Central vs Obstructive Episodes on S9

[John Galt]

I have a new S9. I just downloaded my data for the first time using ResScan 3.11. I did a detailed report for last night, and it indicated that ALL of my apneas were central, and NONE were obstructive. This doesn't match my formal sleep studies. And, it doesn't match my experience which is that my throat does becoming obstructed.

Do others have this experience? Does this mean that it isn't adjusting to deal with my apnea episodes?

Thanks.

[kempo]

I had many obstructives during my sleep study but the s9 has apparently taken care of them. I very rarely have one but I have many centrals. Most of them occur as I am going to sleep, the first 30 to 45 minutes and as I am waking in the morning. There will be some through the night but I think they happen as I wake momentarily to move or turn over to another position. If I go to the bathroom I will have several before I dose off back to sleep.

rested gal made a list of links about central apneas.

viewtopic.php?p=22702

[John Galt]

Thanks for the link regarding "central" apneas. It makes sense that I have some centrals. What I don't understand is that I had absolutely no obstructive apneas. I've never had that experience before. Plus, my S9 periodically kicked up from a low setting of 7 up to near 12 (my top pressure). I thought that it only responded to obstructive episodes, not centrals. But, it reports that I had 0 obstructive episodes. Does that make sense?

[ldj325]

Thanks for the link regarding "central" apneas. It makes sense that I have some centrals. What I don't understand is that I had absolutely no obstructive apneas. I've never had that experience before. Plus, my S9 periodically kicked up from a low setting of 7 up to near 12 (my top pressure). I thought that it only responded to obstructive episodes, not centrals. But, it reports that I had 0 obstructive episodes. Does that make sense?

It seems like there is a lot of missing information here like at a minimum what your AHI was in the sleep study, how much was OA, Hypopneas, and CA and what your AHI and mix is now.

I don't know the actual mechanism but the S9 can sense changes in your breathing and respond accordingly to prevent OA, and if this was your main problem on your sleep study then the S9 is doing its job by fluctuating the pressure. Centrals at points of sleep transition (going to sleep, awakening, bathroom breaks etc.) can be normal--it just depends on how much and how long they are occurring.

[John Galt]

My AHI during my sleep study was over 50. Most were obstructive ... only about 10% were centrals. When on apap, I usually average below 5 total. My former machine didn't tell me the proportion of centrals vs obstructive episodes, hence my question with my new S9.

I understand thta the S9 adjusts pressure to respond to the obstructive episodes. That makes sense. But, despite the pressure adjustments, it lists no obstructive episodes, only centrals. I assumed that if it kicks up the pressure, that was evidence that it was in response to an obstructive episode, but it reports none.

[ldj325]

My AHI during my sleep study was over 50. Most were obstructive ... only about 10% were centrals. When on apap, I usually average below 5 total. My former machine didn't tell me the proportion of centrals vs obstructive episodes, hence my question with my new S9.

I understand that the S9 adjusts pressure to respond to the obstructive episodes. That makes sense. But, despite the pressure adjustments, it lists no obstructive episodes, only centrals. I assumed that if it kicks up the pressure, that was evidence that it was in response to an obstructive episode, but it reports none.

My point from the earlier post that the S9 senses a change and adapts accordingly to prevent the OA from ever occurring. I does not need to wait for a full 10 second OA before initiating pressure changes. This would explain why you are seeing none. So this would be effective therapy as long as the Centrals are not kicking up too much and they are at points of natural sleep transition. That's a big if without knowing the data. But maybe look at the bottom line--how are you feeling?

It would be great is a more experienced member jumped in here because I don't know I have enough experience to be telling you how to change your therapy, I should think that what I am suggesting is also what more experienced members would want to know as well. At least this will give your thread a a bump.

If the Centrals are not simply due to natural sleep transition then that beings up other possibilities, including Complex apnea. (That is why a post of what you CA index is would be useful. Also consider screenshots to indicate where the CAs are occurring. And what is your auto range set at, as wels as what you median,95th, and max pressure.)

If it were me, I'd look at my pressure range and see about cutting it down (if it's too wide) so that the S9 can be quicker in response. And then watch what happens with the Centrals.

[torontoCPAPguy]

Anyone else having wierd stuff going on with their S9's? I get centrals showing up every time I get up for a tinkle and turn the machine off and then back on, for example. It just does not seem to perform in the same manner as my S8 Autoset II did. Or is it just me?

[jdm2857]

Most APAPs respond to signals that obstructive events are coming, like snoring and flow limitation, in order to prevent obstructive apneas from occurring. They don't always succeed, but they try.

Also, I believe that no APAP will increase pressure during an obstructive event. It waits until the event ends before responding with pressure adjustments.