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New user, are centrals normal in the beginning? and other Q's
#1
Question 
Hi everyone.  I'm pretty certain I have a sleep breathing disorder based on my symptoms and made an appointment with the only good sleep doctor in the area.  Unfortunately, he doesn't have an opening until April.  So, I decided to pick up a Dreamstation Auto in the meantime to see what the data could tell me about my sleep and see if it might help me feel better.  I got an F20 full face mask because my nose is often too stuffy to effectively breathe through (due to LPR reflux, allergies, deviated septum, etc).

The mask fits well and doesn't seem to noticeably leak.  However, the sleepyhead data reports total leaks of 23 with a leak rate of 0.  What does that mean, and how is that possible?

One of the first things I did was run the mask fit check which may have been a bad idea.  Trying to exhale against the 20 cmH20 pressure as a complete novice almost gave me a panic attack.  My cheeks were puffing out like a chipmunk.  Unpleasant experience.

In general, with the pressure anywhere above 4-5 cmH20, the exhalation effort required was noticeable and uncomfortable.  Is that something you adjust to with continued use, and are able to tolerate more pressure over time?

In order to keep the exhalation pressure low, but get enough inhalation pressure to feel like I was getting enough air, I set the machine to fixed CPAP pressure of 7.0 with C-flex+ enabled on level 3, and tried to sleep with that.  It made me pretty anxious but I was eventually able to fall asleep.  Unfortunately, I kept waking up with a start as soon as it felt like I had drifted off to sleep, and it seemed like it was breathing related.  After this repeated a couple more times I took the mask off because it didn't seem like I was going to get any quality sleep.

Looking at the data from my use of the machine for about an hour last night, it looks like I was having all sorts of problems.  I'm wondering how you would interpret this data?  It seems like there were alot of central apnea events.  Could that be because my brain is not used to the machine yet?  Or because I was in transition between awake and sleep?  I'm hoping it's something benign like that.  In case it is relevant, I'm a tall skinny 37 year old man.

As I said before, I do have an appointment with a sleep doctor and will get a formal study done in the spring.  Any suggestions or comments would be appreciated as I wrestle with this on my own in the meantime.  I couldn't link to the screenshot of my data because I needed 4 posts apparently so I attached it to this message. Thanks!


Attached Files Thumbnail(s)
   
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#2
Well the good news is you have no problems with leaks. The leak total is intentional leaks plus unintentional leaks. The intentional is the vents built into the mask to allow CO2 to escape. The unintentional leaks are what you have to worry about and you have none.

As far as the Clear Airway events they can be caused by the machine. But usually not to the extent your getting them at such a low pressure. A lab sleep study would be able to detect if it's central or not.
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#3
(11-08-2017, 01:51 PM)Walla Walla Wrote: As far as the Clear Airway events they can be caused by the machine. But usually not to the extent your getting them at such a low pressure. A lab sleep study would be able to detect if it's central or not.

Thank you for the reply.  The reason I think the machine might be involved is because as soon as I removed the mask I slept normally without waking up again.  I don't normally wake up to full consciousness with that anxious feeling unless I try to sleep on my back (which I've learned is a bad idea).
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#4
Central Apnea can be caused by attempts to treat obstructive apnea with pressure. In most cases, this does diminish with getting used to a CPAP. There are cases like my own that they will not go away after getting used to a CPAP.

If you've not done so yet, get Sleepyhead so you can give us reports please, then these savvy guys and gals will help with suggestions for setting edits.

FWIW: OSA is typically addressed by adding pressure, but central apnea is addressed via lowering pressure. So it's important to monitor what your results are, and that includes charted results AND how you feel. Both count pretty much equal to me.

Best to ya,
Dave B Coffee
Due to my sarcastic nature, it may not be obvious that I am not a doctor nor do I pretend to be one. My advice is from personal experience. Follow my advice as a choice not as an order. 2 of these  Coffee Coffee per day keep the bad times away.
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#5
(11-08-2017, 02:14 PM)SarcasticDave94 Wrote: Central Apnea can be caused by attempts to treat obstructive apnea with pressure. In most cases, this does diminish with getting used to a CPAP. There are cases like my own that they will not go away after getting used to a CPAP.

If you've not done so yet, get Sleepyhead so you can give us reports please, then these savvy guys and gals will help with suggestions for setting edits.

Thank you for the info Dave.  I did post my sleepyhead data above, I just wasn't able to link to it because I didn't have enough posts yet, so I attached it as a file.
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#6
We are seeing a small sliver of your night.  You are using a fixed pressure and I think Flex as well.  The best CPAP therapy tends to be a low fixed pressure with no exhale pressure relief. Complex or Mixed Apnea is typically a mix between Obstructive and Central Apneas. For high levels of events Machine of choice is an ASV machine. These are among the most expensive of all PAP machines.

For now I would suggest turning flex off and reducing your Pressure to 5 cm then post your data, better put it in auto mode with a range of 4-7 cm and no flex.  With CPAP flex tends to increase Clear Airway/Central Apnea events.  

Until you reach "Member" status add a space to the url such as "htt p://imgur.com/xxxxx.png"

Fred
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#7
(11-08-2017, 03:08 PM)FunkOdyssey Wrote:
(11-08-2017, 02:14 PM)SarcasticDave94 Wrote: Central Apnea can be caused by attempts to treat obstructive apnea with pressure. In most cases, this does diminish with getting used to a CPAP. There are cases like my own that they will not go away after getting used to a CPAP.

If you've not done so yet, get Sleepyhead so you can give us reports please, then these savvy guys and gals will help with suggestions for setting edits.

Thank you for the info Dave.  I did post my sleepyhead data above, I just wasn't able to link to it because I didn't have enough posts yet, so I attached it as a file.

OK. A work around is to use Sleepyhead data on Imgur. Then break your link with a space to separate for now until your post count passes 4.
Dave
Due to my sarcastic nature, it may not be obvious that I am not a doctor nor do I pretend to be one. My advice is from personal experience. Follow my advice as a choice not as an order. 2 of these  Coffee Coffee per day keep the bad times away.
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#8
Such as "htt p://imgur.com/xxxxx.png"  we will take it from there.


Fred
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#9
Thanks for the replies so far. It looks like I'm going to try setting it to auto with 4-7 cm pressure (maybe minimum of 5 if I can't fall asleep with the low air flow feeling of 4 cm) and no flex tonight. Hopefully I can adjust to the higher exhale pressure enough to sleep.

I can finally post the sleepyhead data properly:
[Image: rc8p3cQl.png]
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#10
Hi FunkOdyssey,
Yes, at the beginning of therapy some people experience a lot of clear airways events.
I was diagnosed with OSA and an AHI of 20. The first week with my machine I had an AHI average of 24, the majority of them CA.
Within a month it had largely settled down with a lot less clear airways being reported.
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