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+--- Thread: Understanding tightly clustered CAs (/Thread-Understanding-tightly-clustered-CAs)
Understanding tightly clustered CAs - GuyScharf - 05-30-2020
Last night, I decided to use my P10 mask instead of my usual F30 but with no change in pressure settings. AHI jumped up, caused primarily by two tight clusters of CAs (average AHI for me is about 1.7.)
Can someone tell me what was probably happening during these CA clusters? I see waxing and waning in the flow rate. SpO2 values have the same pattern. SpO2 was high for me (98%) before this sequence began and dropped to its lowest value of the night (81%) during this sequence.
Any suggestions are most appreciated!
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RE: Understanding tightly clustered CAs - sheepless - 05-30-2020
looks like my periodic limb movement pattern.
RE: Understanding tightly clustered CAs - jaswilliams - 05-30-2020
Guy you’ve had periodic breathing and CA’s before. A p10 nasal mask has a smaller volume than a F30 maybe this caused sufficient over ventilation to cause the rise in CA’s you will prob find the tail off if you keep using the P10
It does seem to coincide with REM sleep maybe. Mine is like that every night but the cluster lasts upto 30 min hence I use an ASV
Here’s a typical night for me on an Autoset a bit more dramatic than yours
RE: Understanding tightly clustered CAs - GuyScharf - 05-30-2020
Thanks for the explanation; your chart is pretty dramatic! I had wondered if the high SpO2 graph before the onset of this sequence was related, and over ventilation would probably raise the SpO2 level?
The pressure did feel noticeably higher -- like I was constantly breathing very deeply -- with the P10. When I used a P10 before, I probably used a lower pressure, so I'll try that again if I stick with the P10. (I stopped using the P10 because of excessive mouth breathing. Since the F30 had kept my mouth closed, I wondered if mouth breathing might have stopped. At least it did for this night.)
RE: Understanding tightly clustered CAs - Gideon - 05-30-2020
Overventilation would tend to raise O2 levels and I'll bet your CO2 levels are dropping at the same time.
Any persistence and I'd cut back on EPR.
RE: Understanding tightly clustered CAs - GuyScharf - 05-30-2020
I increased my min pressure from 9.8 to 10.2 on the first of May and have been using those settings all month. My goal was to see if a slight pressure increase would improve treatment measuires. Overall, HI and OAI seem relatively unchanged, while CAI is slightly increased (even without last night's contribution), so this does not seem to have been a useful adjustment.