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Having Centrals but not Diagnosed with Centrals, also having CSR's - Printable Version

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RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 07-24-2020

Have set it up as previous commented though so - we will see *crosses fingers*


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Sleeprider - 07-24-2020

I’d rather push maximum pressure down for the CA


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 07-24-2020

Last night 

(Oscar overview)

[attachment=24951]

(Oxygenation Saturation)

Ring ran out of batteries which sucks as I would have like to see the rest of the night,

[attachment=24952]

Its still dominant Centrals

Clear Airway : 6.02
Unclassified Apnea : 0.00
Hypopnea :1.69
Obstructive : 0.95
Pulse Change : 11.30
SpO2 Drop : 7.08


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Sleeprider - 07-24-2020

You see that big cluster of OA with flow limitation and a whole bunch of hypopnea? Read this http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea Note the example graphs...looks familiar? Your pressure could have be 20 cm and it would not stop that. See the soft cervical collar wiki.


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 07-24-2020

(07-24-2020, 07:57 PM)Sleeprider Wrote: You see that big cluster of OA with flow limitation and a whole bunch of hypopnea?  Read this http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea  Note the example graphs...looks familiar?  Your pressure could have be 20 cm and it would not stop that.  See the soft cervical collar wiki.

Ok, not exactly what I was expecting but to clarify 

Reading between the lines, I am having OSA/HA due to my sleeping position primarily (assumed based on flow limits, chin tuck caused by on my back for example) & the pressure is still to high, hence the fact that I am still getting CA clusters? Or is the CA clusters still a question mark / further investigation required?

Thank you in advance for the advice.


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - SarcasticDave94 - 07-24-2020

There's no advice mentioned from Sleeprider to change pressure, but a suggestion to read the positional apnea link to learn about this issue. It will teach you that a collar or other physical device is needed to block the chin tucking. What this means is that there's chin tucking/positional apnea occuring causing event clusters. This is a physical/mechanical situation causing positional apnea, and cranking up the pressure cannot reopen the collapsed throat.


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Sleeprider - 07-24-2020

I concur with Dave, and will just clarify we cannot treat CA with your CPAP, but we can address the obstructive apnea and events that appear to be "positional". Increased pressure will only increase CA. I'm not necessarily advocating you use a soft cervical collar, but I certainly don't want to increase pressure. Your CAI is over 6 and OAI is less than 1 in spite of the events. Hypopnea are not defined, but with high flow limits when they occur, I'm inclined to consider them mostly obstructive.

If, you want to try a soft cervical collar, I would not argue against it. You have pretty long periods where flow limitation and obstructive events seem to predominate. The CA events do not appear to be pressure related.


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 07-24-2020

(07-24-2020, 09:50 PM)Sleeprider Wrote: I concur with Dave, and will just clarify we cannot treat CA with your CPAP, but we can address the obstructive apnea and events that appear to be "positional".  Increased pressure will only increase CA.  I'm not necessarily advocating you use a soft cervical collar, but I certainly don't want to increase pressure.  Your CAI is over 6 and OAI is less than 1 in spite of the events.  Hypopnea are not defined, but with high flow limits when they occur, I'm inclined to consider them mostly obstructive.

If, you want to try a soft cervical collar, I would not argue against it.  You have pretty long periods where flow limitation and obstructive events seem to predominate. The CA events do not appear to be pressure related.


Thank you, for your comments. 

The comment "The CA events do not appear to be pressure related" suggests that I do follow up with the doc and get a lab titration study & see if the CA events persist & go from there if she feels they are a issue requiring treamment.

I might see if I can get a soft cervical collar next week, as they seem cheap, and see if that helps.

Thank you all for your input.


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 07-24-2020

this is the Hypo section zoomed in

[attachment=24956]

and the other difference, normally I don't have snoring recorded, this time I did

[attachment=24957]

Anyway, thank you for the feedback / lessons.


RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Sleeprider - 07-25-2020

This is what positional apnea and hypopnea looks like with strong indicators of flow limitations and repeated arousal (RERA). Those events are clearly obstructive.