Seems that centrals have started,...

Hello all, I am a new member here, and was diagnosed with OSA on 6/19/17. I received my cpap on 7/28/17, and have been having quite a time since. First off I was shocked to be diagnosed at all since I do not snore to any real degree, and my BMI is 24.8 ruling out needing to lose weight. My initial AHI was 16, and I was setup at a constant 8cm/h2o with an EPR reduction of 3. My machine was set for auto ramp, and smart start is enabled.

I will not lie and say I have been compliant as I have been using it for 3 or 4 days, and then skipping a week. I have been through three masks now from full face, to hybrid, to a F&P Brevida nasal pillow setup. I am sticking with that one since it doesn't leak on me at all, at least when awake. I am not claustrophobic, so that was not an issue with the full face, it just leaked horribly, and made the bridge of my nose hurt like heck.

Anyway, I have begun to play with SH a bit, and the last two sessions I recorded have shown quite a number of centrals. This is from the view point of a newbie though, and is the reason I ask this question here. My doc is next to impossible to get in touch with, so I don't even bother. I know the pics do not allow interactive use where you can see real numbers from minute to minute, but I will be glad to look up and report back any info needed by a member that knows how to interpret these. I am trying to figure out if the cpap is causing me to have centrals, or if it has something to do with mouth breathing, as I have had several instances of awakening with an almost painfully dry mouth and throat.

Thanks for having me, and maybe someday I will be able to render assistance to others.

https://i.imgur.com/MtB91pW.png

https://i.imgur.com/jqyj3ce.png

How is your sleep quality? Waking a few times during the night?

I don't know if some of your centrals might be related to awake irregular pauses in breathing getting flagged by mistake or not but even if all your centrals were the real deal there's not enough of them happening hour after hour to get a doctor all excited.

If you go to the Events tab...then click on the ClearAirway category and then pick one of the timed events and click on it the flow rate graph on the right will change and zoom in on the event.
Get a screen shot at that level of zooming.
If you happen to have 2 CAs/centrals flagged close together...see if you can get in one screen shot at that level of zooming.

When logged into your Imgur account pick the image you wish to share and a little box of addresses will show up.
Click on "Large ThumbNail" first...then copy the last line in that box of addresses.
You will get a large (but not huge) image that we can click on and enlarge it if necessary....like this one.
This one was done just to show the flow rate.

check your pm box please

I hope this is what you are referring to.

Pugsy wrote:How is your sleep quality? Waking a few times during the night?

I don't know if some of your centrals might be related to awake irregular pauses in breathing getting flagged by mistake or not but even if all your centrals were the real deal there's not enough of them happening hour after hour to get a doctor all excited.

I actually felt like my sleep quality was better prior to cpap. I used to have extensive vivid dreams, and now,....nothing. I typically awaken once or twice a night for a visit to the restroom.

I have always been told that I breathe shallow while sleeping. Actually, I breathe shallow whenever I'm relaxed I think,

Hey Mark, I am in central florida as well! I am sending you a pm

The fact that you aren't remembering dreaming isn't necessarily a bad thing.
When we remember dreams it means that we woke up during one...and that's not a good thing...the waking up part.
Just because you aren't remembering dreams doesn't mean they aren't happening. Just means you aren't waking up during one.

tiredNorlando wrote:Hey Mark, I am in central florida as well! I am sending you a pm

I'm just North of you by a little over an hour.

Pugsy wrote:The fact that you aren't remembering dreaming isn't necessarily a bad thing.
When we remember dreams it means that we woke up during one...and that's not a good thing...the waking up part.
Just because you aren't remembering dreams doesn't mean they aren't happening. Just means you aren't waking up during one.

The reason these two nights of therapy bother me is more than the charts. I woke up with headaches both days, and on 10/15 I had really bad tinnitus in my left ear. Granted, I have a bit normally, but it was a lot worse and lasted half of the day.

I have no idea whether they are connected or not.

Are you of an age where the middle night bathroom breaks could be related to the prostate?

How is your neck feeling?

Pugsy wrote:Are you of an age where the middle night bathroom breaks could be related to the prostate?

How is your neck feeling?

I'm 55, but don't seem to have any prostate issues to speak of. I drink too much water before bed mainly.

My neck has been killing me for the past week, but I have orthopedic issues with it. Why the question about the neck?

Question about the neck is because I know first hand that the neck can cause headaches.
Not saying that it is the cause of yours but it wouldn't be impossible especially because sometimes with the mask we end up sleeping in a weird position which can make the neck give us tension headaches.
Straps being too tight can cause headaches also.

And of course we can simply wake up with a headache just as a coincidence.

If you were thinking the centrals caused the headache as in oxygen too low headache....highly unlikely unless the apnea events were extremely long in duration and your longest was 22 seconds and we can hold our breathe longer than that and not have a desat.
And I don't see enough of them back to back to do it even if short lived.

Pugsy wrote:Question about the neck is because I know first hand that the neck can cause headaches.
Not saying that it is the cause of yours but it wouldn't be impossible especially because sometimes with the mask we end up sleeping in a weird position which can make the neck give us tension headaches.
Straps being too tight can cause headaches also.

And of course we can simply wake up with a headache just as a coincidence.

If you were thinking the centrals caused the headache as in oxygen too low headache....highly unlikely unless the apnea events were extremely long in duration and your longest was 22 seconds and we can hold our breathe longer than that and not have a desat.
And I don't see enough of them back to back to do it even if short lived.

I got ya! I've been dealing with ortho issues with my back and neck for quite some time (HVAC Contractor 25 years), and typically I don't get headaches, but when I do they are good ones.

I actually have the best luck with the Brevida pillows with a loose fit. I can lay there and watch TV and have zero leaks at all. I don't really understand what is causing some of my brief crazy leak rates because I move very little when I sleep, and I spend 90% of the night on my back.

I have a crazy question,....is it possible for an open mouth event to look like a central on the SH chart? I know I'm having issues with my mouth dropping open enough to bypass a lot of air. The sore, dry throat is proof of that.
I have a chin strap on order from Amazon that should arrive tomorrow btw.

As far as desats I only know that my sleep study showed a couple into the mid eighties, and none on my titration study. I have an spo2 meter, but it doesn't record unfortunately. I have been looking at them online, but they either cost a fortune, or they appear to be cheap junk.

Thanks much for all of the help!

Actually there are some overnight recording pulse oximeters that aren't junk and do a decent job and don't cost a small fortune.
http://www.pulseoxstore.com/overnight-pulse-ox

I have no idea if a mouth opening leak would/could mimic a central apnea that appears to be real. I can't see how myself.

As long as any leak (no matter the cause) doesn't wake me up and I don't spend an inordinate amount of time in really bad large leak I don't worry about the leaks.
I learned a long time ago that trying to obtain a perfect pretty leak line usually came at the expense of my sleep quality and my sleep was already fragile so I elected to accept less than perfection and keep the sleep quality as my primary goal.

Here is an example of a very brief one that spikes up to 25.20 although I have had some well into the thirties. I'm thinking it's mouth leaks for me, as I have never awakened to a leaking mask.

I'm not sweating the leaks really, I'm more concerned about centrals and desat events since heart disease is the killer in my family. I have been reasonably lucky to date, but my last echo picked up some very minor chamber thickening that made my cardiologist suspicious of sleep apnea.

Thanks for the oximeter links also. I had been told Contec was to be avoided, but I don't claim to be an expert by any means. They had the wrist version on Amazon for $83.00 the other day.