My first days of trying
A study like WatchPat can under estimate real AHI because it does not account for awake time. This dilutes the real AHI (events per hour). CPAP can also treat flow limitation and respiratory effort related arousals. While many sleep doctors do not look for this, it can significantly affect your sleep quality and health. Your settings of 7-20 with EPR 2 is treating flow limitation very well. It is likely that if you turned off EPR you would see more flow limitation and experience even more arousals. Your main challenge at this point is to get more hours of use from your CPAP each night. The charts above are only 24 minutes to 1:45 per night, and that is not going to be nearly enough. Your goal should be 7-8 hours per night.
Sleeprider
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#6
RE: My first days of trying
If the test results didn't show Central Apnea, these are treatment emergent Centrals. A Central is typically going to occur when your CO2 level is lower than normal and delays a breath. This is somewhat different than a sleep position shift and breath hold. The breath hold type is totally controlled by you, the treatment emergent type isn't.

If there's treatment emergent CA, you can reduce them by changing settings if the CA are a disturbance. You'd need to reduce things like EPR or PS depending on the machine you have. Your AutoSet has EPR at 2, so if CA become a problem, reduce EPR to 1 or off. Also Ramp can add variable that increases CA. Reducing ramp and EPR reduces the efficiency of the PAP in exhausting CO2.

Realistically right now the CA sound bad at AHI-C 5.0, but this was I think 2 in the 25 minutes you used the PAP. So no CA trainwrecks here.

Here's what my pre-dominant CA would be as a visualization of the Trainwreck would look like on the same AutoSet. For comparison/contrast. Note I have pre-dominant Central Apnea and COPD/Asthma. And yes my settings are intentionally not optimized to avoid CA.

   
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: My first days of trying
Ha, we won't scare OP with mine too. Big Grin

Definitely seconding what Sleeprider says. Work on being able to use it all night, because any time you're sleeping without it, then you're undoing the good that you get from using it.
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#8
RE: My first days of trying
Currently, i will countinue to try with Nasal Pillow Mask the next night, i feel comfortabler with it than with Full Mask. And hopefully try to full 8 hours with it, because after some time, i will wake up and remove the mask myself without noticing it. Because "feeling without the mask" feels better.
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#9
RE: My first days of trying
If you're removing it in your sleep, there are some tricks that might help you stop that (by making it more tricky and hopefully waking you enough to stop). Things like using hair grips/bobby pins to attach the headgear to your hair, if it's long enough, I've heard of someone taping the straps to their cheek with medical tape (just a little to draw attention!), or even wearing socks or mittens on their hands until they stop trying to take it off. So there are definitely things to try if that becomes a persistent issue. Wink

It does get easier though. When I started I thought I would never get used to it, but now, after 10 months, I can't fall asleep without the mask, I keep jerking awake if I'm not all masked up.
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#10
RE: My first days of trying
A few additions to the good comments you've gotten so far.

WatchPat studies -- at least some kinds -- include inferences about waking periods and sleep stages, and then they calculate AHI for the sleep periods only. The accuracy would be better with a full polysomnographic study, but some studies suggest a correlation of about 89% between WatchPat results and PSG results. Can you get a copy of your test results?

CAs are notoriously inconsistent from one night to the next, so I think you're right to base your choice of mask on comfort rather than correlations with CAs.

To add to Ratchick's excellent list of suggestions, some people put on a cap at night that has strings to tie under the chin.
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