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machine causes central apnea?
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vsheline Offline

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Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #21
RE: machine causes central apnea?
(04-04-2016 12:35 AM)dewfend Wrote:  To set the min pressure to 95%, if I understand correctly, is to keep high pressure and to prevent obstruction?

Right. If obstructive events are the main problem, it usually helps to increase the pressure, especially the Min Pressure.

Quote:I had tried auto set and I have the report, I am asking help to show them here.

Your post count is not yet 7. I think you may be able to post several short posts (like "Hi") until you reach your daily limit or until your post count increments at least to 7. After your 7th post, I think you can post a link to an image.

Quote:According to the daily report, CA is most part of the events. During night when I am about to fall asleep, sometime I can sense that I stop breathing and I wake up to breath. So I think now CA is my main concern, hopefully turning EPR off will help resolve it.

Having central apneas as we are falling asleep is not uncommon, maybe even for people who are not very susceptible to CA's.

I'm glad turning off EPR helped. To me that means it is likely you will not be able to use a standard bilevel machine (which, like EPR, produces a pressure drop when we breathe out and a pressure boost when we breathe in), that you will need an ASV machine (unless simply by turning off EPR you are lucky enough that your AHI reduces to less than 5).

I also suggest increasing your Min Pressure gradually (changing the Min Pressure setting not more than 1 or 2 cmH2O per week) to see if a higher Min Pressure improves or worsens your AHI. Every night will be at least a little different in some way, so our AHI varies each night. After making an adjustment it is often best to leave the settings unchanged for a week or two, so we can obtain an average over many days before changing settings again.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-09-2016 02:17 AM by vsheline.)
04-09-2016 02:07 AM
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DeepBreathing Offline
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Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Perth, Western Australia

Post: #22
RE: machine causes central apnea?
Quote:Quote:
I had tried auto set and I have the report, I am asking help to show them here.

Your post count is not yet 7. I think you may be able to post several short posts (like "Hi") until you reach your daily limit or until your post count increments at least to 7. After your 7th post, I think you can post a link to an image.

Just to clarify, you need 8 posts to be able to post a link. However it doesn't happen instantly, but must wait for a batch process which is run a few times a day. So even when you get your 8th post, you might have to wait a couple of hours before the permissions are updated. In the meantime, you can attach a screen shot, following the instruction here: http://www.apneaboard.com/forums/Thread-How-to-HOW-DO-I

DeepBreathing
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04-09-2016 04:21 AM
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dewfend Offline

Members

Posts: 6
Joined: Apr 2016

Machine: S9 auto escape
Mask Type: Full face mask
Mask Make & Model: mirage quattro
Humidifier: unsure
CPAP Pressure: 4-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #23
RE: machine causes central apnea?
Hi guys, I bought new S10 Aircurve to get more detailed info, here below is the report of yesterday:


Attached File(s) Thumbnail(s)
   
04-09-2016 09:47 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #24
RE: machine causes central apnea?
(04-09-2016 09:47 PM)dewfend Wrote:  Hi guys, I bought new S10 Aircurve to get more detailed info, here below is the report of yesterday:

Hi dewfend,

Your new machine is a very good one and is considered an optimal machine for Obstructive Sleep Apnea when not complicated by an excessive amount of Central Sleep Apnea.

How did you feel upon waking, rested?

Your sleep data does not look bad, but leaves room for improvement.

On average, a Central Apnea occurred 2.8 times per hour, which is a little high, but is only about half as high as when an ASV machine is commonly considered needed. Also, this was at Pressure Support of 4 cmH2O, which may have contributed to an elevation in the number of centrals.

Your AHI of 4.4 is usually considered good, so you can afford to take your time to very gradually tweak the settings. Also, two thirds of the events were central apneas. I am of the opinion that central apneas, especially if fairly short (under 30 seconds), are usually far less stressful to the body than obstructive apneas having similar duration.

Your 95% EPAP was 9.14 cmH2O (in your SleepyHead display, the 95% EPAP can be calculated from the 95% Pressure minus the Pressure Support). The 95% (IPAP) Pressure is the pressure which IPAP was at or lower than, for at least 95% of the night, and it is also the pressure IPAP was at or higher than for at least 5% of the night.

After at least a week with the present settings, I would suggest gradually increasing the Min EPAP setting until, eventually, it sits around 2 cmH2O lower than your long term average 95% EPAP, in order to see if you can lower the number of obstructive apneas without unduly increasing the number of central apneas.

For example, if a week after the Min EPAP was increased to 5 the average Central Apnea Index is below 3, then I would suggest the next step would be increasing the Min EPAP to 6.

However, if increasing the Min EPAP to 5 had (on average) resulted in a significantly higher number of CA events per hour, then I would suggest reducing the Pressure Support from its present value near 4, to 3, and watching for another week before further adjustments.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-10-2016 05:08 PM by vsheline.)
04-10-2016 04:45 PM
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dewfend Offline

Members

Posts: 6
Joined: Apr 2016

Machine: S9 auto escape
Mask Type: Full face mask
Mask Make & Model: mirage quattro
Humidifier: unsure
CPAP Pressure: 4-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #25
RE: machine causes central apnea?
(04-10-2016 04:45 PM)vsheline Wrote:  After at least a week with the present settings, I would suggest gradually increasing the Min EPAP setting until, eventually, it sits around 2 cmH2O lower than your long term average 95% EPAP, in order to see if you can lower the number of obstructive apneas without unduly increasing the number of central apneas.


Take care,
--- Vaughn

Hi Vaughn,

Thanks for the advice.

To be honest, still today, with apparently good data, when upon waking, I didn't feel rested like before when there was purely OA. Therefore CA is main cause from my point of view.
Yesterday I did several things:
1) no smoking
2) go to bed early before 12 p.m.
3) push-up 10 times*3
4) set the pressure support from 4.0 to 3.0
Today the data as follows:
1) CA 1.6, OA 0.2, Hypo 0.4, AHI 2.3
2) CA events average time 13 secs comparing with yesterday's 16 secs

I am not sure which action of above four is the major reason. I will continue sharing my report.
04-10-2016 09:17 PM
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