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Central's [and exhale relief connection?] - GuppyDRV - 01-09-2018
Hello all,
I was just reviewing some of my old data today and had a question about central apnea. What is the connection with Aflex/EPR or as I think many call it pressure support and central apnea? The use of the aforementioned seems to generate central Apnea for me that clears completely when turned off. The central count would be between .5 - 1 per hour. I'm not using any at the moment I'm just interested in the dynamics.
When using Aflex I never have Obstructive events only central and hypopnea. Without Aflex I never have central events only Obstructive and hypopnea. I feel better without Aflex even though the Obstructive index and AHI are higher. Still in the experiment phase.
GuppyDRV
RE: Central's - jerry1967 - 01-09-2018
(01-09-2018, 01:00 PM)GuppyDRV Wrote: Hello all,
I was just reviewing some of my old data today and had a question about central apnea. What is the connection with Aflex/EPR or as I think many call it pressure support and central apnea? The use of the aforementioned seems to generate central Apnea for me that clears completely when turned off. The central count would be between .5 - 1 per hour. I'm not using any at the moment I'm just interested in the dynamics.
When using Aflex I never have Obstructive events only central and hypopnea. Without Aflex I never have central events only Obstructive and hypopnea. I feel better without Aflex even though the Obstructive index and AHI are higher. Still in the experiment phase.
GuppyDRV
I have the same problem and my Dr.. wants me to try a ASV machine. Need another sleep test though I guess for insurance reasons .
RE: Central's - Sleeprider - 01-09-2018
Put simply, because I'm basically pretty simple, pressure support can increase the ventilation of the lungs which reduces CO2 in the blood. This in turn, increases pH from carbonic acid, and that is what affects the respiratory drive. The respiratory system is designed to eliminate CO2, and when a respiratory ventilator helps with that function, it sometimes increases central apnea. The side-effect of central apnea with CPAP pressure, or especially CPAP with Pressure Support/EPR, is a very individual reaction. So some people develop the complication with CPAP alone, and others with EPR or Flex, and others never have a problem at all.
http://mypages.valdosta.edu/dodrobin/3450/Labs/RespDrive.htm
http://www.articles.complexchild.com/april2010/00197.pdf
http://www.atsjournals.org/doi/full/10.1164/ajrccm.163.6.pc1201a
How deep do you want to go into this? The rabbit hole is deep.
RE: Central's - jerry1967 - 01-09-2018
Sleeprider I wish I knew what you are talking about.
RE: Central's - Walla Walla - 01-09-2018
(01-09-2018, 04:41 PM)jerry1967 Wrote: Sleeprider I wish I knew what you are talking about.
Yeah it's deep and it's dark.
RE: Central's - jerry1967 - 01-09-2018
(01-09-2018, 04:45 PM)Walla Walla Wrote:(01-09-2018, 04:41 PM)jerry1967 Wrote: Sleeprider I wish I knew what you are talking about.
to me it is
RE: Central's - Sleeprider - 01-09-2018
I'll try to shed some light. When the difference between inhale and exhale pressure is greater, there is usually more volume of air exchanged in the lungs. This flushes the CO2. CO2 is what creates the respiratory drive. When you reduce CO2 by increasing EPR or pressure support, it is more likely that you will experience central apnea events, simply because your body does not generate the signal to breathe until CO2 rises.
How are we doing? I'm running low on simple.
RE: Central's - Walla Walla - 01-09-2018
jerry1967, I wasn't laughing at you I was laughing with you. The first link Sleeprider posted I looked up and I couldn't spell half the words.
RE: Central's - SarcasticDave94 - 01-09-2018
CPAP devices apply pressure, and therefore pack more oxygen-rich air into the lungs. This throws off the natural balance of respiration as monitored by your brain. It interferes, or delays, the naturally occurring signal to inhale because the carbon dioxide level has been thrown off balance from what your brain is expecting. Therefore, your brain interprets, incorrectly, that breathing isn't needed yet.
This balance in breathing, BTW, is regained by most on CPAP, but not in everyone. Some can't get that restored on their own. I believe this is where devices like an ASV machine steps in to assist in restoring that balance to the respiration process.
RE: Central's - ajack - 01-09-2018
At 1 CA an hour, I wouldn't worry either way. Use what is comfortable. You may need to raise the min pressure for OA and H. You could get some charts up to get some opinions on.