Sleep lab couldent believe my `high pressure` !

[rested gal]

Thanks for that... so 3 or 4 centrals showing each night isnt anything to panic over...... thats 1 less thing to worry about

That's how I'd regard them. Nothing to panic over. Nothing to worry about.

At another apnea board:
http://www.apneasupport.org/viewtopic.php?p=24677

In a reply titled "Nope" sleepydave (RRT, RPSGT and manager of an accredited sleep center) responds to honda's question:

honda wrote:
"Thanks for the comments, one other question though, do the 4 central apneas have any significance ?"

"None whatsoever.
sleepydave"

sleepydave's nicknames on cpaptalk are "deltadave" "StillAnotherGuest"(SAG) "Muffy" and "NotMuffy"

_____________________________________________________


Regarding concern about "pressure induced centrals"

viewtopic.php?t=14225
Page 2


The phenomena of pressure-induced central apneas is tossed around far too freely. The vast majority of people do not get centrals because of ultra-therapeutic CPAP levels. BiLevel, Pressure Support (PSV) and Proportional Assist (PAV) Ventilation are another matter. You need some mechanism to drive the pCO2 below the sleeping apneic threshold, and plain old CPAP rarely is able to do that. OK, if you wanna argue that CPAP increases base lung volume (Functional Residual Capacity)(FRC), and since that increases gas exchange, some people can generate centrals that way, fine. But it's not as many as you might think.
SAG

SAG ("StillAnotherGuest") is also "deltadave", "Muffy" and "NotMuffy" on cpaptalk and "sleepydave" on another board.

___________________________________

Those statements and a whole lot more are at:
Links to Central Apnea discussions
viewtopic.php?p=22702

[Pugsy]

From one of your "good" nights that you posted in Jan. No runaway pressures to 20. What do the recent reports show?
Is the leak line all over the place again? Base on this report below which is quite good, I would take a close look at the reports showing graphs to 20. Were you on your side this whole time on the good report and now on your back all the time?

[Chivalry]

Hi Chivalry, I could not understand your hi pressures already in your post from Jan 9, 2011 titled "New to apap, graphs ok?" The Statistics from that time showed zeros for apnea index, central, obstructive, and unknown. Only Hypo index was at 0.4 and so was the AHI. But the pressure that your S9 AutoSet rose to from 4 cm at 03:30 a. m. gradually to 20 cm at 06:00 a. m. Why? Also why the Events graph still showed 20 events per hour. Could it be b/c of your snoring, which peaked when you fell asleep first at 01:00 and next at 03:30?

I would do following:

1) Run the S9 on CPAP at 10 to 12 cm, EPR = off, and see what happens.

2) If the need for hi pressure continues, contact one of these specialist and ask what could be reasons:

West SD, Jones DR, Stradling JR.

Sleep Unit, Oxford Centre for Respiratory Medicine, Churchill Hospital, Headington, Oxford OX3 7LJ, UK. sophie@west66.freeserve.co.uk

i can only assume that my early graphs i posted were when i very first started with apap... and was plagued with massive leaks with my mask which i can only assume was interfering with the machine giving a good accurate result... other than 1 occasion when i somehow managed a night with no real leaks and i think maybe managed to stay on my side? i can only guess myself as i was asleep

i tended to think my increases in pressure was directly linked to my mask leaking..... but it seems since i got my mask leak free its been worse than ever... ;0(

[avi123]

[quote="Chivalry"][quote="avi123"]
i tended to think my increases in pressure was directly linked to my mask leaking..... but it seems since i got my mask leak free its been worse than ever... ;0

Chivalry, I do remember your last post with graphs showing that you got much better results with the leaky mask.I think that you never mentioned what kind of masks and also if you had mouth leaks. I use FF masks but I can still tell that I have mouth leaks b/c my mouse and nose are dry after a 4 hours of sleep.

As to leaks causing the S9 AutoSet to raise the pressure to 20 cm, I doubt it. But I am going to try it, somehow, on my S9 Elite which works only in CPAP mode.

Chivalry, I am back. My Goodness! I set the pressure on my S9 Elite on 20 cmH20. First, I tried to stop the flow by pinching the air hose with my teeth which I could. But loosening my bite on the hose I could not stop the flow with my chicks. It's unbelievable. So I let the air flow out my mouth. Otherwise, if I let the pressure go into my lungs I am convinced that it would have done a pneumothorax on me.

Next, I put on my full face mask. The hefty one and not the flimsy Resmed Quattro FX. I put on the Fisher Paykel FlexiFit #432 which is quite massive. The headgear was not strong enough to stop this mask lifting off my face. So I pushed it with my hands against my face and still could not stop the leaks without hurting my skin.
What's going on? BTW, I am at 220 lbs.

[scrapper]

avi123 wrote:I set the pressure on my S9 Elite on 20 cmH20. First, I tried to stop the flow by pinching the air hose with my teeth which I could. But loosening my bite on the hose I could not stop the flow with my chicks. It's unbelievable. So I let the air flow out my mouth. Otherwise, if I let the pressure go into my lungs I am convinced that it would have done a pneumothorax on me.

Next, I put on my full face mask. The hefty one and not the flimsy Resmed Quattro FX. I put on the Fisher Paykel FlexiFit #432 which is quite massive. The headgear was not strong enough to stop this mask lifting off my face. So I pushed it with my hands against my face and still could not stop the leaks without hurting my skin.

This is ridiculous and insane..........

[Chivalry]

From one of your "good" nights that you posted in Jan. No runaway pressures to 20. What do the recent reports show?
Is the leak line all over the place again? Base on this report below which is quite good, I would take a close look at the reports showing graphs to 20. Were you on your side this whole time on the good report and now on your back all the time?

that graph i believe was 1 night i believe i stayed on my side all night... and thats very rare,,,, below is a typical nights graphs now i have a leak free mask.....,, i would say the last 10-15 nights are similer to the graphs below (except 1 night i think i managed to side sleep all night!)





theta pretty much a standard night for me now... maybe not quite so many apnea events though,,, little higher than usual

[Pugsy]

Wow, huge difference with position. I think Rooster also has huge differences with pressure needs between supine and on the side. Something like 18 on his back and 9 on his side. He worked on training himself to sleep on his side rather than deal with the high pressure I think.

You seem to be doing well with those gale force winds though.

[avi123]

So Chivalry, you can now interpret your Flow Limitation curve in the above graph by going over the following explanation:

http://171.66.122.149/cgi/content/full/158/3/713#F2

But first you need to extract a sample of about 10 to 16 respirations cycles. See here how:


viewtopic/t60987/viewtopic.php?f=1&t=60 ... 22#p571322


viewtopic/t60987/SD-Card-Video-Tutorial.html

p.s. Chivalry, taking another look at your graphs I would like to ask you if it's possible that you don't have OSA but you're snoring and since CPAP is one of the several treatment options for snoring you got it? An Internist or a Neurologist could tell if you have a comorbid ailment.