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01-23-2025, 10:43 AM (This post was last modified: 01-23-2025, 10:45 AM by drist.)
Lots of CA events
Hello!
I have been using my CPAP for 9 days now.
I'm using a DreamWear nasal cushion mask, and I'm starting to feel more comfortable sleeping with the machine.
Over the last 4 days, I've been experiencing around 1–2 hypopneas and 20–24 central apnea (CA) events per night,
and I'm unable to interpret what might be causing all the CA events.
I will attach 4 screenshots (2 wide views and 2 zoomed-in views) for reference.
drist, we can try to work on the CA events, but the settings of a CPAP are not really intended to address that issue. You seem to have random CA at a fairly low frequency through the night, and the zoomed graphs show a very uneven or irregular respiration and these could be central evens. Did you have a sleep test with polysomnography that differentiated obstructive and central apnea? If so, what were the results?
Something we may try is to increase the EPR setting from 1 to 3 to see if that makes CA worse, or if it clears up as flow limits are reduced. I don't know a better way to identify a better therapy approach other than to try the EPR, and if that does not work, to come back to more of a fixed pressure strategy. Another effective method is to use Enhanced Expiratory Rebreathing Space (EERS). This is a way to include some unvented space in your breathing tube to increase respiratory carbon dioxide which stimulates spontaneous breathing. https://www.apneaboard.com/wiki/index.ph...ace_(EERS) Let's start with a trial of EPR 3 at your current settings, and go from there.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-23-2025, 01:46 PM (This post was last modified: 01-23-2025, 01:51 PM by drist.)
RE: Lots of CA events
Sleeprider, Thanks for your quick and detailed reply!
I did a polysomnography in December 2024 (I was able to sleep just 4 hours and 46 minutes).
Here is the resume:
Interpretation
Nocturnal digital polysomnographic recording demonstrates a sleep onset latency of 19 minutes (normal) and a REM sleep latency of 297 minutes (prolonged), with a sleep efficiency of 59.2% (reduced).
Microarousals are within the normal range.
The distribution of the proportions of different sleep stages is normal.
The apnea/hypopnea index is normal (1.0/hour) (normal is less than 5), mostly hypopneas, with desaturation down to 92% and a CT 90 of 0% TST.
There is a higher proportion of respiratory events in REM sleep (1.2/hour) compared to non-REM sleep (1/hour).
There is also a higher proportion of respiratory events in the supine position (1.1/hour) compared to the left side (0.9/hour) and the right side (0/hour).
Snoring is observed during 0.1% of TST.
The periodic limb movement index is 0/hour (normal is up to 15).
Bruxism episodes are observed at a rate of 0.2/hour.
No parasomnias or other sleep disturbances are observed.
The extrapolation of blood pressure data shows mildly elevated diastolic blood pressure levels.
Diagnostic
Abnormal nocturnal digital polysomnography due to:
Prolonged REM sleep latency.
Reduced sleep efficiency.
Thanks for the results. There is nothing show that central apnea is a pre-therapy issue, so this is PAP onset CA and should clear up as you adapt. Let's try the higher EPR and see where that takes us, then we can decide the best course of action.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
The actual EPR was only 2.4 cm because you set CPAP mode at 6.4 pressure, and with EPR 3 the minimum pressure is 4.0. This did not significantly change the event rate with 3.11 vs 3.00 AHI. Flow limit moved from 0.09 to 0.07. You switched to CPAP mode at pressure 6.4 and EPR 1 at the end of the session on Jan. 22. Let's give that a try for a full night. Just change EPR back to 1 and keep the 6.4 CPAP pressure.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
