Can pressure pulses cause CAs?

[dimorgansmith]

My Remstar System one readings on Sleepyhead show a correlation between pressure pulses and CA events. Could the pressure pules actualy cause CA events?

[elixeus]

Please bear in mind I'm new to this (please go easy on me vets ). But yes, pressure-induced central apneas can occur. The solution is either try lower pressure that still treats the obstructives/hypopneas, or you'll need a more expensive machine to treat the centrals. If everyone of your CAs are caused by pressure increases, then it can mean the pressure is too high. If you find the centrals are occurring with increases and decreases in pressure, CPAP mode may work better and variable pressure may make it worse, or may make it better (this last part I'm not sure about); or you don't have the right machine and may benefit from ASV. Personally, the largest contributor to my AHI right now are the CAs, my obstructives/hypopneas are occurring less frequently now, but I haven't eliminated them. I think during my follow-up visit I'll be inquiring if APAP is treating my centrals before this fiscal year is up for insurance and ensure I have adequate pressure to optimize my treatment. As you are already aware, CPAP and APAP don't treat centrals all that well, if at all.

Feel free to correct me if I'm wrong guys.

[Pugsy]

Feel free to correct me if I'm wrong guys.

I will try to be gentle.
What you say about pressure increases in general can happen for a small percentage of the cpap users.
But it is incorrect in this situation because the original question was about pressure pulses and not pressure increases.
Pressure pulses are something that the Respironics machines do to help it determine if the airway is obstructed or open when there is a reduction in airflow. You are using a ResMed machine and it uses a different technology to help it decide where to call something obstructive or central in nature.

Pressure pulses are NOT pressure increases that could/would cause centrals. Pressure pulses are very brief tiny puffs of air that the machine uses to determine if the airway is open or not. They are so tiny they don't show on the pressure graph because the overall pressure doesn't change.
Changing the pressure may or may not impact the pressure pulses themselves and I wouldn't go changing things until I fully understood what was happening and just how many pressure pulses we were seeing and how many centrals/CAs we were seeing and how many OAs & hyponeas. Lowering the overall pressure might reduce or increase the number of pressure pulses...it just depends on why it needed the pressure pulses in the first place.

Pressure pulses wouldn't cause centrals. If they are showing up a lot when centrals/Clear Airway are flagged it is because the machine was needing help in determining the status of the airway...the pulses didn't cause the problem but instead the pulses are a byproduct of the problem.

[elixeus]

Hi Pugsy. Thanks for the explanation and clarification. You were very gentle on me, which I appreciate. Still so much to learn, but that is one thing I can cross off my list because your explanation makes perfect sense and you are well-seasoned in your knowledge. Glad you answered this and provided the clarification!

[Wulfman...]

My Remstar System one readings on Sleepyhead show a correlation between pressure pulses and CA events. Could the pressure pules actualy cause CA events?

Are you talking about the 1.5 cm. pressure "probes" (spikes on the pressure report)?
Do the event indicators on your reports line up with any/many/most/all of them?

I would think it might it might be conditional on how sensitive your subconscious is to those pressure probes (causing a reflex reaction). I would think it may not be "logical", but maybe not completely out of the realm of possibility. It could also be ( ? ) the pressure probes are also in response to the Centrals.......or somewhat coincidental, or maybe in response to a mouth-leak/breathing.

Please fill in your equipment profile with all of your settings. And, if you could post a sample report for us to look at, that would be great.


Den

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