Am I on the right track

So I am finally back to using my machine for more than 2 hours with the current settings plus humidity of 2 and heated hose at 70 degrees. Wet pillow issue taken care of.
However, I am regularly waking up at 2 with a beating heart (I go to sleep at 10 usually) and when I checked my graphs I've had an apnea.

Can you tell from graphs what is happening and should I consider changing settings? I am still waking up pretty tired.

I'll take a crack at this one..... I would up minimum pressure to 8 and raise Max to 12 to see what happens.

That said first it would be helpful to show more up close data for flow rate at times of centrals. You do have a lot of those. Do you know if your awake when they happen?

If not maybe you need a new machine.

That said I'm sure you will get better information from more knowledgeable members.

Which ones are the centrals?

I am usually very asleep until 2 and then something wakes me up and my sleep becomes very restless.

Here are two expanded flow rates of the clear airways which I think are the centrals for two different times.

Yes the clear airways are the central apneas. I have only had a couple period so I'm not too familiar. I know you can get false ones if awake and that some are ok.

Honestly don't know how many is to many .

Personally I would raise your minimum and maximum like I said but I'm no expert myself.

I'd turn the EPR down to 1 or 0 is you want to reduce the CA clear airway, they may be new user pressure induced. It may well be a short pause, 20-30 seconds? till the co2 levels catch up and trigger a breath. It will settle for most people within 12 weeks.
I would increase your min and max pressures.

USMCVet wrote: ↑

Thu Feb 22, 2018 11:47 pm

I'll take a crack at this one..... I would up minimum pressure to 8 and raise Max to 12 to see what happens.

That said first it would be helpful to show more up close data for flow rate at times of centrals. You do have a lot of those.

12 potential centrals in a night isn't "a lot".

A little more pressure is probably a good idea, for the obstructives, but the centrals, at this point. aren't anything to worry about.

palerider wrote: ↑

Fri Feb 23, 2018 12:15 am

USMCVet wrote: ↑

Thu Feb 22, 2018 11:47 pm

I'll take a crack at this one..... I would up minimum pressure to 8 and raise Max to 12 to see what happens.

That said first it would be helpful to show more up close data for flow rate at times of centrals. You do have a lot of those.

12 potential centrals in a night isn't "a lot".

A little more pressure is probably a good idea, for the obstructives, but the centrals, at this point. aren't anything to worry about.

At what point do centrals become worth caring about?

USMCVet wrote: ↑

Fri Feb 23, 2018 12:30 am

palerider wrote: ↑

Fri Feb 23, 2018 12:15 am

USMCVet wrote: ↑

Thu Feb 22, 2018 11:47 pm

I'll take a crack at this one..... I would up minimum pressure to 8 and raise Max to 12 to see what happens.

That said first it would be helpful to show more up close data for flow rate at times of centrals. You do have a lot of those.

12 potential centrals in a night isn't "a lot".

A little more pressure is probably a good idea, for the obstructives, but the centrals, at this point. aren't anything to worry about.

At what point do centrals become worth caring about?

The OP's CAI is only 1.88. if that was their only AHI number, that'd be a good not even worth looking at level. Even added to the 0.94 CAI (which, in and of itself is very good), it's still quite low... looking at the traces zoomed in above, you aren't seeing any disturbances around the centrals, OP is just holding their breath for a few seconds for some reason, but there's no recovery breaths afterwards, which, to me indicates that sleep isn't being adversely affected, and holding one's breath for short periods *occasionally* isn't significantly deleterious (as you can verify with your oximeter.

I woudln't put a number on centrals where they're worth worrying about, I pay more attention to patterns... are they happening here and there (like the OP)? then they're generally of little concern. Are there larger numbers in clusters? more concerning... are they accompanied by long periods of CSR? go see a cardiologist...

Thank you all for your responses. I am glad to hear I should not be concerned with centrals. Do you know if me waking up at 2 hours after falling asleep and not being able to catch my breath is REM related? I did try lowering my ESR to 2 and it was very uncomfortable - felt like my breathing was being rushed. I notice my pressures are never reaching my maximum and you sill think raising pressure will help?

Last night was another bad night - condensation again made the pressure of 7-8 feel like 4 (arghh) back to adjusting hose temp. Very cold here.

REM related would be my first thought.
It's normal to awaken after completion of REM cycle...and at around 90 minutes after sleep onset is when we normally will have the first REM so at about 2 hours we would usually be having REM cycle ending.
Normally people just wake up and it is so brief they form no memory of it but some people wake up and become more fully alert for some reason other other.

Now why you would be feeling like your heart is racing..dunno. Bad dream maybe???
Next time it happens you might just reach over and turn the machine off and then right back on again so you will have a clear marker for the time frame and can easily go back just a little with the flow rate and see exactly what might or might not have happened in terms of flow rate to see if you spot anything there. Like maybe a lone apnea or something.

I also wouldn't worry at the centrals that you are seeing. Some centrals are normal anyway...like a sleep onset central where we are transitioning from awake state to asleep state. When we have wake ups during the night and go back to sleep with obviously have an increased chance of having some of those normal sleep onset centrals.
We also increase the chance of having awake breathing pauses earn a flag and they aren't real centrals. We have to be asleep for them to be real.

How many centrals (assuming they are real and not awake breathing) does it take before we start worrying....doctors won't worry until someone is have like 5 per hour average and pretty much happening all night long and every night.
Even if every single one of your flagged centrals were real you don't have enough of them consistently to be a big concern.
Sleep onset centrals are normal but they can be a problem if you have so many of them that they keep causing you to wake up and not proceed into sleep.

Right now I wouldn't worry about changing the settings. There's no urgent need.
We can't do much about the centrals with your machine (assuming they are real) and the stuff we can fix with pressure on your machine you aren't haven't enough of them to need fixing.

I would just concentrate on getting good sleep first. Whatever it takes to get you to sleep more soundly with fewer wake ups.
Don't expect zero wake ups though. Just want to keep them to a minimum and have you go right back to sleep.
So more hours of sleep using the machine...6 hours isn't enough for most people. Heck, my butt is dragging if I get less than 7 hours.

Snorynomore wrote: ↑

Fri Feb 23, 2018 10:32 am

I notice my pressures are never reaching my maximum and you sill think raising pressure will help?

Maximum pressure is, for the most part, irrelevant. I keep mine at 25.

It's the *minimum* pressure that's important, and if yours was raised a bit, it might prevent some of the obstructives you're having, which are where the pressure jumps up... then you're good until it gets back down too low again... whether it's because of REM, or because you've changed positions... but you can see you need more pressure after you've been asleep for a while.