Centrals been on the rise a bit.. Lower pressure?

[lazer]

This is becoming rather common for me lately as I'm seeing my "centrals" out numbering my other events. Should I consider a slight reduction in my min pressure I wonder?

Currently: Apap/ 9min - 17max

Comments?

[SleepyToo2]

Possibly not, based on my conversation with my sleep doc. Maybe it's those pesky leaks that are fooling the machine into thinking you are not breathing. Maybe you are changing positions and stop breathing to do that (perfectly normal). You need to look at the flow chart for each CA and see if there is anything odd. In my case, most of them are preceded by a fairly active breathing period. Overall, the doc said that if my average AHI is below 5, then he is not at all worried. Especially if I and my wife are feeling good! If there is nothing disturbing our bed partners, it seems that he is not worried!

OTOH, your average pressure is only just above the minimum pressure, so maybe a slight reduction might help - APAP users may be able to advise better on that.

[JohnBFisher]

I don't think your centrals are connected with the pressure. They just don't seem to have a tight correlation (though it's hard to tell at this scale) with pressure. Some might be due to leaks. Some might be due to pressure. But not enough (in my mind) to jigger the pressure settings. You might be able to reduce your pressure a little bit. But it seems to happen when the unit feels you need added pressure (presumably to clear an obstruction). It's not all that often, nor does it appear to be sustained. So, I would suggest you just keep an eye on it for now.

[lazer]

Thanks for the replies. I just thought of another thing that may or may not have attributed to the increase of centrals in my reports. Looking back through my sleepyhead data, I changed my A-flex setting from a 3 to a 2 about 2 1/2 weeks ago and on the whole, this seems to correlate somewhat to the rise in centrals also.

I don't feel they are really disturbing my sleep although my Zeo seems to indicated a bit of an abbreviated period of REM throughout the night also.

[lazer]

Just revisiting this as it's been some days of evaluation. I put my Flex back to 3 from 2 a few days back and do feel a bit more comfortable with the breathing and falling asleep again. I'm still bothered to see so many centrals in my reports looming and not going away and spread out throughout the night and though I can't consciously remember awaking, I do feel they may be knocking me out of REM and I'm having some issues wanting to wake up in the mornings off and on again.

Here's the latest and I'm impressed with my leak line! ::

[Uncle_Bob]

Here's the latest and I'm impressed with my leak line! ::

Why ? Its not exactly flat. Its what I would be working on if that was my data. You seem to have plenty of leaks going on througout the night, so you have leak compensation in the mix.
I would work on locking down that leak line ASAP and then the data is likely to be more reliable.

I had leak issues with the Swift FX, do you use it with the hose attached to the headgear somehow? Its does not come with a head clip and any head/body movement during the night is enough to dislodge those delicate little pillows with that heavier hose swinging around, pillows that dont pivot to get a good fit in the first place. Maybe its time to try a new mask?

[Xney]

Your leak line is great, 6lpm is nothing

[lazer]

Here's the latest and I'm impressed with my leak line! ::

Why ? Its not exactly flat. Its what I would be working on if that was my data. You seem to have plenty of leaks going on througout the night, so you have leak compensation in the mix.
I would work on locking down that leak line ASAP and then the data is likely to be more reliable.

I had leak issues with the Swift FX, do you use it with the hose attached to the headgear somehow? Its does not come with a head clip and any head/body movement during the night is enough to dislodge those delicate little pillows with that heavier hose swinging around, pillows that dont pivot to get a good fit in the first place. Maybe its time to try a new mask?

I'm confused. Looking at that fairly consistent top line of a total 24lpm and throwing in the intentional leak (exhaust) per 9cm pressure avg at the low end, I would think comes out pretty solid.

No I don't have it attached overhead, although I have an overhead setup that elevates the hose from the mattress about 3'. I miss the Swift LT in this regards and unfortunately the one I just ordered recently (used) is missing that top attachment.

You actually think the leaks are what are mis-directing the data into flagging periodic centrals throughout the night?

[Burkebang]

If I remember correctly, you have UARS?
You have a lot more centrals than flow limitations and apneas and your machine is hardly regulating you pressure at all. To me, this is all clear indications that your pressure is too high. I would recommend that you lower the pressure until the machine starts to make regulations for a good part of the night, that way you know that you are not over treated and your centrals should then drop. You'll also be on actual APAP treatment, not streight CPAP @ 9, as you are today.

I see nothing to worry about in your leaklines.

[lazer]

If I remember correctly, you have UARS?
You have a lot more centrals than flow limitations and apneas and your machine is hardly regulating you pressure at all. To me, this is all clear indications that your pressure is too high. I would recommend that you lower the pressure until the machine starts to make regulations for a good part of the night, that way you know that you are not over treated and your centrals should then drop.

Thanks. that is correct on the UARS suspicion. Do you think a .5 or a full 1cm drop at a time regarding the low end/starting pressure is indicated best?

[Burkebang]

I would suggest that you just drop your pressure down as low as you can go without feeling suffocated. 5 or 6 maybe? Then just check out your data each day and adjust upward if there is any reason to do so. As flat as your pressure graph is at 9, I find it very unlikely that you'll find any reason other than comfort to increase your pressure.

Being careful when increasing your pressure is a prudent thing to do. But I think you need to actually retitrate yourself, then you can just drop your pressure down as much as you wish, the APAP algorithm will take care of your needs.

[lazer]

I would suggest that you just drop your pressure down as low as you can go without feeling suffocated. 5 or 6 maybe? Then just check out your data each day and adjust upward if there is any reason to do so. As flat as your pressure graph is at 9, I find it very unlikely that you'll find any reason other than comfort to increase your pressure.

Being careful when increasing your pressure is a prudent thing to do. But I think you need to actually retitrate yourself, then you can just drop your pressure down as much as you wish, the APAP algorithm will take care of your needs.

I may try 7. I remember at 6, things seemed a bit too suffocating. It seems ever since I visited that FFM a month back, give or take a week, and my pressure needs increased with it along with the leaks that now back on the nasal pillows, it's a whole new scenario and like you mention, I made need to re-tittertrate or whatever. Thanks for your wisdom.

[Burkebang]

I may try 7. I remember at 6, things seemed a bit too suffocating. It seems ever since I visited that FFM a month back, give or take a week, and my pressure needs increased with it along with the leaks that now back on the nasal pillows, it's a whole new scenario and like you mention, I made need to re-tittertrate or whatever. Thanks for your wisdom.

7 is a good start. Try it and check out your data

[lazer]

I may try 7. I remember at 6, things seemed a bit too suffocating. It seems ever since I visited that FFM a month back, give or take a week, and my pressure needs increased with it along with the leaks that now back on the nasal pillows, it's a whole new scenario and like you mention, I made need to re-tittertrate or whatever. Thanks for your wisdom.

7 is a good start. Try it and check out your data

3 Nights with min. dropped to 7cm. Not sure what to make of things..:

[Starlette]

Good morning Lazer.

One thing I may suggest is to keep some type of journal so you can track the changes that you're making and to visually see what is and what is not working.

Starlette