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Totally Confused by Airsense 10 Data - Centrals - Problem machine... ?
#21
I had almost the exact same numbers as you. Robysue explained how centrals can be caused by both low EPR and high EPR. As I went from EPR off to 1, my AHI did not change. Last week I set my EPR to 3 out of desperation and my results were very positive. Three is just a bit too high, as I can feel the machine drop on exhale at the lower pressures.

I lowered min pressure to 6, max to 10, and EPR=2. Last two nights were .8 and .2. Very comfortable night sleep. I nope I didn't just jinks myself.

I plan to leave it here no matter what. Well for the rest of the month.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#22
So my progress is not bad, but I continue to see quite a few Central events and cannot yet see much in the way of correlation with other data...

My total AHI typically varies between 4.0 and 8.0 and it's still predominantly shown as Centrals, with almost nothing in the way of OA events.

I post a couple of sample SleepyHead graphs below - however, I have also been keeping a spreadsheet of my main data points to help see any trends and I have also included this.

The only firm conclusions I have come to so far are that lowering EPR has certainly reduced the number of CAs (we went from EPR of 3 to 0), but increasing it to 1, has allowed me to overcome most aerophagia issues, without really increasing CAs again.

My average pressures seem pretty low (which is great), but I struggle to see how my current data ties back to my typical "no cpap" sleep study AHIs of (25-64), zero CAs and a titration test, that recommended pressures of 12+

Any additional thoughts ?

My machine settings have now been unchanged for 2-3 weeks and given that my median pressures are so low, I'm thinking of trying a night of straight CPAP at a fixed pressure of 6 or 7, to see what happens to the data... ?

Data Spreadsheet:

[img][Image: msliwXZl.png][/img]

Graph from 12/6:

[img][Image: 187EFtNl.png][/img]

Graph from 11/29:

[img][Image: v6YNL5zl.png][/img]
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#23
(12-09-2016, 02:15 AM)mymontreal Wrote: My average pressures seem pretty low (which is great), but I struggle to see how my current data ties back to my typical "no cpap" sleep study AHIs of (25-64), zero CAs and a titration test, that recommended pressures of 12+

Any additional thoughts ?
One night in a lab does not always represent what's going on. Although "over titration" is rarer than "under titration" it does happen. You may have had a nasty cluster that night shortly before you woke up which lead to the final recommended pressure setting.

Do you have the summary graphs from the titration study? They would show exactly when the pressure was adjusted and why it was adjusted each time.

Quote:My machine settings have now been unchanged for 2-3 weeks and given that my median pressures are so low, I'm thinking of trying a night of straight CPAP at a fixed pressure of 6 or 7, to see what happens to the data... ?
It's certainly worth a try. Not everyone does better on APAP than fixed CPAP. I'd say it's well worth experimenting with fixed pressure for 3 or 4 nights to see what happens.
Questions about SleepyHead?
See my Guide to SleepyHead
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#24
Hi again mymontreal. I want to go back and look at some of the questions that you had earlier in our ongoing discussion.
You asked: "1. Where are the OA events... in every sleep study I had, I had mainly OA (with quite a few H) - here, there appears to be no sign of any OA events, even when the pressure is as low as 4 or 5... ?
2. Still surprised that average pressures are so much higher since we turned off EPR ?
3. What is relationship (if any) between # of CA events, and the "Cheyne-Stokes Respiration %" that I oft see ?"
Regarding question #1: Two different things could have happened to you. The first and least likely is that you are a different person than the one who had the original sleep study. By that I mean that you are cured somehow of most of the OA events found in your original sleep study. You did mention a surgery. The other possibility that I am considering is that you were completely misdiagnosed in your previous sleep studies (it happened to me). You never did have Obstructive Apnea. What you did show were Hypopnea and Apnea events. Based on the Sleepyhead graphs that you posted it appears that you continue to show Hypopnea and Apnea events. Question #3 is relevant here. CSR or Cheyne Stokes Respiration is a particular pattern of Central Apnea. The respiration pattern looks like a sine wave. My machine produced long intervals of CSR at fairly low pressure. CSR has also been associated with Congestive Heart Failure. Most of the research on CSR has been done on CHF patients. I do not have CHF but I did have machine induced CSR. You most likely do not have CHF and it is only an issue if you get an ASV machine. For question #2: EPR lowers your exhalation pressure and thus lowers your overall average pressure.

Now, you have made some good progress in taking charge of your treatment. I like your idea of using straight pressures and gradually lowering your pressures to see if the Centrals and Central Hypopneas go away. I said Central Hypopneas but I don't know for sure if that is what they are unless I and others can see the wave forms of the individual Hypopnea breaths. You need to highlight 5 minute intervals of your Flow waveform so that you can see the individual breaths during a Hypopnea episode. Hypopnea breaths look similar to normal breaths but are much reduced in size. Obstructive Hypopneas on the other hand have a flattened top more like an upside down box. The top is flattened because the inhalation flow is cut off or partially cut off and is followed by the exhalation. You may be able to reduce the Central events which include CAs Hypopneas and Cheyne Stokes respiration by lowering your pressures. You have to try anyway. You may find that these CA events can't be substantially reduced or eliminated. If this is the case you would be a candidate for an ASV machine. You would also be a candidate for a different Sleep Doctor. I found mine at my "local" University Teaching Hospital. So, keep working on this and post some of those 5 minute wave forms along with your other data.

Rich

pressure.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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Organize your Sleepyhead Charts
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#25
You do need to look at more than just the number of central events. You need to look at the airflow waveforms to see how long they last and how "real" and "total" they are.

Look at the "Useful Links" in my signature line at the bottom of this post for info on how to save and share a copy of your SD card. That way we can look at your airflow waveforms and other info.

You can also zoom in on the airflow waveforms for your central events and post them, but it's a lot more useful to look at the full data.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#26
Thanks robysue - let me see if I can dig out that titration study...

On a sidenote - any idea why my screenshots are appearing so large (and un-zoomable) in my postings - I've tried to follow the guidelines for incorporating link from IMGUR upload, but I must be doing something wrong... Sad

I expected to see just a small image appear in my post & that anyone could click to open the full image & possibly zoom ?
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#27
Your graphs look like mine 9 months ago. I just had my first full week with AHI <1 every day. Be patient, keep good records of what works and not. It takes an adjustment period.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#28
(12-10-2016, 05:41 PM)mymontreal Wrote: On a sidenote - any idea why my screenshots are appearing so large (and un-zoomable) in my postings - I've tried to follow the guidelines for incorporating link from IMGUR upload, but I must be doing something wrong... Sad

I expected to see just a small image appear in my post & that anyone could click to open the full image & possibly zoom ?

When I click on the large blurry images in your posts I am taken to an image which is clear and zoomable.
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#29
Images in post 22 were not clickable for me. Others in this thread were clickable.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#30
(12-10-2016, 09:39 PM)richb Wrote: Images in post 22 were not clickable for me. Others in this thread were clickable.

Rich

Thanks Rich - I just played around with some of the links in IMGUR and I think I now have it figured out... Smile
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