Jay Aitchsee wrote:What do you think Pugsy, 8.0, or something lower, like 7.6? I'm afraid, though, at 8.6 we're pretty much at the lower limit for FL, hypopneas, and OA's, but one night wouldn't hurt.
I don't think the centrals are pressure related but just thought a reduction in pressure might be worth a try since there is a little wiggle room available in the obstructive component events.....and I would put the FLs on the back burner for now.
Just to see if the centrals will reduce at all....I don't think they will but there's a part of me that says "they might" and I would want to know what was causing the centrals if at all possible.
He's having enough centrals that we can't explain away to cause me to have concerns now. He didn't have a formal titration sleep study so we are really doing a lot of "what iffing" and there's just a lot of different "what ifs" to consider....
Like what if they are pressure related or what if they are arousal related meaning maybe a post arousal central (and the arousal may not be remembered).
To be honest I am scratching my head over this one but if it were me I would at least attempt to answer the "what if it is pressure related" question and not worry about what the obstructive side of things do during trying to answer that question. One night won't hurt to use a lower pressure and I was thinking of taking a big jump down to probably 7.
So if this were me...I would first try turning off EPR and no other pressure changes...just to see if EPR itself is the trigger. There is the very remote possibility that it could be a trigger even at 1 cm.
And if no joy there then I would try reducing the pressure to 7 (no EPR) and yes, I know the FLs will go to hell and maybe the OAs and hyponeas will too but my main objective is to see if the centrals will reduce or not.
Eventually I think the doctor needs to be brought into the loop probably no matter what gets figured out.
To Jimnlacy:
Oh...one other thought which I may or may not have addressed elsewhere but question .....are you taking any meds that might suppress respiration? Especially pain control meds?
Oh..one other request...can you zoom in on a central cluster for me? There's one really ugly CA cluster between 00:00 and 00:20...go to the events tab on the daily detailed report from last night...click on the CA group...so that all the CAs are shown with the time they occurred and click on on single event that has other CAs before and after it shown real close in time to that one....then get me a screen shot of the graphs after you do the clicking on the one event. I want that level of zoom and would like to see 3 or 4 centrals (more if you have them) at that level of zooming in. I just want to see the flow pattern up close but not too up close and clicking on just one event in the group will give me the level of up close I want to see.
I may have to RISE but I refuse to SHINE.
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