High CA Events

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Try reducing PS to 1 and see if the centrals are still too numerous.

How is your sleep quality? Sleeping soundly for the most part or having lots of wake ups with lots of awake time spent with mask and machine on?

What is your altitude?

Do you take any meds of any kind? If so, what?

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lazyfoxjumps wrote: ↑

Mon Mar 11, 2024 5:20 pm

my nose tends to get congested when I'm sleeping.

Using the humidifier??? If so, at what setting?

If not using it....use it.

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Humidity needs vary widely among individuals.
Some find that too little added moisture causes congestion.
Some find that too much added moisture causes congestion.
And to complicate things the amount of moisture may not even be what is causing your congestion.

If a hot steamy shower seems to help then I suggest going to manual settings and use a higher humidity setting and see if it helps or not.
The "auto" setting is roughly equal to a manual setting of 4.

Also make generous use of something like Simply Saline right before bedtime.

Also...I don't know if reducing PS will do much with your centrals or not. We don't know if the PS is the trigger...and we don't know if those centrals are being flagged while asleep or awake. If you aren't asleep they don't count. You have to be asleep for anything flagged to matter.
But reducing PS is about all we have in our bags of tricks to try in terms of machine settings ...worth trying.

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If lowering PS doesn't help then we need to dig a little deeper and try to figure out if those centrals are arousal related or real asleep centrals and then based on what we see then come up with a different plan.

Not all centrals are asleep centrals. I was just looking at my centrals flagged last night and I had 8 centrals flagged and not a single one was flagged when I was asleep. They were all related to arousal/awake breathing.

Remember these machines only measure air flow or breathing. They have no way to measure or know if we are asleep or not.
Our awake/arousal breathing is irregular when compared to asleep breathing and those irregularities can and will get flagged by the machine but if we aren't asleep they simply don't count.

Pugsy wrote: ↑

Mon Mar 11, 2024 7:40 pm

(snip)
Remember these machines only measure air flow or breathing. They have no way to measure or know if we are asleep or not.
(snip)

If you wear an O2Ring you can often tell arousals from the Movement graph... if you remember to shake your ring hand this gets more reliable... hillbilly EEG.

I'd have to say those CA's look like too much treatment... I agree with lowering the PS... maybe even the IPAP.

vandownbytheriver wrote: ↑

Mon Mar 11, 2024 8:56 pm

I agree with lowering the PS... maybe even the IPAP.

Lowering the PS effectively also lowers the IPAP.

I am not so sure that those "centrals" are related to "too much pressure"....I see a cluster of them and IPAP was only around 9ish.
I am thinking that these centrals are likely related to arousal/awake breathing but reducing PS is easy and quick to try.
Learning how to distinguish asleep centrals from awake/arousal centrals isn't so easy or quick.....but we can do it if we need to.

I have seen some dramatic results in terms of centrals with just a small reduction in PS.
I have a friend who gets about 15 real asleep centrals per hour with PS at 4. I thought for sure she was going to end up needing ASV but on a whim I had her try PS of 3 after she told me "I never had centrals when I was using the other machine and EPR was at 3"...
Guess what happened??? At PS of 3 her centrals went totally away essentially.

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You can try turning PS off or using 0 but if those centrals are awake centrals it won't help because it's the being awake that is causing the central flagging.

Your choice. I don't think PS is your problem but it won't hurt to give it a try.

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lazyfoxjumps wrote: ↑

Sat Mar 16, 2024 11:33 pm

Wanted to share an update on adjusting the PS level since my last post. My average AHI is now consistently ranging around 4. A great improvement compared to it being above 5 when using the default PS level. So thank you pugsy and vandownbytheriver for the suggestion.

Good to hear.

While I've noticed that the frequency of me waking up during the night has reduced significantly, my AHI has largely remained the same. So I am hoping to ask if there is any settings I could look into adjusting based on my latest OSCAR result?
https://imgur.com/a/Yy5xr6t

Looks like you're getting 1cm PS anyway... I guess that's the min. 5cm looks too low... it wants to bump you up almost immediately. It's fighting the hypopneas and OA's... the big pressure jumps come from the OA's. Maybe you don't need bi-level? My APAP doesn't do anything for hypopneas but jumps 0.8cm for every OA... here's where a professional titration would do wonders... getting mine Tuesday night, half CPAP, half bi-level.