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Need Help - Centrals? + I just can't stay asleep!
#11
RE: Need Help - Centrals? + I just can't stay asleep!
Based on your above statement and not data, I GUESS you should increase your EPR to 3.

thanks
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#12
RE: Need Help - Centrals? + I just can't stay asleep!
Sorry I didn't upload data. I'm at work right now, but I can do that later. I really do appreciate your help. I understand what you're saying about adjusting the EPR to 3 and I will try that.

A couple of questions: My initial sleep study ONLY showed centrals, so I don't think necessarily that the general presence of centrals is reflective of a treatment-emergent situation. Being that I'm not an expert, is my thinking accurate? Also, If I stick with sleeping with EPR on, is it possible for any additional centrals (due to the EPR) to resolve themselves over time while the flow limit reduces?

And honestly, is the issue really just that this is the wrong machine for me?
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#13
RE: Need Help - Centrals? + I just can't stay asleep!
It's probably just me but I'd vote to get the ASV. With zero Obstructive and otherwise all reporting Central Apnea, it may be where you're headed. We have seen quite a few apnea patients that can be treated on straight CPAP which avoids spending big dollars on the ASV. Try the one you have a few days at least, reporting how you feel, and with OSCAR data. This tells us what to suggest.
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#14
RE: Need Help - Centrals? + I just can't stay asleep!
If increasing EPR doesn't substantially increase your central apnea we know that your central is not treatment-emergent as is suspected than there is a stronger case to get a different machine. I saw flow limitations that would be nice to be treated, and they were in absence of significant obstructive events. That means that you may have UARS which complicates your treatment, It is very important for you to state your issues, all of them as well as watching your numbers. You stated that your AHI increased, you did not say what the components of the AHI did. I thought that there was a reasonable explanation of your issues and it wasn't what was being chased. Your central events are not that bad, and they need to be balanced with all that is going on.
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#15
RE: Need Help - Centrals? + I just can't stay asleep!
bonjour really knows his stuff. You may want to do a bit of research on UARS.

It is something most sleep doctors ignore, due to ignorance or because it sits outside of “AHI” data. In overly simplistic terms it is a narrowing of the airway that is not quite a hypopnea or obstruction; but it is enough to disturb your sleep even if you are unaware that it happened. Sometimes you wake up after numerous disruptions, and sometimes you “sleep” through them and feel horrible and tired the next day.

I think bonjpur wants more EPR so there is a definite increase in pressure from exhale to inhale to try and eliminate them. He, and some others here, will point you in the direction to go with this machine, or maybe one that is more advanced.

I don’t know about CBT-I, other than a cursory glance. I can see how getting into a set schedule will help in some ways, but if you have USRS, it won’t open your airway.

John
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#16
RE: Need Help - Centrals? + I just can't stay asleep!
Thank you and than you Bonjour as well. I’m going to try the EPR at 3 tonight. Will report back with data. Y’all are very kind to help out!!!!!
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#17
RE: Need Help - Centrals? + I just can't stay asleep!
Hello, welcome.

I don't know anything about treating CA.  But I have some experience (of myself only!) of UARS.  You have major flow limitations all night long.  Basically it means your body's working really hard to try to get air through a constricted passage, whether that be throat or nose. People with UARS don't get to the point of having an actual apnea, their body wakes them up before the full obstruction.  That can means waking hundreds of timer per night in an attempt to use muscles that we use when we're awake, but not asleep, to do the the work of breathing.  Have you had an ENT take a look?  Can you breathe freely through your nose during the day and during the night?
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