Am I having centrals?

[fortomorrow]

First off, hello everyone, long time, no see, etc, etc.

I had gastric bypass surgery three weeks ago. I've lost about 35 lbs.

Now, before surgery my AHI was consistently under 1. I stopped using it for three weeks because I have problems with aerophagia and I was really concerned about inflating my tiny new stomach.

Anyway. I just started using my APAP again three nights ago, and my AHI is up to 4.5. I know that's still really good for most people, but it concerns me. When I look at the reports on Encore Pro it shows that I'm having several apneas at once in a cluster - which indicates centrals, yes?

So I'm wondering - because I've lost a decent amount of weight in a short time, should I try lowering my pressure and see if that doesn't take care of this problem? Or is it merely a matter of getting used to XPAP again?

Thanks guys.

[Wulfman]

Are any "NR" (Non-Responsive) events showing up on your reports?
Can you determine at what pressure they're occurring?
Are they happening consistently over several nights?
Is it possible that they're "positional" in nature?
Is your pressure range still the same? (if they're happening at lower pressures, maybe the minimum is too low)
Are you using A-Flex or what? What are all of your settings)?

That wasn't quite "20 questions", but it's a start.....


Den

[ozij]

A cluster does not necessarily mean a central apnea.
Is the machine tagging anything as NR (non-responsive ---> possbily central)?
O.

[fortomorrow]

Are any "NR" (Non-Responsive) events showing up on your reports?
Can you determine at what pressure they're occurring?
Are they happening consistently over several nights?
Is it possible that they're "positional" in nature?
Is your pressure range still the same? (if they're happening at lower pressures, maybe the minimum is too low)
Are you using A-Flex or what? What are all of your settings)?

That wasn't quite "20 questions", but it's a start.....

Thanks Den!

There aren't any NR events.

Pressure range is still 8-20. AFlex is set at 1. Humidity is 1.

The 90% pressure is 9. Average pressure is 8.3.

I'm stumped by the whole thing. My AHI has always been really low!

[Wulfman]

Are any "NR" (Non-Responsive) events showing up on your reports?
Can you determine at what pressure they're occurring?
Are they happening consistently over several nights?
Is it possible that they're "positional" in nature?
Is your pressure range still the same? (if they're happening at lower pressures, maybe the minimum is too low)
Are you using A-Flex or what? What are all of your settings)?

That wasn't quite "20 questions", but it's a start.....

Thanks Den!

There aren't any NR events.

Pressure range is still 8-20. AFlex is set at 1. Humidity is 1.

The 90% pressure is 9. Average pressure is 8.3.

I'm stumped by the whole thing. My AHI has always been really low!

That's good to hear about the NR events.
If the Apneas are occurring at or around your minimum pressure, maybe you need to bump it up (to your 90% number).
With that machine, you've got a lot of options to try, too. Maybe switching from A-Flex to C-Flex.....?

Congratulations on your surgery. Hope everything goes well. My son had that procedure done in December.

Den

[track]

It's my understanding having apneas in clusters is not necessarily a sign they are centrals. I can have clusters when I get on my back....move back on my side and they disappear.

[Georgio]

Congratulations, you have a new body now.....so your apap needs may also be changing. Does anyone think that significant weight loss could lead to lower required pressures?

Georgio

[Julie]

Tell you a secret - but from what I've read, seen and heard, having bypass usually eliminates the need for Cpap altogether, cures GERD and possibly even diabetes (and I'm not talking about snake-oil stories, but real serious research). You may be just in the early stages of things, so wait a while and see where things stand.

[fortomorrow]

Tell you a secret - but from what I've read, seen and heard, having bypass usually eliminates the need for Cpap altogether, cures GERD and possibly even diabetes (and I'm not talking about snake-oil stories, but real serious research). You may be just in the early stages of things, so wait a while and see where things stand.

Yes, I know. It cures GERD and acid reflux because there's no longer any acid in the stomach. They haven't quite figured out how it cures type 2 diabetes (not type 1 insulin dependent though) yet - although the results are instantaneous. Apparently type 2 diabetes goes away the day you have surgery - I wouldn't know, I didn't have it. It also seems to cure hypertension as well.

As for eliminating the need for CPAP - that's only the case if your OSA is caused by obesity, and as we all know, not ALL sleep apnea is the direct result of being fat. There are quite a few people on my WLS support message board that have stopped using their CPAP, some as directed by a doctor after a sleep study, and some not. I worry about the ones who assume that they've been cured of their sleep apnea, because it's not necessarily the case.

Especially as it seems that I've lost weight and I need to INCREASE my pressure. BOOOOOOOO.

[Wulfman]

I had read a "blip" sometime back about the procedure "curing" Type 2 diabetes, so your posts about it made me curious. I just did a Google search on the following phrase and got lots of links. I haven't read them all yet, but glanced through a few.

"how gastric bypass cures Type 2 diabetes"

Den

[fortomorrow]

Okay, I bumped my pressure up to 9 last night. AHI was 3.6 which is still pretty high considering, and my 90% pressure went up to 10. Does that mean I should move the pressure up to 10 as well?

Or should I just leave it and accept 3.6? I feel okay this morning. I didn't wake up at all last night for the first time in weeks (thank god). But looking at the charts just makes me feel unhappy. Over 4 minutes in apnea and all those events...



I think it's lame that I'm losing weight and my pressure is going up. Everyone else I know got to go down in pressure, or of CPAP completely.

Or maybe it's a longer term side effect of general anaesthetic. Who knows?

I'll stop whining now...

[Engransan]

Following my coronary artery bypass surgery I had about two weeks of erratic data.
Ken

[Hawthorne]

I think your body is still recovering from surgery and all that is involved in the procedure.

Engransan is right. You need 6 to 8 weeks or maybe even more for your body to recover. Your data is bound to be erratic during that recovery time.

Bumping your minimum to 9 seems to be helpful for now. You may be able to lower than again as your body heals and adjusts. You could raise it to 10 but, in my opinion, things are going to be very erratic for awhile yet. Your AHI, at 3.6, isn't to bad so maybe you just need to leave the settings for a week or so , as we all should do when making any pressure changes.

You've done a major thing to help your health! Good for you! Give it time.

[Wulfman]

Your call.
You might leave it where it's at for a few more nights to see if it's consistent. (and then, if it is, bump it up)

I've read a few posts by forum members that DID have to bump up their pressure when they lost weight.

Den