(06-26-2015 05:09 AM)DocWils Wrote: There is a debate in the medical community whether or not CAs measured really are Central Apnoeas or just a cessation of breathing without an indicative flow limitation, which indicates an OA - in short, a skipped breath or held breath or rhythm change or a swallow would all read as a CA in that case - all CPAP manufacturers saw no, their devices measure real Centrals, but all medic types say - how can that be without an EEG to confirm? So, the increases in CA events may not be actual Central Anpoea events at all. If they are, and you were not diagnosed with Central Apnoea, it is likely caused by the pressure increase, which can trigger the mind to cease breathing for a beat or two to compensate. EPR often solves this...
There are reports here on the forum that EPR can also aggravate this. I guess it makes sense to try the various settings and see what works for you.
What also makes sense, is to move my intake of C to directly before bedtime. That seems pretty safe, possibly beneficial. If C helps, that is actually a pretty revolutionary discovery. Timed-release is probably a good idea as well; I usually break mine (non-time release) in half and try to take the second half later.
I hope a thousand forum members take this to heart, and maybe we can see if it actually makes a difference.
What I am skeptical of is the nocturia thing. It is proven that nocturia can decrease or even disappear under xPAP therapy. I had it for 5 years, and it went away for good the first night I ever wore the mask. (yay!) But a small decrease in CAs? I'm not sure that could make that much difference.
What I find interesting is that the high minds in the med community actually debate this whole faux CA thing. This may be why I have not found anything supporting why this happens. Because we just don't know.
But everybody needs to realize what is important. A low AHI is important, but only because the real goal is to prevent 02 desat. If you have fewer or shorter events, 02 desat is lower. AHI considers more or fewer events, but it does not measure nor consider shorter or longer events. So it is very imprecise when indicating success towards the actual goal of less 02 desat.
But xPAP does not raise 02 sat directly, it does is secondarily, by eliminating and preventing most apnea events. Lowering 02 desat is what is important, and xPAP is just one effective tool.
Don't put too much importance on AHI at the expense of what the real goal is; AHI is a dumbed-down number that only gives a general fuzzy idea of how good you are doing. And it does that because respiration and the entire apnea thing is much more complex than that and hard to really understand, so we lay people need some sort of indicator, even one as imprecise as AHI, to get a general report.
Theoretically, you could have perfect respiration and an AHI of zero. You could also have a 9-second gap in breathing every 11 seconds for the entire night, and that would still result in an AHI of zero, because an apneic event has to be 10 seconds long to be flagged. But what might your 02 desat levels be if you stopped breathing for 9 seconds, every 11 seconds, all night long?
If that is a question that haunts you, about the only way to answer that is with an oximeter. Or find out how significantly your 02 desats in relation to the apneic events in your PSG, because your xPAP won't have any way to know and won't tell you.
And how accurate is "10" seconds, anyway? It seems just like a convenient round number someone pulled out of their...very dark place. Is that really the hard cutoff between where everything is absolutely peachy, and where the alarms all go off?
I.............sort of doubt it. Generally, probably yes. Actually, probably not so much, at least not in everyone's case.
On another topic of Doc's, I would prefer to debate the symphony too. Or True Detective
or Game Of Thrones
, maybe. But you guys should keep on debating these important things you can't come to a conclusion on just yet, because you have a higher odds of being able to figure this one out. Due diligence. And thank you for your service.