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+--- Thread: Weinmann SOMNObalance suitable for central apnea? (/Thread-Weinmann-SOMNObalance-suitable-for-central-apnea)
RE: [split] Weinmann SOMNObalance suitable for central apnea? - Sleeprider - 12-08-2017
I'm working with Mark on that and I think TBMx is also doing some cleanup on the Weinmann extensions. TBMx is on the Sleepyhead Development Forum on Apneaboard. JediMark is the moderator of that forum, and we're trying hard to get him engaged. The efforts of TBMx were a big step forward to make that happen.
RE: [split] Weinmann SOMNObalance suitable for central apnea? - dark - 12-11-2017
(12-07-2017, 01:48 PM)TBMx Wrote: If it would be me, I would turn off SoftPAP (the exhale pressure relief) and see how that goes regarding your central events ... 5cmH20 and SoftPAP gets you DEEP in the "unsure" range regarding obstructive / central differentiation.
I set up the Pmin to 7 hPA, and SoftPAP to 0. I have sinusitis and my nose is a little congested, so it could have an effect on the results. On Friday night AHI was 4.14, and on Saturday night 3.57. On Sunday night I turned SoftPAP to 2, and the AHI was 2.0.
Friday, 2017-12-08, Pmin=7hPa, SoftPAP=0:
![[Image: nmp2Nya.png]](http://i.imgur.com/nmp2Nya.png)
Sunday, 2017-12-10, Pmin=7hPa, SoftPAP=2:
![[Image: 9mG7irn.png]](http://i.imgur.com/9mG7irn.png)
RE: [split] Weinmann SOMNObalance suitable for central apnea? - TBMx - 12-11-2017
I have to admit I am a bit confused, puzzled, astonished (pick one^^)
Are you still using the JOYCEone? How does it go with that mask (or your current mask and which one is that)?
And more important: how is your sleep? are you feeling rested? - way better than before the therapy?
just by the way: how did you got diagnosed? in home test (PG) or in a sleep lab with a full blown PSG? (big difference - and your amount of centrals and your response to the APAP-therapy makes not that much sense - at least to me)
You seem to respond well to softPAP ... If you don't really need the ramp and tolerate the pressure well enough, than loose the ramp (softStart off) - you should be able to get rid of the remaining leaks that way (fair warning: I am a leak-"nazi" ... If you start with 4cmH20 you have no exhale pressure relief the 1st minutes - if you start with your "therapeutic" pressure right from the start you can make your mask a little bit thighter without causing discomfort in the beginning - thus less leaks in the upper range)
but I would like to draw your attention to the "status graph" and the rMV - IF(!) you are "not feeling it".
The Flowlimits are that per breath - the Hypopneas and Apneas there are ... well ... some sort of "temporary" or partial ones. As you have a Pulsoxymeter you can check if those do have an impact on you! (I would suspect you have there mostly temporary hypopneas which may or may not correlate with your PCs and SDs)
Don't overvalue the central hypopneas (if you would have gotten a ResMed device instead of Löwenstein you wouldn't even see those^^) .. sometimes you just come back to normal breathing from a phase of some more intense breathing - no big deal - for the machine that is a cH! (and well ... yes! your SPO2 will drop too in that case - bit if it was ELEVATED before that is returning to normal as well^^)
(.. sometimes the SB-way of "overwhelming you with data" is helpful - sometimes you just see something that simply is not there! ... the very proactive RERA-"detection" is 'such a thing' too ... just BTW: you can make SH include the RERAs in your AHI - preferences ... CPAP-Tab (I believe - dunno have no SH on this machine ... should be on the right on the top somewhere - says than RDI which is AHI + RERAs)
from the looks of it, I would say that you never reach the 14 cmH20.
That is a "good" thing - It gives you the opportunity to INCREASE(!) the upper pressure range. (sounds ridiculous- trust me: it is not!)
Your device responds to flowlimits only if you have enough to make up an "epoch with flowlimitation" and it only responds to them in the lowest pressure-quartil.
for you with your current 7-14 the pressure quartils are 1,75 cmH20 "wide" ... 1st: 7 - 8.75 .. 2nd: 8.75 - 10.5 .. and so on.
The respone to the epochs with mild obstruction (snoring + RERAs) and severe obstruction (more snoring + oA + oH) is also based on the current pressure. (the higher the current pressure the lower the response or vice versa)
this means that you only get a response to flowlimitations up to 8.something - after that an eFL will "only" stop the declination of the pressure.
If you would raise the upper pressure to 20 - that would mean that your eFL get a response as high as 10 cmH20 - and the response to RERAs and oHs will also be higher. Sounds like a bad plan - but it *should* result in a lower overall pressure for you and more important less: (real) 'breathing events'.
(fair warning: on a bad night (like: coming home totally drunk / wasted) you might end up getting that pressure and waking up from the resulting leaks or ending up having really bad aerophagia)
but that is one thing you should test AFTER your sinusitis and only if you flowlimits are a problem at all or what you showed is "normal".
(at first the color for eFLs was much lighter ... I had them all over the place - couldn't stand seeing virtually everything colored^^ - but you can change the coloring too in the preferences!)