Central Airway events and AHI increasing (new APAP user)

Pugsy wrote: ↑

Mon Mar 18, 2024 1:29 pm

Remember....your primary goal is "get decent, solid sleep"...because without sleep none of this data really amounts to much. Awake/arousal flagged events cloud the data reported and makes it hard to know if what we are seeing is real or not.

This is such a helpful reminder -- thank you! The fact is that with even just three days' experience, I can tell that I'm getting better sleep because I'm less likely to feel even a bit drowsy by afternoon.

Here's the link to my uploaded sleep data from March 15 on SleepHQ.com.

eric_sleeps wrote: ↑

Mon Mar 18, 2024 1:51 pm

Here's the link to my uploaded sleep data from March 15 on SleepHQ.com.

Thank you. I think we can safely put your concerns about the flagged centrals way on the back burner.....I scrolled through the entire night and not a single one of the flagged centrals/CAs were you sound asleep. All were related to arousal/awake breathing irregularities. You may or may not be aware of the arousal but you weren't sound asleep.
In fact your flow rate is chocked full of segments of arousal breathing. Some very brief but some fairly prolonged.

EPR isn't a central trigger for you. Neither are higher pressures.
Not the greatest of sleep quality is your prime culprit for the irregular breathing that in turn got flagged.

My prescription for right now anyway......work on getting better quality sleep.
Your biggest problem right now....sleep quality but that's not unusual. Heck, it took me 3 months to get used to sleeping with all this "crap".

So take 2 patience pills every day for 30 days...give or take.

Minor setting changes might help with sleep quality but right now I don't see them as being critical.

That's soooo helpful and encouraging. Time to run down to the pharmacy and pick up those patience pills!

Would it be premature to knock down the max pressure setting from 20 to, say, 15 to prevent it from blasting me so much here and there?

eric_sleeps wrote: ↑

Mon Mar 18, 2024 2:15 pm

Would it be premature to knock down the max pressure setting from 20 to, say, 15 to prevent it from blasting me so much here and there?

Well if it never goes above 13 cm then it isn't blasting you at higher pressures....is it?
Then reducing the max pressure to 15 isn't going to do a damn thing if the machine never goes above 13?

The maximum setting has no bearing at all on how the machine responds in terms of the algorithm anyway.
It doesn't have one algorithm for max of 20 and a different algorithm for max of 15 and another for max of 10.

BUT.....if you want to limit the max and see if that helps or hurts things.....go big or go home...limit it to 10 for one night.
See if you sleep better or not.

Pugsy wrote: ↑

Mon Mar 18, 2024 2:24 pm

Well if it never goes above 13 cm then it isn't blasting you at higher pressures....is it?
Then reducing the max pressure to 15 isn't going to do a damn thing if the machine never goes above 13?

Well, what prompted me to start posting to begin with wasn't just the CA events; it was also that on nights two and three, I was woken by pressure well above what I experienced on the first night. Hence the idea of reducing the max from 20 to something less...

Yes I understand but if you want to stop the machine from blowing at 13 then limiting the max to 15 isn't going to stop the machine from blowing at 13. You have to limit it to something below the 13 if you are thinking the 13 (or whatever) is what might be waking you up.

Generally speaking the machine won't go higher than it thinks it needs to go for whatever reason.
Only problem if the higher pressure is chasing the nasal congestion or not. More pressure won't fix nasal congestion.
Sometimes we do have to make compromises and that's okay.

I can understand limiting the max to see if it helps with sleep without allowing too much other stuff to show up.
Only way to know is to try it.
Just make sure that you are limiting the max to something the machine actually might be reaching or you are defeating your experimental goals.

That makes perfect sense. Thanks!

Just posting a little follow-up three weeks on... frustrated with trying unsuccessfully to side-sleep comfortably with an F30i mask, I asked my DME to send me an N30i mask instead, and started using it last week... to startlingly improved results. Not only do I find it more comfortable (for side sleeping and in general), but my AHI scores dropped to being consistently under 1.5; on at least two nights, the only events recorded were CA events which I suspect were actually "awake" false positives (i.e., I had zero OA and H events!). What's more, my wife helped make the connection between my starting CPAP use (and a couple days when the pressure ramped up to almost 20) and some alarmingly puffy upper and lower eyelids starting around day 3 of using CPAP; well, switching to the nasal pillow completely eliminated what remained of those pink/puffy eyelids.

I'm starting to narrow my pressure range as well; on day 4, after posting here and getting helpful input, I'd narrowed the range to 7-13, but after switching to the nasal pillow, I've been gradually lowering the max pressure and seeing whether the results stay good. I'm guessing my final pressure and/or range will be between 7 and 9.5, based on what the median values have been over the last several days.

Excellent! Side-sleeping FTW. Cut down on EPR if you want those CA's (awake *or* asleep) to go down. Good job.

With an AHI consistently below 1.5, you don't need to give a thought to reducing the number of CAs that you're seeing. Keep your EPR where it is if it is comfortable for you. Don't mess with success!

vandownbytheriver wrote: ↑

Sat Apr 06, 2024 11:44 am

Excellent! Side-sleeping FTW.

What's surprising to me is that I'm not actually side-sleeping that much more; I've always a side + back sleeper, and I still am; with the nasal pillow, I can start on my side and then roll over as usual, but my events are far reduced now compared to before.