RE: CA while "awake" or "restless"
WcWilson, the majority of your events are central, and may be related to your use of EPR at 3 as well as the relatively wide-open range of pressure of 5-14. Where obstructive apnea occur, they are tightly clustered. If you are open to trying something a bit different, I'd like you to try a night with lower EPR and a tighter pressure range. EPR at 0 or 1 and a minimum maximum pressure range of 8.0 to 11.0. The objective here is to get the OA under control by reducing the disruption of pressure changes, and avoiding EPR, other than what you need for comfort. If we see obstructive events continue to be clustered, we can deal with that separately.
RE: CA while "awake" or "restless"
Hi Wcwilson,
First thing to do is turn the EPR setting to 1 or off. Let’s see if that brings your CA’s down.
If not, and if the CA’s continue at the same high rate, you should talk to your doctor about an ASV machine, as an ASV is the standard treatment for Central Sleep Apnea.
RE: CA while "awake" or "restless"
Agree with SleepRider on the pressure too. But definitely lower the EPR to 1 or preferably 0 if you can.
RE: [split] Should I increase starting pressure and/or try a collar
I think this thread was split in error. I was commenting on charts posted by wcwilson. I see that the issues I was flagging have now been addressed by Sleeprider and OpalRose.
RE: CA while "awake" or "restless"
Thanks all for your great support. You are my new BFsF! I will first try and set the EPR to 1 or zero. When I first got the machine, the CPAPStore I purchased it from had it set at zero, despite the prescription indicating EPR 3. At the time, I was having a difficult time with the pressure bloating me and forcing me to open my mouth.
RE: CA while "awake" or "restless"
Given your history of aerophagia my suggested maximum pressure of 11 may be helpful. The suggested minimum pressure of 8 is also based on your chart showing 5-cm does not meet your needs.
RE: CA while "awake" or "restless"
Last night was best night yet. EPR set to 1. Everything else the same. 95% pressure at 11.18. med at 7.3, max at 12.51. No real issues with mouth breathing. Most of the CAs were clustered in the last hour of sleeping. Will carry on with this setting through the weekend.
RE: CA while "awake" or "restless"
(09-12-2019, 09:25 AM)Sleeprider Wrote: WcWilson, the majority of your events are central, and may be related to your use of EPR at 3 as well as the relatively wide-open range of pressure of 5-14. Where obstructive apnea occur, they are tightly clustered. If you are open to trying something a bit different, I'd like you to try a night with lower EPR and a tighter pressure range. EPR at 0 or 1 and a minimum maximum pressure range of 8.0 to 11.0. The objective here is to get the OA under control by reducing the disruption of pressure changes, and avoiding EPR, other than what you need for comfort. If we see obstructive events continue to be clustered, we can deal with that separately.
So, over the last few days I've taken your advice and taken EPR to 0 (zero), and pressure range to between 8.0 and 11.0. Last night was good, and I've attached my data for the night. There were a lot of leaks which I wasn't really aware of but I believe they primarily have to do with bringing the minimum pressure up from 5.0 to 8.0. I can deal with that. OAs were essentially non-existent. Once again, I clustered CAs (all between 10 - 24") right before I got up at 5:45 tired of tossing and turning. What I noticed from the higher pressure was that I felt like my breathing was quickened, and generated a little anxiety. I read everything I could find on CAs, EPR, etc., but I never quite got the theory as to why you wanted me to increase the minimum pressure. If the reasoning is that by forcing air up my nose I have to breathe, then mission accomplished! Similarily, I see the EPR as more of a comfort setting now and utilizing that feature (dropping the pressure on the exhale) allows me to stop breathing, is that correct?
I'm inclined to carry on with these settings for another day, or continue on to a suggestion on eliminating the clusters. Thanks.
RE: CA while "awake" or "restless"
(09-11-2019, 09:29 AM)DeepBreathing Wrote: G'day Wcwilson. Welcome to Apnea Board.
The centrals you describe are commonly known as sleep-wake junk. During the transition from sleep to wakefulness (and vice versa) our breathing gets quite erratic, often with long pauses, especially if we move around during this period. If a pause exceeds 10 seconds, it's flagged as an apnea. It's really a false positive and can generally be ignored.
The Autoset doesn't respond to central apneas. It diagnoses the type of apnea while it's happening - if it's obstructive, it will raise the pressure to prevent another one occurring in the next little while. However increasing static pressure is contra-indicated for central apneas.
If your screenshot is that size my guess is that you're using a Mac with a retina screen. There is a known problem with the way Macs capture screen shots which will be remedied in the next release of Oscar. Is it possible to reduce your screen resolution?
This is an incredible post.
I woke up with the same schedule Bed about 9:30; up at 6:40
Problems from about 4:00 am. after a rushed pee break. Had problems until I got up.
sleep-wake junk
I like that.
My machine is a ResMed S9 E; I have EPR set at 3
I sometimes mouthbreath. I use a chinstrap.
I have a humidifier.
Pressure is 14
Mask is a ResMed N20.
AHI last night was 2.6 IIRC.
My question is: how do I improve my treatment.
Thanks to the OP for such a specific post. It's helping me learn "what I don't know I don't know"
RE: CA while "awake" or "restless"
(09-13-2019, 12:07 PM)Wcwilson Wrote: Last night was best night yet. EPR set to 1. Everything else the same. 95% pressure at 11.18. med at 7.3, max at 12.51. No real issues with mouth breathing. Most of the CAs were clustered in the last hour of sleeping. Will carry on with this setting through the weekend.
Wonderful! I'll read more posts.
This is so helpful.
You're teaching an old dog new tricks.
|
