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Thanks jaswilliams. I appreciate the response! Funny you should mention the CA's and the thought about holding one's breath when changing positions.
I'd like to open this up for discussion because there is something about the length of the CA's and a possible association to breath holding and position changes that makes me curious.
Sleeprider, SarcasticDave, Bonjour, jaswilliams and any others, feel free to chime in if you have any thoughts!
I've attached some charts from last night to dovetail on my prior post(s).
When I have these CA events, many of them range in the 15 to 16 second timeframe. Is it really possible that i'm holding my breath that long? That seems like an awfully long time to hold one's breath when flipping over, spinning around, etc. I can definitely confirm that i'm NOT holding my breath when i'm awake AND changing position. I'm actually pretty aware of what's going on when I wake up to move. I have no idea about the times when I move and are still asleep. As I initially and recently mentioned, I was reported to have Centrals in the sleep report and through the notes by the reviewing Dr. Who know's if that was accurate.
What's the best practice when i'm still having CA's but seem to have dialed in the therapy for most other considerations? And what's the typical threshold where one would push other therapy, like ASV, in cases like mine when CA's are still persistent? I know there's a lot of issues to consider, but i didn't know if there was an overarching template or best practice to follow. I also know it's about how I feel. I feel a lot better than I did before therapy, but it's impossible to tell if I could feel even better. Makes me wonder. I still never wake up perfectly "refreshed", at least I think that's the case as I don't believe i've ever experienced that in my life! lol. However, I don't feel like I was run over by a truck anymore. That's a positive sign. Ha.
Curious, do you think I could possibly even reduce the FL even more? I know it's pretty low already, but would EPR help? It would be easy to try, but I just didn't want to then deal with possibly introducing more CAs. More of a minimum pressure? I'm currently set at 9 for the minimum.
Like you, I'm skeptical that you're holding your breath. For one thing, the CAs ensue after you have exhaled.
It looks to me as though you're hitting your "apneic threshold" every so often. A bigger-than-normal breath washes out just enough CO2 to reduce your "breathe now" signal.
Your body may continue to adjust as time goes by. A few centrals are completely normal and nothing to worry about.
Eventually, you could try reducing the FLs by gradually increasing EPR, but I'd suggest you hold off on that for another month or so. The increase in EPR might increase the number of centrals you see.
That makes more sense to me than holding my breath, at least in my particular situation, when dealing with the length of the CAs and the location of the event being after an exhale. I was also contemplating raising minimum pressure a bit, but according to the titration protocol, that might also increase the number of CA's. Also, I've pretty much eliminated other Hypopneas and Apneas so I wasn't sure that would even result in anything beneficial.
Much appreciated! I'll guess I'll just keep rocking these settings, and try to get more sleep, unless anyone else wants to chime in! ?
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
To me the data looks very good. If the therapy is maintaining comfort, keep it as is. I myself didn't see any cause to change it.
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.
My comment on breath holding was purely that a thought you can normally see on a zoomed flow if the CA’s are arrousal related as there is a disturbance in the flow prior to the CA. With your current number I would not change anything
I'll stick to what I have for now! I have a little bit of a competitive spirit, so I'll see if over the course of a few weeks/months a slight variation in pressure and/or EPR might assist even slightly more with CA's and FL's
All the assistance and suggestions are greatly appreciated! I'm glad this board exists. There should be an uproar in the medical (sleep) community about how we are getting better help in an online forum than with our very own Dr.'s. It's both a sad state of affairs and fantastic at the same time! Good luck to all!
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
The docs still get the boat payment despite poor assist on a medical condition that they can't be bothered to take a hands on approach. Their hands are busy grabbing the cash but can't scribble or type good therapy scripts or notes regarding the sleep study.
Check in with OSCAR and some feedback how your therapy is going. And ask questions as well. No charge.
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.