high CA ahi

[buckc12]

My overall AHIs are less than 5 but are more than 50% CAs. I have Res Med Air Sense 10 auto set at 7.0-7.6 and use an N30 mask. I am happy basically wonder what I should change to lower CAs? My sleep is good and consistently over 8hrs/night. Any help will be appreciated

[Pugsy]

You really can't treat CAs/centrals with anything but a bilevel machine with a back up rate like an ASV model machine.

AND....they don't really need treatment until you see number of centrals that point to being a problem...and they are for sure asleep centrals and not just awake pauses in breathing flagged centrals.

Doctors don't even start to blink an eye about centrals until the number exceed 5 per hour average...every night and all night.
They just don't because some central apneas are normal so doctors won't do anything about them until they cause a problem of some sort.

So even if your AHI was 5.0 and 50% of it was central...that's only 2.5 per hour average and doctors won't do anything except tell you not to worry about them. Sleep onset centrals are normal...and it's normal to wake after a REM sleep stage and go back to sleep so potentially with 4 or 5 REM stages we have the chance of 4 or 5 centrals just from post REM arousals...then add in at the beginning of sleep night...greater chance for a few normal sleep onset centrals.
Even during sleep it's normal to have an occasional central. Usually they are very brief and no big deal. Hold your breath for 10 seconds...that's essentially a 10 second central apnea and you will see it doesn't cause you any distress at all.

In terms of machine tweaks that might be done that might (note I stress the "might" part) about all you can do is reduce or eliminate exhale relief (EPR on your machine) and see if the centrals reduce. Please note that this only works if you are a part of a very small percentage of people who use exhale relief that it actually triggers centrals. Chances are you aren't because you aren't having enough centrals or the number we normally see when using exhale relief is triggering central apneas. It's a very rare situation and not common at all.

You report sleeping good and I assume feeling decent an happy with therapy overall....I would shrug my shoulders and move on if it were me.

[buckc12]

Thank you so much Pugsy I really respect your advice. It's kinda what I thought but hearing it from you matters. I look at OSCAR and it is helpful but sometimes TMI in a way. Have a blessed weekend!

[nlt6mor]

Have lowered my CAs by limiting sleep to seven hours. I have very few clear airways in the first seven hours sleep. But after that, it really jumps up to a higher number. My AHI is always double or triple if I allow the luxury of 8 or9 hours of sleep. I t really doesn't matter for quality of sleep, but always nice to read a lower AHI!