How long did it take your centrals to go away after starting

[Budleigh]

Hey all,

Still in dire straights, I'm off CPAP after trying it again for 2 weeks. My downloads all showed that my apneas, which were all obstructive and hypopneas, were gone (down to 1 an hour each or so) but they were replaced by central apneas which were not present in the studies without CPAP. Two weeks in and they remain the same (usually 6-7 an hour). Net result: I'm more tired than before. I don't have health insurance and can't afford bipap so I need more motivation or advice to keep with CPaP. My mask is perfectly comfortable and no leaks so that doesn't need to change.

Sorry for the solemn tone, it's been a long year and a half.

[OutaSync]

Were the centrals present in the sleep study WITH CPAP? Did you have a split study? Or two studies, one without and one with CPAP?

[Budleigh]

I have had both, one full CPAP and one half and half. On the first study ever with CPAP the titration study, there were no centrals, nor on the half and half. My techs never mentioned seeing any so I didn't know they were happening until I did a download myself. They kept upping the pressure.

[Budleigh]

Unfortunately i don't have digital copies of those studies nor have I even seem the half and half from Stanford so I'm not sure. During the half and half they significantly bumped the pressure up so I doubt they were seeing centrals, unless they all don't care about them.

[OutaSync]

Can you post a copy of your download ? What pressure were you prescribed?

[Budleigh]

I'll try to post my home downloads soon

[Budleigh]

My most recent study at Stanford saw them prescribe a pressure of 11 after the half an half. Previously I was on auto6-10 where the 90% pressure was 8. My centrals for the first night were 15 an hour I think. After that I went down to 8, where the centrals decreased to 6 or 7 an hour.

[Budleigh]

Sorry if I'm not making much sense I'm at work and am utterly comatose

[OutaSync]

To answer your original question, once I got the right machine, my centrals went away immediately. I would still be using the wrong machine if I had not come here with my questions, just as you are doing now.

You can request a copy of your studies. You have a right to anything in your medical record.

Have you tried going going lower than 8, just to see what happens? My doctor told me I needed 19 to not have apneas but he would start me out at 16 since he didn't think I could handle 19. I'm now using a range of 13-23 with a average of 14. I rarely have more than one apnea a night and sometimes only one in a week.

[Emilia]

You should request a copy of your full study (ies)... you are entitled to copies under the law. You should have a 5-8 page copy of each. Not just a summary!! This should include the doctor's dictated notes as well.

[timbalionguy]

This kind of thing does not surprise me.

I have all sorts of things that go on at night, many of which are centrals, but don't show up as centrals on more conventional machines. They clearly show up on sleep studies, though. And during the last sleep study I had, I could actually sense the centrals at times. In any case, an ASV machine turned out to be the right machine for me, and I am now enjoying good therapy, and much lower pressures.

You should at least get your doctor to write you a prescription for an ASV machine, even if you cannot afford one. That way, if a chance arises to get one at a good price, you will be ready.

(I am no sleep doctor. Take the following advice accordingly.) In the meantime, you might try using an auto range that starts a bit lower than you think you need (perhaps 4 CM below your 'titrated pressure' and maybe 6 above.) Work your way up to the new high pressure limit; don't do it all at once. Stop raising pressure if you see a sharp increase in centrals. You might find that this gives you a little more relief than the traditional CPAP or narrow-range APAP. This kind of setting is what I use with a DeVilbiss IntelliPAP Autoadjust when I camp, and it works moderately well for a few nights. (I need to get the official Respironics power supply, so I can camp with the ASV machine.)

BTW, beautiful cat, Emilia. We have a couple of ragdolls who have run of the zoo, and they are beautiful cats!

[echo]

It's not uncommon for some people to be prone to centrals upon waking and falling asleep, that eventually resolve after getting used to the cpap. Your downloads will help us see whether that's the case.

If you do have true pressure-induced central apnea, and cannot afford or get an ASV, then it might still be possible to self titrate at home so that you find an ideal pressure where your centrals are minimized, and so are your apnea's and hypopnea's. If you are luckily, your threshold for the pressure-induced centrals may well be around 10 or 11. Then you set your pressure to just below the threshold for the central's. A copy of the titration/PSG will also be very helpful in determining this.

Anyway I hope this is not too much information considering your tired state. Just post some graphs first, and insist on getting a copy of your sleep study. (To requote Emilia: you need the full 7-8 pages of info including the graphs for AHI, Sleep stages, etc. The 1-2 page written summary is _not_ sufficient.)