Mostly Centrals
Mostly Centrals
Hello,
I finally have an resmed auto vpap machine. I have an ahi of 17-27 each night which are 99% centrals. I've only been on it 8 days. I can only seem to usually sleep on my side, with a full face mask. "the resmed f10" I often wake up with a very dry mouth (I assume breathing with my mouth a lot). I am happy because the obstructive and hypopnea are now very low or gone, but the centrals are high. Also, I still can only sleep about 1-2 hours at a time. Sometimes 3 hours, but rarely.
Should I be concerned about the centrals? Looks like I'm not breathing on average 15-45 seconds.
Looks like I'm kind of between a rock and a hard place. I have used cpap (regular), in the past, but I was never able to get obstructive and hypopnea down. I also had an auto cpap, before. Both were around 35-45 AHI with the old machines. Now with the new vpap, they are down to less than 1, but the centrals are the majority and very high, 17-27. Attached sleephead:
Thank you for your help, recommendations...
I finally have an resmed auto vpap machine. I have an ahi of 17-27 each night which are 99% centrals. I've only been on it 8 days. I can only seem to usually sleep on my side, with a full face mask. "the resmed f10" I often wake up with a very dry mouth (I assume breathing with my mouth a lot). I am happy because the obstructive and hypopnea are now very low or gone, but the centrals are high. Also, I still can only sleep about 1-2 hours at a time. Sometimes 3 hours, but rarely.
Should I be concerned about the centrals? Looks like I'm not breathing on average 15-45 seconds.
Looks like I'm kind of between a rock and a hard place. I have used cpap (regular), in the past, but I was never able to get obstructive and hypopnea down. I also had an auto cpap, before. Both were around 35-45 AHI with the old machines. Now with the new vpap, they are down to less than 1, but the centrals are the majority and very high, 17-27. Attached sleephead:
Thank you for your help, recommendations...
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- sleepy02.jpg (339.77 KiB) Viewed 18310 times
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- sleepy01.jpg (305.62 KiB) Viewed 18310 times
Re: Mostly Centrals
First, please look at the 'shorganize' link in my sig and do your charts like that next time, you only need one per day.zzzk wrote: ↑Mon Jul 16, 2018 10:10 pmHello,
I finally have an resmed auto vpap machine. I have an ahi of 17-27 each night which are 99% centrals. I've only been on it 8 days. I can only seem to usually sleep on my side, with a full face mask. "the resmed f10" I often wake up with a very dry mouth (I assume breathing with my mouth a lot). I am happy because the obstructive and hypopnea are now very low or gone, but the centrals are high. Also, I still can only sleep about 1-2 hours at a time. Sometimes 3 hours, but rarely.
Should I be concerned about the centrals? Looks like I'm not breathing on average 15-45 seconds.
Looks like I'm kind of between a rock and a hard place. I have used cpap (regular), in the past, but I was never able to get obstructive and hypopnea down. I also had an auto cpap, before. Both were around 35-45 AHI with the old machines. Now with the new vpap, they are down to less than 1, but the centrals are the majority and very high, 17-27. Attached sleephead:
Thank you for your help, recommendations...
Second, yes, that's a worrying amount of centrals, I'm willing to bet you're suffering significant O2 desaturations with that many centrals that close together.
I suggest trying dropping the PS to 2 and see if that helps any.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Mostly Centrals
Hello,
Ok, I attached a new screenshot with your sleepyhead settings. Are the other settings ok? Just bring down the ps to 2? Thank you for your help.
Ok, I attached a new screenshot with your sleepyhead settings. Are the other settings ok? Just bring down the ps to 2? Thank you for your help.
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- SleepyNew.jpg (348.65 KiB) Viewed 18300 times
Re: Mostly Centrals
Please turn off the calendar next time (f9).
Until we can see if we can get rid of a lot of the centrals, there's not much else to do, you're obstructives are very well managed.
