05-29-2019, 01:22 PM
(This post was last modified: 05-29-2019, 01:25 PM by DD2754.)
RE: DD Therapy (Centrals?)
UPDATE:
So I am still struggling. If I go to bed on my normal schedule 10:00PM to 6:00AM I am never able to sleep through the night. The last two mornings I actually woke up with my mask on the ground. Must be taking it off in the night. But I have lowered my pressure to a fixed 6.0 and I am not really having any obstructive apneas. Still just the centrals. The screenshot I have attached is only a short example because I have been unknowingly taking my mask off during the night. Is it possible that 6.0 pressure is really all I need to prevent my OSA? Am I still just not used to the machine which is causing the centrals?I am definitely feeling worse than when I first started therapy although I have been able to lose nearly 10 lbs just from diet alone. I just feel like I am not able to get any quality sleep. It almost looked like I was going to get some uninterrupted sleep last night but then I woke up for some reason and it looks like i took off my mask for the rest of the night. It doesn't help that i am going through seasonal allergies at the moment but I thought I would be feeling better by now. Please let me know what you think and thank you again for all of your help.
RE: DD Therapy (Centrals?)
I guess what I am hoping for is that these centrals are treatment emergent. Sort of unrelated, but I have a dreamwear nasal pillow that my DME recommended I try. I am a mouth breather but she told me to use a chin strap. Do you think this will just delay my therapy even more? I feel like trying to train myself to not mouth breath will be another added struggle. Lots of questions I know. But thank you. I dont know what I would do without this forum.
RE: DD Therapy (Centrals?)
IDK if this is accurate but I've read that treatment emergent pressure induced ca can take 30 to 90 days to ease so be patient.
not to worry about so many questions. I've been pestering the good folks here for a good long time and they haven't kicked me out (yet!). ask away.
as for mouth breathing, if you can figure out how to train yourself not to, it'll serve you well no matter what mask and machine you use. I don't think I'm a mouth breather but I do suffer from lip leaks with my nasal pillow mask. a soft cervical collar, much as I'd rather not wear it, works well for me. you've read or can read a lot about mouth breathing and managing leaks on this site. try everything you can to find what works best for you. it's hard, but try not to be too discouraged; it can take a while to get everything sorted out.
RE: DD Therapy (Centrals?)
(05-29-2019, 05:40 PM)sheepless Wrote: IDK if this is accurate but I've read that treatment emergent pressure induced ca can take 30 to 90 days to ease so be patient.
Yes, IIRC, a study based on Res Med's patient data showed that treatment emergent centrals got better, the same or worse over 90 days. I think the 90 days was arbitrary on the part of the study design, though. Regardless, I had a fair number of treatment induced centrals when I started (which did not show in my WatchPAT sleep test), and that number has gone down over the months, as it does for about half of people. I was surprised it went down, since there was a chance the opposite would happen, but I lucked out and it did.
RE: DD Therapy (Centrals?)
UPDATE:
I am still having a very difficult time. I tried sleeping without my machine the last couple nights and still feel terrible. I tried switching to nasal pillows and mouth tape with no luck either. I am not sure what I need to do. I will be calling my doctor on Monday. Do you think I need a different machine? BIPAP or ASV? This is just awful and I need to figure out how to get some sleep.
RE: DD Therapy (Centrals?)
Please work on getting your Sleep Study results, The Diagnostic (first) study without a mask will indicate if you had Centrals prior to CPAP, As stated before, the full study, not just the summary. You are entitled to them. This study is important because it is from before CPAP. If you had centrals (Central/Clear/Mixed/Complex/Treatment-Emergent) on this study you should be talking about getting an ASV now. If your Doctor says no, ask if he can see an ASV in the future, if yes ask him what is the path to go and get one.
You have only been using CPAP for about a month, If the diagnostic study has no Centrals mentioned in it (it is common not to mention them in the summary) you have another 1 to 2 months of hell (sorry) before advancing to another machine.
I would argue that fixed CPAP is not working for you and you have already demonstrated that BiLevel (EPR=3 is the same as BiLevel w PS=3) also does not work for you.
RE: DD Therapy (Centrals?)
My doctor informed me that my sleep study had over 100 events. 15-20 central and the rest obstructive.
RE: DD Therapy (Centrals?)
That is your argument for getting an ASV now. That tells me that you are not having Treatment-Emergent Apnea.
If you were ever to move, change doctors, change Insurance, or change DME's it is highly likely you will either need a copy of your sleep studies or have to redo the sleep studies. I do not want to EVER do that again.
RE: DD Therapy (Centrals?)
Bonjour, I have a question about these charts that arises from my efforts to understand my own charts. In the two most zoomed-in views, are there arousals right before the CAs? If yes, does that change the understanding of the problem? In other words, when CAs are “awake” or “semi-awake” events, is the disrupter the arousal rather than the CA?
RE: DD Therapy (Centrals?)
(06-15-2019, 11:02 AM)Dormeo Wrote: Bonjour, I have a question about these charts that arises from my efforts to understand my own charts. In the two most zoomed-in views, are there arousals right before the CAs? If yes, does that change the understanding of the problem? In other words, when CAs are “awake” or “semi-awake” events, is the disrupter the arousal rather than the CA?
It doesn't change the overall impression, ResMed calls them Clear Airway because their "sonar" did not detect an obstruction and they have no way of detecting sleep or tossing. I do look for areas around a break and CAs in that area I typically totally ignore as likely tainted and not real "sleep" apneas. You ask if the disrupter is the arousal rather than the CA? In some people it definitely is. But note that there are a lot of CA events here which have already disturbed the sleep and the body is looking for a more comfortable position.
