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Sanity check on next steps (still tired)
#11
RE: Sanity check on next steps (still tired)
EPR helps with Aerophagia because higher EPR allows for a lower average pressure
Note: Higher EPR may also increase central events, turning EPR off should reduce Central events.

Set your max pressure to 9 to minimize pressure fluctuation which also may increase central events.

In the end you need to identify a balance between central and obstructive events.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#12
RE: Sanity check on next steps (still tired)
(08-12-2020, 09:59 AM)bonjour Wrote: EPR helps with Aerophagia because higher EPR allows for a lower average pressure
Note: Higher EPR may also increase central events, turning EPR off should reduce Central events.

Set your max pressure to 9 to minimize pressure fluctuation which also may increase central events.

In the end you need to identify a balance between central and obstructive events.

Thanks, I'll make this adjustment and see how it goes!
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#13
RE: Sanity check on next steps (still tired)
Hello fellow Canuck! I have nothing to add to Bonjour's comments. You are in good hands there. I just wanted to give you some encouragement. I too had to go through a period of adjustment and until things were tweaked (due to the help of Bonjour and others here when I first joined) and adjusted it took a little while. However, eventually my sleeps got better and though I don't expect to sleep like when I did in my teens or 20's since I am over 50 now I still get much better rest with my Resmed APAP than before I had it. Stick with it, it will get better.
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#14
RE: Sanity check on next steps (still tired)
(08-12-2020, 11:41 AM)Marillion Wrote: Hello fellow Canuck!  I have nothing to add to Bonjour's comments.  You are in good hands there.  I just wanted to give you some encouragement.  I too had to go through a period of adjustment and until things were tweaked (due to the help of Bonjour and others here when I first joined) and adjusted it took a little while.  However, eventually my sleeps got better and though I don't expect to sleep like when I did in my teens or 20's since I am over 50 now I still get much better rest with my Resmed APAP than before I had it.  Stick with it, it will get better.

Hey there! Thanks for the kind words! The good thing is that I'm trying something different, which is more than I've been doing. Thank you for the kind words!!

(08-12-2020, 09:59 AM)bonjour Wrote: EPR helps with Aerophagia because higher EPR allows for a lower average pressure
Note: Higher EPR may also increase central events, turning EPR off should reduce Central events.

Set your max pressure to 9 to minimize pressure fluctuation which also may increase central events.

In the end you need to identify a balance between central and obstructive events.

Slept on my back (didn't want to throw too many changes into the mix).

AHI is relatively unchanged. Central events are the big thing. When I was waking up, in that groggy/semi-conscious state, I found myself holding my breath for longer than I would expect, but it didn't seem to bother me... Not sure if that's just because I was thinking about CAs in the back of my mind.

Thanks again for taking the time to help!


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#15
RE: Sanity check on next steps (still tired)
I realize I set the max to 10... Do you think I should ramp it down to 9, then 8, see if it helps with the CAs?
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#16
RE: Sanity check on next steps (still tired)
I think they want the pressure lower to see if your CA will go down, try 9-9.4 and see what happens for your comfort. CA can be associated with higher pressures.
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#17
RE: Sanity check on next steps (still tired)
(08-13-2020, 04:18 PM)Canuck 2 Wrote: I think they want the pressure lower to see if your CA will go down, try 9-9.4 and see what happens for your comfort. CA can be associated with higher pressures.

Thanks for this. I thought dropping it from 16 to 10 would be good, given that I maxed out around 11 before... Perhaps it's still too high.

Given that the OA didn't shoot up, I suppose that I can just keep lowering the pressure little by little until the CAs fall, or the OAs go up without a reduction in CAs.

Out of curiosity - if I were making a trade between OA and CA, is one "worse" than the other? Either in terms of long-term physical impacts and/or impact on restfulness? For example, is there a difference between having 10 OAs and 5 CAs vs 5 OAs and 10 CAs, or is it irrelevant?
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#18
RE: Sanity check on next steps (still tired)
It depends on the cause of the apnea. If the centrals are CO2 driven then, in general, obstructive is worse because there is a narrowing . If the centrals are Neuro muscular in origin you need to breathe, the centrals become far more important than the obstructive. If the obstructives are positional, and you are seeing clusters together the obstructives are more important because a small change will make a huge improvement.

It just depends on the individual
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#19
RE: Sanity check on next steps (still tired)
(08-13-2020, 04:54 PM)bonjour Wrote: It depends on the cause of the apnea. If the centrals are CO2 driven then, in general, obstructive is worse because there is a narrowing .  If the centrals are Neuro muscular in origin you need to breathe, the centrals become far more important than the obstructive. If the obstructives are positional, and you are seeing clusters together the obstructives are more important because a small change will make a huge improvement.

It just depends on the individual

Interesting! I'll have to take some time to look more into that. Thanks again for this and for all the advice. I've shifted the pressure down to 9 (from 10). Fingers crossed.
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#20
RE: Sanity check on next steps (still tired)
(08-13-2020, 06:51 AM)TSomm Wrote: When I was waking up, in that groggy/semi-conscious state, I found myself holding my breath for longer than I would expect, but it didn't seem to bother me...

When you think about centrals, keep in mind that awake breathing is much less regular than asleep breathing.  As you observed, when we're awake, or even just aroused to a half-awake state, we often pause between breaths.  If the pause is 10 or more seconds long, we get a CA flag.  In such a case, the problem isn't so much the CA as the fact that you were not entirely a sleep.
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