S9 Reports & Centrals concern

[bob007]

Hi guys,

Previous post: viewtopic/t62370/Apnea-readings-higher- ... ml#p583684

Thanks to many helpful tips from users here at cpaptalk.com I've figured out the software and have posted links to last nights details and summary's going back to July 2010.

My apneas are increasing over the past couple months and the details show centrals. I went to my sleep doctor a couple weeks ago and her report said my centrals were low. Most all of my apneas seem to indicate centrals based on these reports going back from when I began CPAP.

I can't seem to figure out the discrepancy with the doc's report and mine.

I also wonder if my S9 is not working properly. Last night I went to bed at midnight and woke up at 8:00. The graphs show the recorded sleep and wake time wrong and this is consistent on my graphs (I checked going back several nights). I also have the S9 bug that skews the graphs but I lined them up for this report.

Any ideas? I'm a bit concerned about these centrals and can't figure out why my apnea reading are going up over time. I can say that overall I'm feeling better but I don't want to regress.

Please let me know if there is other info you need to know to answer.

Thanks,

Bob
https://picasaweb.google.com/vccrwp/CPA ... qzr0aDcqAE#

[Slartybartfast]

That's interesting. Something's wrong there. I don't view what ResScan scores as Centrals as gospel. They make an assumption that if the forced oscillation thingy (FOT) indicates that your airway is open, then it's a Central. But without having EMG data, it isn't possible to say that with certainty. Your sleep doc DOES have the EMG data. If she says your centrals are low, then it's likely a machine-caused artifiact called a Hering-Breuer reflex. My sleep doc told me that you can anesthetize a rabbit and stick a ventilator tube down its trachea and it will stop breathing all by itself because it has sufficient oxygen from the ventilator tube. That's probably what's happening with you, if your pressure really is too high.

You can Google Hering-Breuer reflex and read about the difference between a true central and a non-responding apnea on page 4 here:
http://www.devilbissclinicaleducation.c ... nology.pdf

To me, that many "centrals" indicates your pressure is set too high. Were I you, I'd set the starting pressure down 1 or 2 cm and see if your reported centrals diminish. If what you're encountering is actually a machine-caused Hering-Breuer reflex, which mimics a central apnea, then you should see the number of "centrals" diminish, and if you reduce pressure further, you should see some obstructive and hypopneic events start to show up.

[Otter]

Another possibility is that you aren't actually asleep when the S9 scores these centrals. If you stop breathing while you're awake, the techs will eliminate that event, but the S9 only knows you weren't breathing and your airway was clear.

[TooGroggy]

Your leaks are way out of line, especially given the mask you're using. You may want to get a handle on that.

[Breathe Jimbo]

Your leaks are way too high! They should stay below the red line. When they get over the red line, the machine cannot compensate adequately and maintain good therapy. Search for prior threads relating to your mask and leaks. You need to get the leaks below the red line.

[idamtnboy]

Your leaks are way too high! They should stay below the red line. When they get over the red line, the machine cannot compensate adequately and maintain good therapy. Search for prior threads relating to your mask and leaks. You need to get the leaks below the red line.

Last few nights look pretty good, I think! Hey Bob, do us a favor and change your equipment list to text. This is one case where a picture is not worth a thousand words!

[bob007]

Equipment list is set to text.

Last night indicated the worst centrals ever, after I brought down the pressure from 8 to 7. Leaks were high also. Maybe it's time for a new mask.

Bob