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05-14-2021, 02:09 PM (This post was last modified: 05-14-2021, 02:10 PM by Hoagie73.)
RE: 3 Months Until Sleep Study
(05-14-2021, 12:45 PM)Geer1 Wrote: Both higher pressures and EPR can cause these centrals. A lot of your apnea/hypopnea reported appear to be incorrectly flagged or post arousal and not real per say. They are increasing your pressure though which isn't ideal. I would try fixed pressure, 9 cm with 2 EPR, as you drop EPR you can also drop min pressure (you were previously using 10 cm min with 3 EPR which is the same EPAP as 9 cm with 2 EPR for example).
Thanks Geer1! I think I'll try it fixed tonight. I may put EPR back to 3 despite the centrals. It definitely feels better at 3 and while flow limits aren't huge, I basically had them at 0 at 95% before going down on EPR. Interesting about the post arousal. How can I tell what constitutes an arousal?
(05-14-2021, 01:40 PM)SarcasticDave94 Wrote: Are the events bothering you in any way? If so then continue to address it. But it appears they're small in event count, there will be a point where further changes will make things worse on the other end of your teeter-totter.
What I'm trying to say is edits to EPR may in fact reduce the CA a bit, but expect something on the Obstructive side to go up. Maybe flow limits, or Hypopnea, full Obstructive Apnea.
Bottom line it's your call to address or not. If you do address them, make sure your reason is because they're interfering with well rested state of sleep.
Actually, just seeng so many centrals is my main concern. But I have been less comfortable dropping EPR to 2 and noticed slightly more flow limits. I'll take your advice. I'm going to raise EPR back up to 3 and try what Geer suggested with a fixed pressure.
Arousal breathing is usually large amplitude slightly erratic breathing (flow rate chart). If it follows an apnea then the apnea probably caused the arousal. If your breathing was normal, you have arousal breathing and then an "apnea" it likely isn't a real apnea and can be because you held your breath, changed position or some people have them when transitioning back to sleep. These machines aren't capable of telling when you are awake or asleep so they flag everything as an apnea, in an in clinic sleep study they don't flag apnea if you aren't asleep when they occur.
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
Find where your events are low enough that you're sleeping comfortable and rested. Personally I felt best treated if AHI is about 2 or 3 than a zero as it's more comfortable feeling.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
05-14-2021, 05:49 PM (This post was last modified: 05-14-2021, 05:50 PM by Hoagie73.)
RE: 3 Months Until Sleep Study
(05-14-2021, 02:21 PM)Geer1 Wrote: Arousal breathing is usually large amplitude slightly erratic breathing (flow rate chart). If it follows an apnea then the apnea probably caused the arousal. If your breathing was normal, you have arousal breathing and then an "apnea" it likely isn't a real apnea and can be because you held your breath, changed position or some people have them when transitioning back to sleep. These machines aren't capable of telling when you are awake or asleep so they flag everything as an apnea, in an in clinic sleep study they don't flag apnea if you aren't asleep when they occur.
Thanks again. If this is the case many of my nights are plagued with arousals. Not all of them are followed by apneas. But I get a boatload of large amplitude, erratic breathing throughout the night. Some nights I'll wake up 4 or 5 times seemingly for no reason. If it's not the apnea that's causing the arousals, I wonder what it could be.
(05-14-2021, 02:24 PM)SarcasticDave94 Wrote: Find where your events are low enough that you're sleeping comfortable and rested. Personally I felt best treated if AHI is about 2 or 3 than a zero as it's more comfortable feeling.
(05-14-2021, 05:49 PM)Hoagie73 Wrote: Thanks again. If this is the case many of my nights are plagued with arousals. Not all of them are followed by apneas. But I get a boatload of large amplitude, erratic breathing throughout the night. Some nights I'll wake up 4 or 5 times seemingly for no reason. If it's not the apnea that's causing the arousals, I wonder what it could be.
Sleep can be affected by many things. Sleep disordered breathing is only one of many contributing factors. Insomnia, health issues, digestive issues, stress/anxiety/depression. Tons of things that screw up sleep. SDB is just one of the main ones that is fairly easy to treat and the most common so gets 90% of the focus.
Researching sleep hygiene and cbt for insomnia are a couple things that might help a bit.
Also not all large amplitude breaths are necessarily arousal so without seeing examples it is kind of hard to know. I figured out what my breathing looks like by video recording my sleep which helped me understand the flow rate patterns and what they mean physically.
(05-14-2021, 05:49 PM)Hoagie73 Wrote: Thanks again. If this is the case many of my nights are plagued with arousals. Not all of them are followed by apneas. But I get a boatload of large amplitude, erratic breathing throughout the night. Some nights I'll wake up 4 or 5 times seemingly for no reason. If it's not the apnea that's causing the arousals, I wonder what it could be.
Sleep can be affected by many things. Sleep disordered breathing is only one of many contributing factors. Insomnia, health issues, digestive issues, stress/anxiety/depression. Tons of things that screw up sleep. SDB is just one of the main ones that is fairly easy to treat and the most common so gets 90% of the focus.
Researching sleep hygiene and cbt for insomnia are a couple things that might help a bit.
Also not all large amplitude breaths are necessarily arousal so without seeing examples it is kind of hard to know. I figured out what my breathing looks like by video recording my sleep which helped me understand the flow rate patterns and what they mean physically.
Thanks Geer! I have noticed my centrals spike when I'm dealing with anxiety. I'm not sure if there is a connection there or just a coincidence.
I had a bizarre night last night. Hoping I can get some help with this.
The first half of the night was riddled with centrals. According to my data from the prior night, I was getting a bunch of obstructive apneas. I tend to get these when I'm on my back. So, I taped a rolled-up towel to the back of my shirt last night to help keep me on my side. I fell asleep on my right side and woke up a couple of times laying on my back anyway. I got up to use the bathroom halfway through the night. When I went back to bed, I slept on my left side. From my left side I never turned onto my back, my flow rate smoothed out, and I only registered only 1 apnea which was an obstructive apnea, apparently. I am familiar with positional apnea, but I only thought that was relevant to obstructive apneas. I'm wondering how and why there was such a difference when laying on different sides. I've attached an overview chart of the entire night, one showing just the session after turning onto my left side, and one zoomed in on a portion of the right side. Any input would be greatly appreciated.
That one example you posted you can see how there are large amplitude breaths before the central apnea. That is not a real central apnea, it is either you changing position or holding your breath while transitioning back to sleep after an arousal. The obstructive apneas following are real though and potentially positional based.
Not sure if all of your centrals were the same but one other possibility is that these machines aren't perfect and will sometimes mislabel obstructive apneas as centrals.
(05-17-2021, 09:07 AM)Geer1 Wrote: That one example you posted you can see how there are large amplitude breaths before the central apnea. That is not a real central apnea, it is either you changing position or holding your breath while transitioning back to sleep after an arousal. The obstructive apneas following are real though and potentially positional based.
Not sure if all of your centrals were the same but one other possibility is that these machines aren't perfect and will sometimes mislabel obstructive apneas as centrals.
I appreciate your input Geer.
