Newbie question

[12gauge]

Been cpap resmed airsense 10 auto,with nasal air pillows small,unit came set at 7.0 after a week with no improvement,I changed it to auto 7.6-20 still no improvement after another week.Events per hour 24 ahi 12.9 total ai 12.1,central 9.5,on the clinical menu pressure7.8,epr and ahi are pretty close to these readings for an average.90% 10.62,can you give some idea why ahi is not coming down,thanks

[Pugsy]

Centrals won't respond to more pressure using your type of machine.
If you are averaging 9 centrals per hour then maybe should be talking to your doctor.

Are you using EPR and if so at what setting. For a small number of people using EPR can make centrals worse and you might try turning EPR off or reducing it and see if the centrals drop or not.

Can you post an image of a typical detailed report from whatever software you are using?
See this thread
viewtopic/t103468/Need-help-with-screen-shots.html

don't know how to post an image? Explained here
https://sleep.tnet.com/reference/tips/imgur

[12gauge]

Are centrals part of ahi or eph? Epr set at 3

[12gauge]

What do high centrals indicate?

[Pugsy]

Central apneas are cessation of breathing (no air flow) but the airway is open.
Obstructive apneas or hyponeas are either cessation of breathing or a reduction in air flow but the cause is blockage by the airway tissues.
All 3 make up the AHI.

EPR is strictly exhale relief and with a ResMed machine a 1 cm drop in pressure during exhale per setting but the lowest it can drop to is 4 cm.

You can try turning off EPR to see if the centrals reduce in number (it works for a few people) but if it doesn't you really need to be getting with your doctor if the central index (hourly average) is running 5.0 or more consistently. You very well could need a different type of machine.

Do you know if you had centrals in any numbers on the diagnostic sleep study (no cpap)?
Did you have an in lab titration sleep study where they attempted to find optimal pressure or were you given the apap machine so it could find the optimal pressure?
If you had an in lab titration sleep study were there documented centrals during it?

If you don't have a copy of the results of your sleep study you need to request it.

[Pugsy]

What do high centrals indicate?

It depends on the cause of the centrals....if a cause can be determined.
Some people have centrals even when not on cpap but some people will develop centrals after being put on cpap. The pressure causes unstable breathing and centrals are a byproduct of the unstable breathing.

Some centrals are normal...like sleep onset or sleep stage transition.
If you aren't sleeping particularly well then some of your centrals might be awake/semi awake breathing centrals and they aren't real and thus not a problem.
When someone is consistently seeing more than 5 per hour they need to alert the doctor and he needs to try to help figure out if the centrals are real or not and if anything needs to be done about them.

We can't fix centrals with more pressure using your machine. It simply won't help but you might get lucky and have them reduce by turning EPR off.
Worth trying and costs nothing.
Probably should for sure make a follow up appointment with your sleep doctor if you don't already have one.

I don't know that you for sure have complex sleep apnea but it's a possibility with that number of centrals.
This might explain CompSA for you.
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

If you do have CompSA and those centrals aren't awake breathing flags by mistake then you may need a different machine. A lot depends on did you have centrals before adding cpap pressure or not. Best to run all this by your doctor.

[12gauge]

I did have an in house sleep study ,and my cpap came with a string of 7.0 manual,I set it auto myself and set the pressures.

[Pugsy]

Can you post an image of a typical detail night report?
Maybe something will show up on it that would be useful.

[12gauge]

I will try,I'm an old geezer and not great on computers.

[Pugsy]

Do you happen to have any cardiac issues going on?

[12gauge]

Well,haven't figured how to import yet,but looked at figures before I put unit on auto,and my ahi was in the 2's and 3's and my centrals was around 3.8's,what do you think?

[Pugsy]

Events per hour 24 ahi 12.9 total ai 12.1,central 9.5,

So if your AHI is 2 to 3 then where did the 24 AHI come from?....or were you listing the total number of events over the entire night? Total number over the entire night doesn't help us much without knowing how many hours.

If your total AHI is 2 to 3 then there's nothing to worry about in terms of centrals.

The central index is part of the AHI

AHI is the Apnea Index plus the
Hyponea Index
and in the Apnea index there is the Obstructive apnea index and the Central/CA apnea index.

If your total AHI is less than 5 and even if half of that number is central then centrals are not usually numerous enough to be a problem.

[12gauge]

I have been diagnosed with a-fib

[12gauge]

All right changed cpap back to 8 will ck it for a few nights and repost,thanks for everybody's help

[Goofproof]

Central apneas are cessation of breathing (no air flow) but the airway is open.
Obstructive apneas or hyponeas are either cessation of breathing or a reduction in air flow but the cause is blockage by the airway tissues.
All 3 make up the AHI.

EPR is strictly exhale relief and with a ResMed machine a 1 cm drop in pressure during exhale per setting but the lowest it can drop to is 4 cm.

You can try turning off EPR to see if the centrals reduce in number (it works for a few people) but if it doesn't you really need to be getting with your doctor if the central index (hourly average) is running 5.0 or more consistently. You very well could need a different type of machine.

Do you know if you had centrals in any numbers on the diagnostic sleep study (no cpap)?
Did you have an in lab titration sleep study where they attempted to find optimal pressure or were you given the apap machine so it could find the optimal pressure?
If you had an in lab titration sleep study were there documented centrals during it?

If you don't have a copy of the results of your sleep study you need to request it.

=======

i keep requesting my study

i asked for it after the test and they said no

i have asked several times more recently but still not sending it to me
what govt agency could be used to leverage my getting them to actually provide it

Russia or North korea even China. Jim