New to CPAP - First Night Great, Second Night not so much

[OpalRose]

Thread split as requested. New thread for [Sheepless PLM] find here:
http://www.apneaboard.com/forums/Thread-...epless-PLM

[Gideon]

Thanks Opal

[sheepless]

oasised, I'm mentioning plm as something to keep in the back of your mind if you continue to see this pattern and have trouble resolving it with pap.

I've attached a screenshot from a bad night that looks a bit like your csr/pb.  I think the pattern I show would be flagged csr by my apap and asv (I don't think vauto flags csr) but I don't think it is csr but rather periodic limb movement. I see this pattern frequently, sometimes punctuated by events (of all kinds) sometimes not.  notice the oa in addition to the ca.  I saw oa and h in addition to ca in your posting.  

while I suspect mine is plm, I don't know that for sure (it's a bit different from the pattern I'm very sure of) and I don't know for sure I don't have heart problems in the making. again, plm in these patterns is just a suspicion at this point, but maybe worth a look for plm in the details of your sleep study.

as far as I know, the causes of most non-csr periodic breathing are largely unknown.  I'm beginning to wonder if periodic limb movement is a more common source than we know, particularly since we're not aware of it. 





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[oasised]

Hi Guys,

Been a bit busy the past few days, I've attached my last 2 nights - still a few CA's. Also, on both nights around 4:20 or so OSCAR reports no data at all - does anyone know what that could be? I've included a close up of that on the night of the 21st. I started using a Nasal pillow mask last night, so was kind of adjusting it here and there - I showed a few CA's 1:10 but I'm pretty sure I was awake fiddling around with it.

Bonjour - thanks for your detailed responses. Am I right in thinking that because I'm brand new to CPAP, that my body is essentially waiting for the CO2 level to build up before signalling to breath? As before, this happened quite regularly but now with the extra Oxygen from the CPAP it doesn't need to trigger this response, and this could be a cause of the CA's / Periodic breathing?

Do you think there is any settings I could adjust to improve this situation?

[Gideon]

at 4:31:30 you had a big inhale and a big exhale, that signals an arousal, next is no breathing followed by a CA event. The breathing that follows is biggeg, more volume than 'normal' and is flushing CO2, subsequent breaths are getting smaller, flushing less CO2 utill your CO2 drops below your apneic threshold which signals your body that your CO2 is low enough that you have no need to breathe. While you are not breathing CO2 is increasing ti just a little above your apneic threshhold and you take a small breath. Still low you take imcrementally larger breaths until you are breathing 'hard' enough to once again flush CO2 from your system and the cycle repeats.

Does that help some.

[oasised]

Hi Bonjour,

Thanks for that, it does make sense. I wonder will that change as I get more used to the device. Do you think there are any settings I could fine tune to make things better for me? 

Below is my most recent night, numbers a good bit higher but have to say I've woken up feeling the best I have since getting the machine.

[Gideon]

Your EPR is currently set at 2
Let's try EPR=1 that should reduce your CA events and increase your hypopneas and flow limits. Your treatment on this machine will, at least for now be a balance between Central events, obstructive events and how you feel.

Start keeping a log of how you feel and report that here. The answer to that question either here or two your doctor must never be the rethorical I feel fine. Here and by your doc it is a request for issues which are also known as symptoms. Things like I always wake up with headaches, or it feels like I'm breathing through a straw, groggy thru the day.

In answer to your question, sometimes the Central apnea goes away as your body adjusts to a lower CO2 level over 2-3 months.

This means that your best therapy⁷ settings will definitely change going forward.

[Sleeprider]

Fred, do you think clustering of OA suggests a positional issue?

[Gideon]

In general yes. Group size definitely the larger the more clear the call.
Did I miss something.

[Sleeprider]

No miss but I’ve been seeing small clusters that unusually seem come up when flow limits are low.