[Pressure] Need opinions on my flow rate please

[DeepBreathing]

I couldn't get rid of the piechart though.

You need to go to the preferences window and do it there. See instructions here: http://www.apneaboard.com/wiki/index.php...d_Side-Bar

[Osiris357]

Yes she already balked at the thought for exactly that reason. The thing that bothers me is she claims auto cpap takes care of central. Now from everything I've read she couldn't be more wrong. Only bi-level stops that correct? You would think being a doc, well she's an NP, my original doc pawns all of us on to her after he's diagnosed everyone, would know that central is caused by no Co2 in the body so it doesn't breathe. Well I think I may leave EPR on tonight and see what happens. Hopefully they stop and if they don't I'm gonna start getting insistent with her because I imagine I'll still feel terrible. Thank you for all your help. It's bedtime for me here in NY. I'll think on the other option tomorrow and get back to you here with my thoughts. Thanks again

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Got it, Thanks!

[SarcasticDave94]

The doc or NP is wrong, neither of the CPAP, APAP or bilevel can take care of CA, it can just flag them. But my ASV does take care of CA.

[Gideon]

Neither CPAP nor BiLevel will treat the Centrals.
Centrals on these machines are treated by avoiding them (setting EPR=0) which increases your flow limits which are significant but likely your doctor will ignore them because they do not contribute to your AHI (therefore they don't exist).
An ASV machine is the ONLY machine that will treat Central Apnea and it does so by applying a variable but high PS to "trigger" a breath and maintain your recent minute Vent volume.  Technically ASV is BiLevel.

[Dormeo]

Osiris, just to reiterate what others have written: a bilevel machine can help you with flow limitations more than your current machine can, and that is the reason several people here are recommending it. If you start leaning in that direction and you can't get a prescription and coverage for one, you can probably find a good lightly used machine on line. That's the way I went to address my flow limitations.

But in helping with the flow limitations, the bilevel machine may actually push your CAs back up. Bonjour gives you two options re CAs. One is EERS, which he can explain to you if you want to consider it, and the other is to wait a few weeks or months and see whether the CAs subside on their own.

For what it's worth, my CAs go up each time I try increasing the pressure support on my bilevel machine (though my CAs are never are plentiful as yours were). If I just stick with it for 2-3 weeks, the CAs trend downward.

The ASV machine can address CAs, but it is more expensive and you may well not need it, if either EERS or waiting leads to reduced CAs.

[Osiris357]

Thank you all for all of your help and information. I think I’m going to wait and see if my CA’s drop on their own. Unfortunately I’m still at the beginning stage of all this and I unknowingly  turned off my machine in my sleep after 3 hours last night. It’s happened about 5 times so far.  So I’m not sure how much data it recorded, but I’ll find out after work. As far as coverage goes I am very fortunate on that front as I have full coverage for any and all sleep apnea products. So if they continue passed say month 3 I’m definitely going to bring this up to my doc and hopefully she will understand that I don’t just want to lower my AHI I want to address all the issues associated with it. I imagine I’ll still feel like I’m sleeping while walking at 2 in the afternoon if the CA’s don’t drop from EPR being on by then. Sorry if this seems fragmented, I’m at work training someone and typing this while they work. Have a great day everyone!

[Osiris357]

I did look into those other possible fixes and that’s why I’m going to just stick it out for a few. Also is 3 months too long to wait and see? Or should it be a few weeks instead?

[SarcasticDave94]

I don't think you'd need to wait very long, a few weeks maybe, to at least start seeing CA events diminish if they were to do so.

[Osiris357]

Ok. Thank you

[Gideon]

This is all about managing the pCO2 (partial pressure of CO2) in the blood.  Your centrals are occurring because too much of it is being washed out.  You can use EPR to manage this.
To adapt you want SOME Centrals.  So start with EPR=1 Your goal is to keep AHI around 5 with some centrals.  When they reduce increase EPR.  This is to get your body used to lower CO2 levels.  We are dealing with desensitizing the ChemoReceptors in your body.

This form of Centrals is frequently inconsistent, I call it consistently inconsistent.  Point is the CA component will vary, sometimes a lot, this is normal.