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Strange Nap
#11
(01-12-2014, 09:54 PM)Sleepster Wrote: You would have to check your data to see if the pressure really is maxing out at 16 cm H2O when you sleep on back.

What Sleepster said. Perhaps even 16 is not high enough when sleeping on your back. If the pressure ever maxed out during your nap on your back then the max pressure needed to have been set higher.

Also, before napping on your back it may help to increase your minimum pressure to be closer to whatever tends to be your median pressure when sleeping on your back. It takes at least a little while for the pressure to adjust itself higher, especially if starting from too low a minimum pressure. And the lower the ResMed minimum pressure is, the faster the pressure drifts too low, leading to obstructive events which kick the pressure back up again.

For example, if your median pressure when sleeping on your back was 14, then 12 would probably have been a better minimum pressure (when sleeping on your back).

Or, if you had the Ramp turned on while taking your nap on your back, this may explain the high AHI, because perhaps the machine only starts its AutoSet algorithm after it completes the ramp time. (You would be able to see this in the data -- if there were obstructive events during the ramp period but the pressure did not start to respond until after the ramp period ended.)
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#12
I don't use ramp and unfortunately I could not sleep on my back during my titration so they could not even set an optimal pressure during REM Because I sleep almost exclusively on my sides, my OSA is considered mild but I think if they had made me sleep on my back for the whole sleep study I would have come up as moderate OSA or worse. The specialist who read the titration wanted pressures reset from 6-8 down from 6-16 but fortunately the doctor who saw me said lets leave it at 6-16 because I tend to get worse apnea if I do lie on my back. The apneas on that strange nap day were mostly central. In a 30 min nap I had 2 OA and 6 little CAs so I'm thinking my starting pressure could not catch up with me napping on my back which I almost never do. While my Maximum pressure is 16, the machine couldnt catch up with the six rapid little CA because when I awoke from the nap and looked over at the pressure it was 9. I don't think it is a big deal because mostly my AHI for the night is always less than 1. I might have them tweak it to starting at 8 if this keeps happening which it does not appear to be a common thing.
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#13
(01-13-2014, 08:03 PM)Lukie Wrote: I don't use ramp and unfortunately I could not sleep on my back during my titration so they could not even set an optimal pressure during REM Because I sleep almost exclusively on my sides, my OSA is considered mild but I think if they had made me sleep on my back for the whole sleep study I would have come up as moderate OSA or worse. The specialist who read the titration wanted pressures reset from 6-8 down from 6-16 but fortunately the doctor who saw me said lets leave it at 6-16 because I tend to get worse apnea if I do lie on my back. The apneas on that strange nap day were mostly central. In a 30 min nap I had 2 OA and 6 little CAs so I'm thinking my starting pressure could not catch up with me napping on my back which I almost never do. While my Maximum pressure is 16, the machine couldnt catch up with the six rapid little CA because when I awoke from the nap and looked over at the pressure it was 9. I don't think it is a big deal because mostly my AHI for the night is always less than 1. I might have them tweak it to starting at 8 if this keeps happening which it does not appear to be a common thing.

Your machine won't treat CA's but will include them in the data. Hope this makes sense.
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#14
If the machine does not treat CAs I wonder why I'm sleeping so much better and my AHI has gone from 7 down to and average of 0.1 at night. Most of my events on the machine have been CAs. My 02 sats are better but not perfect. I've gone from 84 nadir to 90 . I'm still dropping O2 but now it is not low enough to qualify for O2 supplementation under Medicare. I imagine it is because the CPAP has eliminated my hyponeas which were the majority of that original AHI of 7 and perhaps the treatment of them has increased the clear airway events.
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#15
It's likely that the CA's are caused by the higher pressure. Check your data and see. This so-called CPAP-induced central apnea tends to fade away as you adapt to CPAP therapy.

What may have happened during that nap is that flow limitations caused the pressure to rise, as they should because those flow limitations are a sign that apneas and hypopneas are about to occur. Then the higher pressure caused CA's. You can check your data for indications that this may have happened.

You can also look at those CA's and see how long they lasted. If they're relatively short they're not as harmful, but count the same in your AHI as do long ones.
Sleepster
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#16
What the machine perceives as a CA event my in fact not be. It has an algorithm that makes its best guess at CA.
It's not as good as being hooked to all the sensors in a sleep lab for differentiating a CA.

Those of us who carry weight in the belly do have a more difficult time breathing while on our back.
(The diaphragm has to work against the central obesity.)

Even in daytime, some centrally obese people desaturate -- it's called Pickwickian Syndrome; and is named for a Charles Dickens character who had daytime sleepiness.
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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#17
The machine don,t treat central apnea as such but by increase pressure in response to snoring and flow limitation which are precursors to obstructive apnea (not central apnea) can prevent the so called "pressure induced apnea"
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