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OSA -> CSA?
#1
OSA -> CSA?
Hello,

Grateful for this community. I'm new here and just started APAP. Based on preliminary data, on average, more than half of my apnea events are central/clear-airway (AHI ~6-8). I am wondering if anyone here had similar preliminary data and underwent CPAP or APAP therapy. My sleep doctor suspects the central events should decrease with continued use of APAP. I'm guessing their logic is that my brain formed a maladaptation to obstructive events. That is, it inaccurately predicts obstructive events, lending to clear airway events. 

I'm 26 yrs old and my weight is considered "normal" for my height. I don't have any other known medical issues. I've struggled greatly with my mood and cognition and really hope my apnea resolves itself. 

Thanks for your input.
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#2
RE: OSA -> CSA?
Welcome to the forum. Your story is a very common one, however the answer depends on unwinding the results from your diagnostic study to see if CA was present before CPAP therapy or if these events are completely treatment emergent. What I can tell from your profile is that you are using an auto CPAP to self-titrate, and the settings are wide open from 5 - 20 pressure. Your Resmed Autoset is also capable of bilevel pressure (Exhale pressure reduction EPR) up to 3-cm. This increased ventilation can be a source of idiopathic central apnea.

You should upgrade your Sleepyhead to the current version of OSCAR (open source CPAP analysis reporter) and consider posting a daily detail chart organize as shown in my signature links. This will let us see the machine settings and distribution of events through the night. I'm confident we can decrease the number of events by narrowing the pressure range and possibly reducing EPR. Your doctor is correct that treatment emergent CA generally diminishes in time, but there are things you can do to help that along, and it's important to really understand your pre-therapy indications.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: OSA -> CSA?
Welcome to AB.

I agree with Sleeprider here. Follow all his suggestions. My only advice to give now is that it's very important to see this detailed PSG sleep study report. This should give us a very good snapshot of your history depending on your CA events and how to act on them. Let's wait for your details on the PSG to show what you're dealing with. Generically speaking, CA has 3 flavors, pre-existing, treatment emergent, and idiopathic. The first 2 have some known causes and indications on how to combat. That 3rd one means simply unknown in cause.
Dave

OSCAR
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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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#4
RE: OSA -> CSA?
Thanks for the input, I really appreciate it! 

I can bring up the pressure suggestions that come up here to my sleep doctor. I started using the APAP on 3/31 and didn't insert an SD card until 4/3. I then collected data from three days (4/3-4/5) and sent it to my doctor. Could central apnea emerge from treatment that quickly (over 3 nights)? I suspect it was there to prior to starting therapy. What do you guys think? I've attached data from SleepyHead from 4/3-4/5 that I sent to my doc, if you'd like to take a look. And I will use OSCAR and attach data as recommended in the future. 


Thanks again for the input. Very grateful!


Attached Files
.pdf   SleepData_4.3_4.5.pdf (Size: 699.63 KB / Downloads: 70)
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#5
RE: OSA -> CSA?
Kuacc912 your last chart shows CA events are not too serious, and only 15 for the night. We may have understood that you had an apnea index of 15 per hour. Please read the link in my signature on Organizing Oscar Data and Attaching an Image. We usually use a screenshot saved in .PNG format, and use the daily details in the left column rather than events.

Your central apnea are not very serious and can be quickly resolved by reducing EPR to a setting of 1.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: OSA -> CSA?
Your EPR = 3, this means that your min pressure should be not less than 7 to allow for the EPR to fully function.

BUT . . .
Your Central Apnea says that your EPR should be lowered. I'd suggest EPR=1.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: OSA -> CSA?
Thank you to everyone who responded. I really appreciate it. I've emailed my doctor about the EPR setting. Hoping for better results in the near future.
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#8
RE: OSA -> CSA?
You can just change the EPR to 1 yourself in seconds. Access the clinical mode via press/hold of Home and Dial for about 5 seconds. Go to settings and edit the EPR and click to lock that setting, then exit clinical. You're done. Or in a few days or a week or 2 you maybe have to see Dr. Dolittle, then he/she may decide you can in fact benefit from EPR 1, he/she will edit your script, send it to the DME, where they will set it. EPR 1 will be delivered in 2 weeks or so. Why wait? Set it by yourself. Get the clinical manual to understand your machine and its settings.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#9
RE: OSA -> CSA?
Thank you I appreciate the response!
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#10
RE: OSA -> CSA?
Welcome. Report on how the EPR edit helps after next sleep session.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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