I'm *hoping* that the centrals are because you're blowing off too much co2, and depressing your respiratory drive... (sort of like taking a bunch of deep breaths, then holding your breath, you don't feel any need to breathe for a bit. The same thing can happen to some people with too much difference between inhale and exhale pressure (called Pressure Support, PS).
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Mostly Centrals
Ok, thank you. I hope so, too. Here's a screen shot without the calendar. I'll work on changing the ps. Thank you for your help.
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- SleepyNew3.jpg (346.79 KiB) Viewed 18283 times
Re: Mostly Centrals
Sometimes with a very small percentage of people the PS seems to trigger the unstable breathing that ends up causing centrals because of the blowing off of too much carbon dioxide and it not getting a chance to build up in the blood stream to trigger the brain to send the command to breathe.
So the easiest thing to try first is reduce PS and see what happens. It may or may not make any difference but worth I try.
I helped a woman who was having 15 to 20 centrals per hour average with PS of 4 but down to 1 per hour with PS of 3. Sometimes just a little change can make a huge difference and sometimes even turning PS totally off makes no difference.
It all depends on what is causing the unstable breathing.
Sometimes the centrals will fade away on their own and a doctor will give it a bit of time to see if they do. A lot depends on how many centrals a person is having and are those centrals causing a problem with desats or wake ups what a doctor decides to do about them.
You can try reducing PS to 2 and see what happens...don't change anything else. Leave EPAP where it is for now.
If no luck or not much joy...try setting PS to 1 and then even to 0 and see what happens.
If changing PS doesn't do anything or enough in reduction then you need to be getting with your doctor sooner than later about what to do about the centrals.
What was the model machine you last used? Did it flag centrals or not? I am wondering if you have been having them all along and not know it because the machine didn't flag them.
Centrals weren't flagged at all until the ResMed S9 series machine was used or Respironics System One machine....or maybe you had one of those model machines but it wasn't full data so they happened but without data couldn't see it.
So the easiest thing to try first is reduce PS and see what happens. It may or may not make any difference but worth I try.
I helped a woman who was having 15 to 20 centrals per hour average with PS of 4 but down to 1 per hour with PS of 3. Sometimes just a little change can make a huge difference and sometimes even turning PS totally off makes no difference.
It all depends on what is causing the unstable breathing.
Sometimes the centrals will fade away on their own and a doctor will give it a bit of time to see if they do. A lot depends on how many centrals a person is having and are those centrals causing a problem with desats or wake ups what a doctor decides to do about them.
You can try reducing PS to 2 and see what happens...don't change anything else. Leave EPAP where it is for now.
If no luck or not much joy...try setting PS to 1 and then even to 0 and see what happens.
If changing PS doesn't do anything or enough in reduction then you need to be getting with your doctor sooner than later about what to do about the centrals.
What was the model machine you last used? Did it flag centrals or not? I am wondering if you have been having them all along and not know it because the machine didn't flag them.
Centrals weren't flagged at all until the ResMed S9 series machine was used or Respironics System One machine....or maybe you had one of those model machines but it wasn't full data so they happened but without data couldn't see it.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
Re: Mostly Centrals
Hello,
I tried before with a Remstar Auto with Aflex 550p APAP, 11-15 pressure range.
AHI never could get regularly below 15, had about even levels obstructive, hypopnea, rera, centrals. Could never sleep more than 3-4 hours a night... gave up until new machine.
With new machine, Resmed, acurve 10 vauto, I can sleep more, but only 1-2 hours at a time, adding up to about 8 hours a night. All seem to be eliminated except for a lot of centrals.
I have to get the doctor to lower the ps because they do it remotely.
Thank you for your help.
I tried before with a Remstar Auto with Aflex 550p APAP, 11-15 pressure range.
AHI never could get regularly below 15, had about even levels obstructive, hypopnea, rera, centrals. Could never sleep more than 3-4 hours a night... gave up until new machine.
