Central Apneas

[Hutzy86]

Hey peeps, anyone had any luck reducing Central or CA events? I heard a higher pressure can make the problem worse. Have been hovering around the 6-7 ahi mark of late with them and not sure how low I should dial down pressure if at all. Also if someone could take a look at my CA events and tell me if they are legit or false flags as on most occasions I get a cluster out of nowhere..TIA
https://sleephq.com/public/47069d54-0d4 ... 2d48b089da

[LSAT]

With the AHI you are showing, your pressures should be increased...not decreased.

[Pugsy]

Your AHI is primarily central apnea events. More pressure won't fix those.

Approx 5 or 6 of those flags appear to be possibly the real deal....the bulk of those CA/central flags are post arousal meaning most likely pausing your breathing while awake (you may or may not remember that arousal).
Those that are possibly the real deal could be sleep onset centrals and there might be a couple that are just the real deal centrals (which it is normal to have a few here and there which isn't a problem).

Do you remember waking often during the night?
Tossing and turning maybe?

I am not so sure that your centrals are pressure related which means that tweaking the pressures either way is going to make a change in the number of centrals.

Did you have very many centrals noted on your diagnostic sleep study?
How long have you been on the cpap machine?

[Hutzy86]

Have been on CPAP for around 8 months, just don't know what to do regarding pressures, lowered it right down to 5 last night and ahi was only 3.3 but feel very tired was originally on an auto range of 4-20 but have changed and tweaked more times than I can count, however when I went to a static 11 which is what sleep specialist recommended my AHI matched the pressure....moved it down to around 7ish had very low ahi of 1-3 for a week then was constantly at around 6-7 ahi. Just feel absolutely lost ATM am I putting too much stock in the ahi numbers? I have attached a copy of my sleep study, appreciate all the help
https://ibb.co/W2L1n9X
https://ibb.co/StTHsbX

[Pugsy]

You had a rather significant number of centrals on your sleep study.
I don't know what to think about the comment "they didn't amount to 50% of the AHI" though.

Since the home study report shows sleep stages then we assume a type 2 home study and they should have been able to figure out if those centrals were the real deal or not and since they mention them...we assume they were the real deal.
Since you have tried fixed pressures of 11 cm...and the central apnea numbers increased that tells us that more pressure isn't the way to go.

Do you take any medications of any kind?
How did you sleep last night? Very many awakenings? How many?

[Hutzy86]

I take Ritalin for AD/HD doctor says that shouldn't effect things, as for awakenings usually just once to go to the toilet, then straight back to bed, last night was an ok sleep on just 5cm of pressure, however felt a little bit tired this morning, got around 6h30 sleep. Have trained myself to sleep on my side now, hence the very minimal OA events, my body seems to adapt to a pressure change for a few days then ahi seems to rise again, hence all my pressure changes ‍♂️ 99% of the time I'm asleep within 10 minutes of putting mask on, usually feel great most mornings then check machine and it tells me otherwise.

[Pugsy]

usually feel great most mornings then check machine and it tells me otherwise.

Quit checking your machine in the morning and change the time so you check the results in the evening so you can better evaluate how you feel without "the numbers clouding" how you feel.
How you feel is so much more important than what the numbers might lead you to believe you should feel.

BTW....Ritalin most definitely will affect sleep quality.

Common side effects

These common side effects may happen in more than 1 in 100 people. Keep taking the medicine, but tell your doctor if they bother you or do not go away:

headache
feeling aggressive, irritable, depressed, anxious or tense
trouble sleeping (insomnia)
loss of appetite – this can lead to weight loss or poor weight gain
stomach ache
dry mouth
feeling or being sick

https://www.nhs.uk/medicines/methylphenidate-adults/

https://www.google.com/search?client=fi ... de+effects

Stick with the same pressure you used last night for at least a week and don't go changing anything.
See how you do...and wait until evening to check the AHI.

[Hutzy86]

Cheers for all the help mate also I think I've been guilty of watching way too many YouTube videos on what to do and why you should change this, mostly LankyLefty27 and CPAP Reviews.

[ChicagoGranny]

Hutzy86

Pugsy is right about judging how you feel in the evening. I use this little questionnaire at the end of the day.

- How was the day?
- Was I energetic?
- Did I have any excess sleepiness? (Feeling a bit sleep after lunch is normal.)
- How do I feel at bedtime? Tired but not stressed?

[Pugsy]

Can I share a little story about how the AHI itself isn't always a good predictor of how the day is going to go.
Many years ago when I was relatively new to cpap therapy I woke up feeling really pretty good (for me anyway) and as the day went on I felt like superwoman.

Back then I never looked at the machine's data until the evening because I didn't want to create a self fulfilling prophecy.
So in the evening I was getting ready to check the data and I was just certain I must have had one of those elusive 0.0 AHI nights. I just knew it had to be the 0.0 miracle.
Imagine my surprise when the AHI was 9.4.....yep 9.4.
Now back then the software we had available wasn't nearly so detailed as what we have now so I couldn't really zoom in on anything to check the flow rate breathing or anything like that.
So I sat there scratching my head about that 9.4 AHI and yet I felt like superwoman all day and into the evening.

I have never duplicated that situation since....but I will tell you right now that if I could do it again that I would gladly take an AHI of 9.4 every single night if that meant I was superwoman again.

Don't let the numbers dictate how you feel....they aren't always entirely spot on or honest. They will lie and screw with you every time they can.

[Hutzy86]

Good advice