mugen4u - Therapy Thread

[mugen4u]

You can try raising pressure to see if that lowers your CA's (could be OA's in disguise).  The experiment will determine if makes your therapy better or worse.  

You are doing the best you can at present IMO.  You are patiently working with your Dr. and insurance; thinking about new, possible solutions, and coming here to ApneaBoard to get new ideas for your apnea treatment and optimize your current therapy as best as possible.

i set the pressure to 7 for 2 days, and it did lower my overall AHI but not by much. OSA went down more, CSA stays the same so i doubt increasing pressure will help.

Anyways i went jogging again yesterday (6.5km this time, huray) and i lowered the pressure from the average of 6 back to 5.2 because i really wanted to know if jogging does impact my AHI that much, and again IT DID. even OSA was lower/

I called my doctor several days ago to tell her about my new findings and the only reason she could think of why my AHI is much lower on days i am jogging is because it relieves stress and less stress can also cause less centrals. is this true? 

cause i think jogging changes my brains breathing center and makes it way more active instead of way more lazy, and thus improving that part of the brain and training it to become more sufficient when it comes to breathing at night.

[Jay51]

If the jogging is working for you, then probably keep it.  

Your OA's occur in clusters; which indicates positional apnea.

[mugen4u]

If the jogging is working for you, then probably keep it.  

Your OA's occur in clusters; which indicates positional apnea.

well i dont know what to do about those cluster OA's... i already changed my pillow to a softer pillow. but an AHI of 2 for OA doesn't bother me, it's the CA's that need to go down and stay down. but i can't go jogging every day

[Sleeprider]

Anyone want to talk about EERS (enhanced expiratory rebreathing space)? There are several members currently using this technique to eliminate CA and improve tidal volume. https://www.apneaboard.com/wiki/index.ph...ace_(EERS)

[mugen4u]

Anyone want to talk about EERS (enhanced expiratory rebreathing space)?  There are several members currently using this technique to eliminate CA and improve tidal volume. https://www.apneaboard.com/wiki/index.ph...ace_(EERS)

what does this have to do with my central sleep apnea? it is not caused by CPAP, didn't you read the thread?

[Jay51]

Sleeprider has a good point.  A few members have had some success with EERs.  Only negative I have read is water condensation fairly quickly; causing interruptions in long term sleep.  

EERs is relatively inexpensive, but takes some work engineering it correctly.  Sleeprider provided the link for it as well. At least give it a read and post (if you want to) what you think about EERs.  

It basically causes a build up of CO2 in the (longer extension tube) that attaches to the mask.  With more CO2, it tricks the brain into breathing more often.  

Your choice as always if you want to give it a try or keep on your current plan.  You may or may not want to give it a try.

[SarcasticDave94]

EERS might be a way to treat Central Apnea, regardless of cause. If CA are your biggest obstacle to good therapy, you may need to think about it.

[mugen4u]

alright thanks, i will read into this.

i have a question about the flow rate.

i posted an attachment with a yellow mark, and a red/orange mark. 

which one is a normal breathing pattern and which one is not good? 

yellow has waves that go up and down. 
red/orange has waves that go up and down, and then there seems to be a mini pause for 2/4 seconds.

[Sleeprider]

In the first three breaths/circles, there are flow limited inspirations followed by extended expiration. That can be normal with CPAP, and with bilevel or ASV, those breaths can often be normalized with a higher trigger sensitivity or using the ASV algorithm to correct the low-volume breathing. I think this is followed by an arousal with higher than normal breathing ahead of the CA event. The CA event following hyperventilation is fairly common, and this is an example where rebreathing space can maintain respiratory drive by conserving some CO2. The final red circle is again typical zero-flow at the end of expiration before inspiration begins.

With regard to EERS, the member that first brought it to my attention, and whose thread is linked in the wiki, was diagnosed with predominately central apnea and was treated by the author of this article that you should read, Alternative Approaches To Treatment of Central Sleep Apnea. https://pmc.ncbi.nlm.nih.gov/articles/PMC3998090/ While we have often characterized EERS as a solution for therapy onset CSA, this doctor routinely uses it in his practice for patients diagnosed with CSA.

[mugen4u]

In the first three breaths/circles, there are flow limited inspirations followed by extended expiration. That can be normal with CPAP, and with bilevel or ASV, those breaths can often be normalized with a higher trigger sensitivity or using the ASV algorithm to correct the low-volume breathing.  I think this is followed by an arousal with higher than normal breathing ahead of the CA event.  The CA event following hyperventilation is fairly common, and this is an example where rebreathing space can maintain respiratory drive by conserving some CO2.  The final red circle is again typical zero-flow at the end of expiration before inspiration begins.  

With regard to EERS, the member that first brought it to my attention, and whose thread is linked in the wiki, was diagnosed with predominately central apnea and was treated by the author of this article that you should read, Alternative Approaches To Treatment of Central Sleep Apnea. https://pmc.ncbi.nlm.nih.gov/articles/PMC3998090/   While we have often characterized EERS as a solution for therapy onset CSA, this doctor routinely uses it in his practice for patients diagnosed with CSA.

hm if those are followed by an arousel then  i think i have A LOT of micro arousels, when i look at the flow chart that is.