With new machine, Resmed, acurve 10 vauto, I can sleep more, but only 1-2 hours at a time, adding up to about 8 hours a night. All seem to be eliminated except for a lot of centrals.
I have to get the doctor to lower the ps because they do it remotely.
Thank you for your help.
Re: Mostly Centrals
Someone recommended this in addition to the ps change. Do you all agree?
EPAP min 6.0, IPAP max 12.0 and PS 2.0.
EPAP min 6.0, IPAP max 12.0 and PS 2.0.
Re: Mostly Centrals
I personally don't like to make more than one change at a time unless it is urgently needed.
Remember Science 101...keep your variables to a minimum to better be able to judge/evaluate any changes.
When we make more than one change we don't know what change brought about any different result.
I see no urgent need for you to make more than one change at a time.
You can indeed change the PS yourself if you want to.
All you need is to know the secret handshake to get into the clinical setup menu area to make the change.
You can get the clinical manual here and it explains the secret handshake.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
Remember Science 101...keep your variables to a minimum to better be able to judge/evaluate any changes.
When we make more than one change we don't know what change brought about any different result.
I see no urgent need for you to make more than one change at a time.
You can indeed change the PS yourself if you want to.
All you need is to know the secret handshake to get into the clinical setup menu area to make the change.
You can get the clinical manual here and it explains the secret handshake.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
Re: Mostly Centrals
Hello,
Lastest with change of ps to 2. Attached 2 screenshots. Please let me know assessments, recommendations, etc. Thank you.
Lastest with change of ps to 2. Attached 2 screenshots. Please let me know assessments, recommendations, etc. Thank you.
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- Sleep.2018.07.18b.jpg (351.06 KiB) Viewed 18214 times
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- Sleep.2018.07.18a.jpg (340.96 KiB) Viewed 18214 times
Re: Mostly Centrals
Your first chart is useless, the second is all that is needed.
Try lowering the ps more.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Mostly Centrals
Ok. Then lower it to 1? It seems to let me lower it incrementally. Also, can you please generally explain to me what the ps does and why lowering it will help with centrals? Thank you.
Re: Mostly Centrals
The more difference between exhale pressure and inhale pressure increases the amount of air you breathe, (tidal volume). The more TV, the more co2 you blow off. Your main respiratory drive comes from the level of co2 in your blood, so less co2 can depress the resporatory drive.
Some people are more sensitive to the drop in co2, and get pushed into a point where their body just decides "meh, I don't need to breathe for a bit.", And you get a central.
Seeing if you are affected by this is easy, just turn down PS.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Mostly Centrals
Ok, I'll try ps 1 tonight. However, I'm a little confused. I lowered my ps to 2 last night, but the inhale and exhale remained the same. Are you referring to a low/high range per inhale or exhale? Does the ps dynamically change those? Also, I don't know if this is relevant, but I'm a runner and I have a very high lung capacity according to the dr's.
Here are the settings:
Machine Settings
ModeCPAP Mode VPAPauto
Min EPAPLower Expiratory Pressure 8.00 cmH2O
Max IPAPHigher Inspiratory Pressure 25.00 cmH2O
PSPressure Support 2.00 cmH2O
Thank you for your help.
Here are the settings:
Machine Settings
ModeCPAP Mode VPAPauto
Min EPAPLower Expiratory Pressure 8.00 cmH2O
Max IPAPHigher Inspiratory Pressure 25.00 cmH2O
PSPressure Support 2.00 cmH2O
Thank you for your help.
Re: Mostly Centrals
I think that you'll find that they didn't.
The PS changes the difference between inhale and exhale pressure, or between EPAP and IPAP. If you look at your chart from last night, and night before, you'll see that in one, the pressures were 4cm apart, in the other, 2cm apart.
MINEPAP is the minimum pressure epap can get to, MAXIPAP is the maximum pressure that ipap can get to, and they're always PS apart.
It's not.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.