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+--- Thread: [CPAP] Central/Open Airway Apneas while going to sleep? (/Thread-CPAP-Central-Open-Airway-Apneas-while-going-to-sleep)
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Central/Open Airway Apneas while going to sleep? - dcsleep - 12-04-2020
Having severe trouble sleeping today. Have normally been down in the 2-3 apnea / hr range the last few weeks. Suddenly tonight I have trouble sleeping and over just a short period of time I'm up over 20 apnea/hr...nearly all of it open airway/central according to report.
My machine always starts at pressure of 4 and ramps up usually 2-3 hrs into the night. During times tonight you'll see it was at pressure = 4.
Are these true apneas or just trouble getting to sleep? Having trouble getting call back from Doctor this week to schedule my normal check in and now really wondering if I need to find someone else to check out these apneas.
Would higher starting pressure than 4 help prevent them while I'm starting to sleep?
Attachments show 5 minute increments though the same patterns continued for 40 minutes before I got out of bed. Apneas totaled 10 minutes (25% of total time).
RE: Central/Open Airway Apneas while going to sleep? - staceyburke - 12-04-2020
Central are not controlled by pressure, They can get therapy from a more advanced PAP machine. But what I am looking at has no therapy for any apnea. You were at 4 or 5 for your pressure. A adult requires a higher pressure, in fact 4 is the lowest the machine can go and it would be like trying to suck air through a straw. If this is ramp - try to eliminate it, most all of the people here do not use ramp. While on ramp the machine does not change pressure to combat apnea. This does not have to do with centrals but again while you are on ramp you are NOT getting any therapy. I'm sure someone else will be by to talk about centrals...
RE: Central/Open Airway Apneas while going to sleep? - Sleeprider - 12-04-2020
A starting pressure of 4.0 is very low and negates any EPR you might be using. We want to optimize pressure to minimize pressure changes and disruptions through the night. While these CA events prior to sleep onset are not "real" apnea, I think a higher starting pressure is very appropriate. We refer to CA arising from sleep disturbance and transition at the beginning and end of the night as "sleep-wake-junk" (SWJ). Increase starting pressure to a comfortable level of at least 6.0 cm, or if you are using EPR, 7.0.
RE: Central/Open Airway Apneas while going to sleep? - dcsleep - 12-04-2020
Thank you for the updates. Increasing to 7 felt better like I was getting some relief and the AHI went down right away. Sounds like I should also do away with ramp setting?
RE: Central/Open Airway Apneas while going to sleep? - staceyburke - 12-04-2020
Yes stop using ramp. Also it would help a great deal to post a whole night report. See my signature about order of charts.
RE: Central/Open Airway Apneas while going to sleep? - Gideon - 12-04-2020
Most, not all, of us do not use a ramp.
You should always post a full night screenshot as at a minimum it will provide context. Your details read as central apneas but I cannot tell if you are asleep or not. The full chart will help with that.
When I see small clusters of events near awake periods I assume they are SWJ.
RE: Central/Open Airway Apneas while going to sleep? - dcsleep - 12-04-2020
Let me know if these are the daily views you're looking for.
One from prior to this week that's pretty standard for me. Usually 1-3 events per hour with a spike in the pressure around 2-3am. Which is also coincidentally the time I'd wake up wide awake in the middle of the night every night. So even with under 5 apneas on a normal night, I'm still not sleeping all the way through.
Second attach is yesterday with 20+ in the short time I was on it.
Thank you!
RE: Central/Open Airway Apneas while going to sleep? - Sleeprider - 12-04-2020
dcsleep, you have a lot of central apnea. I'm going to suggest you eliminate ramp and also turn off EPR, or turn EPR down to 1. Some users are more sensitive to the changes in pressure and increased ventilation of EPR, and you appear to be one of them. If CA continues at the rate you had last night, we will need to consider other strategies.
RE: Central/Open Airway Apneas while going to sleep? - SarcasticDave94 - 12-04-2020
This ain't just SWJ. How long have you been on PAP therapy? And do you have your copy of the detailed sleep study report? If not, request it ASAP. HIPAA ruling states you can get yours, so doc saying you don't need it is not an acceptable answer.
RE: Central/Open Airway Apneas while going to sleep? - dcsleep - 12-09-2020
Took some advice and connected with another sleep Dr since mine wasn't responding. They suggested I should have been off the wide range pressure (4-15) a while ago once my initial CPAP period was done. I've been on it over a year now.
They suggested a smaller range of 7-12 or even a set pressure of 12 - both without any ramp and lower EPR.
Had what looks like a great night on Dec 7th and a bit rougher with hard time falling asleep on Dec 8th. Dec 8th is only partial night since the first 2 hours I was actually awake not able to fall asleep but it still registered a ton of CA so I just included the time I was actually falling asleep/asleep.