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Up for the challenge but not winning
#1
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Hi everyone, great forum!!

My sleep study (shown above) had all obstructive apneas with no centrals


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#2
And....? Do you have a question? Or did you hit the enter key too soon?
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#3
My Sleep Specialist sent me for a cpap study, which resulted in no obstructive apneas, but with a large number of centrals, the longest of which lasted 180 seconds! See stats below:

Respiratory Statistics
Oxygen Saturations
Sa02% Lowest 69
Sa02 awake average 95%
Time Below 95%: 82.6 % sleep time
Time Below 90%: 12.4 % sleep time
Time Below 88%: 7.3 % sleep time
Time Below 85%: 3.8 % sleep time
Oxygen Desaturations (>3%) = 66

Supine AHI = 37.0 events/hr Apnoea Index = 25.11hr
Non-supine AHI = 5.8 events/hr Hypopnea Index = 5.5/hr
REM AHI = 0.0 events/hr Mean Event Duration = 24 secs
Supine REM AHI = 0.0 events/hr
Longest Hypopnoea = 50 secs
Total AHi = 30.7 events/hr
Longest Apnoea = 180 secs

The net result was a prescription for a cpap with max pressure 12, min 4

After 4 nights of getting inflated like the Michelin man and AHI's between 13 and 23 I contacted my sleep Dr, who dropped the max pressure down to 9 and told me how to slowly increase it again as required up to maximum 12.

My best night so far was 2 nights ago AHI 6.5 with 26 CA and 18 OA events, but last night back up to 10 with 21 CA and 43 OA events.

Any comments would be greatly appreciated
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#4
Tried to enter addition graphic but hit limit and managed to post my first post before I wanted to! Remaining data is in the following post. Sorry!!!
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#5
Hi Queenslander,
WELCOME! to the forum.!
Hang in there for answers to your questions and much success to you with your CPAP therapy.
trish6hundred
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#6
G'day Queenslander, welcome to Apnea Board. I'm a bit confused about your condition - do you mean that you experienced a large number of centrals before you had CPAP therapy? Or have the centrals only started once you got on the machine?

If you have "idiopathic" centrals the machine you have wont do you any good. You will need an ASV type machine. On the other hand, centrals can be induced by the pressure. In that case they might go away with time but will need to be carefully managed.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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
Hello, Queenslander. Welcome to Apnea Board.

I gather that you've had to back off on your prescribed pressure to allow time for getting used to sleeping with CPAP machine pressure. That's not an uncommon occurrence. The first couple of months on CPAP require a lot of making adjustments and a lot of patience.

Most of us use an image hosting site like imgur or Dropbox to upload our SleepyHead screenshots to and then share the links here. You will be able to post a link after you reach 5 posts (I think it's 5 - your member designation will change from "New Member" to "Member", in any case.)

Here are some tips on organizing your SleepyHead graphs and charts for uploading and sharing. Organize Your SleepyHead Charts
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#8
All of my sleep study apneas were obstructive and my AHI was 21. My cpap study apneas were all CSA's and my AHI was 34.
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#9
(07-15-2016, 10:31 PM)Queenslander Wrote: All of my sleep study apneas were obstructive and my AHI was 21. My cpap study apneas were all CSA's and my AHI was 34.

It's not uncommon for people to start experiencing central apnea when they first go on to CPAP therapy. To put it simply ('coz I don't understand the detail) your brain primarily relies on the amount of CO2 in your blood to decide when it's time to take a breath. When you go onto CPAP the blood gas balance changes and there isn't enough CO2, so your brain "forgets" to breathe - that's a central apnea. In most people, the problem just goes away over time.

Higher pressure and the use of EPR (expiratory pressure relief) can make the centrals worse. Lowering the pressure as you have done is a good first step.If you are using EPR you might want to reduce the setting (eg from 3 to 2 or 1) or else turn it off. Once your body and brain acclimatise to the new way of breathing, you should be able to raise the pressure back where it needs to be (and use EPR if you need to) without causing too many centrals.

If the centrals don't go away, you might have to consider an ASV machine (adaptive servo-ventilator) which is like a CPAP but has a far more sophisticated means of responding to centrals. ASV machines work remarkably well, but they are remarkably expensive - about twice the cost of an Autoset here in Oz.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#10
Happy to report my CSA's are slowly diminishing in number.

I started cpap on June 23rd and during the first few days Sleepyhead indicated I was in Cheynes Stokes Respiration for some period on 7 out of the first 10 days. % time in CSR varied from 4% lowest night to 17% on the worst night. AHI varied from 9 to 24 over the same period.

The CSR occurred during close grouped multiple Obstructive Sleep Apneas, not CSA's, which I thought are usually associated with CSR.

I have no cardiac history. I have always had blood pressure readings typically in the range of 120/65 to 135/70 until recently when I had a few spikes up to 185/75 or higher. This prompted my GP to send me for a sleep study, as sudden onset hypertension can be related to sleep apnea.

Recently I thought all was heading in the right direction with my AHI two nights ago hitting 4.8 - below the magic target of 5 for the first time. CSA 2.1; OSA 2.4; Hypopnea 0.3.

Last night though it all went to crap.

AHI was 9 consisting of CSA 1.2; OSA 7.4; Hypopnea 0.4 and the Cheyne Stokes reappeared (for the first time in the last 12 days) for 24 minutes , which coincided with the first 24 minutes of a total 42 minute period during which I had 40 Obstructive Apneas.[/b]

Can anyone help shed any light on this?
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