Central????

[sgu]

My 2nd night with the CPAP machine. Looks like Ive actually got Central Sleep Apnoea??? Should I be freaking out!!

I cant add a link to the sleepyhead image as Im a guest.


AHI = 6

Clear airway = 2.9

[TASmart]

Nope

[Pugsy]

You can't insert image links unless you are a registered member and logged in.

2.9 of the AHI being centrals...doesn't qualify as central apnea even if they were all "real" centrals and I am betting that some of them aren't real and are instead the machine flagging awake/semi awake breathing irregularities as centrals.
Quite common with people new to cpap because they don't always sleep so good at first with cpap.
If you see several centrals being flagged real close to a known awake time there's a good chance they aren't real.
The machine doesn't know if you are awake or not. It only senses air flow and often our awake breathing confuses the machine a bit because our awake/semi awake breathing is irregular compared to asleep breathing and the machines can sometimes flag those irregularities as some sort of apnea event and they aren't real if we aren't totally asleep.

So...no you don't have central apnea.
You would need to see more than 5 per hour...every hour...all night long and even then if you were having a lot of OAs/hyponeas the centrals could be post arousal centrals from the obstructive events causing arousals.

[sgu00dir]

Thanks ever so much, this is a great forum!

Here is my second night image, the first night was similar!

http://imgur.com/a/NOfuN

I would love some advice as its all new and scary!

[Goofproof]

I'm good to go, my machine doesn't keep track of centrals, I haven't died in 11 years. Jim

I only worry about AHI and Leaks, if they are good, I'm Good!

[Pugsy]

I think the minimum pressure would be better if it was up around 8 or so. Looks like once you go to sleep you are up around 9 anyway.
You may even need more than that but I would start out at 8 or 9 and see what happens to the maximum if the minimum is more optimal.
It might be that the pressure won't go as high.
The pressures are getting up there...do you think that the higher pressures are a factor in the wake up?

You've got a lot of breaks in therapy where we know you were awake because you turned the machine off and back on again shortly later.
The bulk of your centrals seem to be around known awake times. I wouldn't worry about the centrals at this time. Instead concentrate on whatever it might be that is causing you to wake often and it could be something as simply as just having the mask on your face.
I know my brain did that to me for several weeks before it got used to the alien on my face and I didn't particularly have any problems with the mask....my brain used to poke me and say "hey dude, do you know that there is an alien plastered to your nose""

Can't see your leak rate...for further images (no need to re do this one at this time...remove one of the pressure graphs because you don't need 2 of them and include the leak graph instead.
If leaks are waking you up it might be that your mask needs to be fitted more to the higher pressures. If you are fitting it for seal at the 4 cm starting minimum then it isn't going to seal well when the pressure gets into the teens.

All in all though...it's only been 2 nights and this stuff isn't always so easy to adjust to quickly.

Oh before I forget it...it's okay and normal to have a few centrals even if they are real. There's a central called a sleep stage transition central where we can have centrals as we are actually transitioning from awake status to sleep status...theses are called sleep onset centrals and they are normal and not usually a big deal unless someone is having a truckload of them and they continually get bounced out of sleep. Yours doesn't qualify for a truckload at all.
If you can't deal with 8 or 9 starting out...maybe use the smart ramp thing available on your machine for 20 minutes or so..help you ease into things and if you fall asleep before ramp ends and have an apnea event try to happen the "smart" ramp thing immediately suspends ramp and goes about dealing with the apnea stuff.
This is different from regular ramp. I forget what it is called exactly...might be "auto ramp".
All explained in this manual.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

Overall though...actually a decent enough report for a second night. I don't think mine was that good on the second night.
At least you kept putting the mask back on after the wake ups...some newbies don't do that even.
Yeah, there's room for improvement but Rome wasn't built in a day and neither is this therapy.

[LSAT]

My 2nd night with the CPAP machine. Looks like Ive actually got Central Sleep Apnoea??? Should I be freaking out!!

I cant add a link to the sleepyhead image as Im a guest.


AHI = 6

Clear airway = 2.9

==========

i have had central for decades
nothing to freak about unless your oxygen goes too low
what does the machine oximeter say it is at

if your cpap is causing CA then you need an ASV

That would be true if he was having real CAs.....but he's not.

[LSAT]

My 2nd night with the CPAP machine. Looks like Ive actually got Central Sleep Apnoea??? Should I be freaking out!!

I cant add a link to the sleepyhead image as Im a guest.


AHI = 6

Clear airway = 2.9

==========

i have had central for decades
nothing to freak about unless your oxygen goes too low
what does the machine oximeter say it is at

if your cpap is causing CA then you need an ASV

That would be true if he was having real CAs.....but he's not.

================

took him at his word

what do you call a real CA ?

i guarantee mine are real
what other type could he have ?

READ Pugsy's posts...you may learn something
I believe yours are real...lack of 02 to the brain

[sgu00dir]

Thank you all who replied. Pugsey, thanks a lot you have set my mind at rest.

http://imgur.com/a/t5B0l

Heres last night, night 3. I would very much appreciate if you could take a look. Again, hardly any OSA and loads of Clear Airway ones.Do you still think they are not real centrals? If so then should I be quite happy with my scores as my obstructiove index is very low?

The thing that is waking me up is the crazy high pressure. I have full face mask and on APAP auto set 4 - 20 for 2 weeks before I take it back to get my CPAP. I think this 2 weeks is to let them know what pressure is best for me as the overnight study was inconclusive (didnt sleep much). At the high pressure of 18 it wakes me up and last night I woke up kind of hyperventilating. My body was tensed and not at all relaxed. Maybe I will just get used to it? Also at that pressure I have to put the mask on so tight that it really hurts. Ive put it on a bit too loose just for comfort but am getting leaks.

Any advice is very welcome!

[Arlene1963]

I'm going to leave comments re the pressure to more experienced members here, but want to add my voice of reassurance re the "centrals" almost certainly not being true centrals, but simply the machine flagging breathing irregularities that are most likely Sleep Wake Junk.

I had the same thing happen to me when I started, and it freaked me out badly. Folks here reassured me and it helped me so much to look at my data.

I dug up a thread for you on how to identify true centrals versus sleep wake junk by looking at your flow rate in your Sleepy Head data:

viewtopic/t118663/viewtopic.php?f=1&t=1 ... 8#p1094248

You're doing so well, and congratulations on the time you're spending on the machine each night, over 8 hours is fantastic.

[tooter]

Thank you all who replied. Pugsey, thanks a lot you have set my mind at rest.

http://imgur.com/a/t5B0l

Heres last night, night 3. I would very much appreciate if you could take a look. Again, hardly any OSA and loads of Clear Airway ones.Do you still think they are not real centrals? If so then should I be quite happy with my scores as my obstructiove index is very low?

The thing that is waking me up is the crazy high pressure. I have full face mask and on APAP auto set 4 - 20 for 2 weeks before I take it back to get my CPAP. I think this 2 weeks is to let them know what pressure is best for me as the overnight study was inconclusive (didnt sleep much). At the high pressure of 18 it wakes me up and last night I woke up kind of hyperventilating. My body was tensed and not at all relaxed. Maybe I will just get used to it? Also at that pressure I have to put the mask on so tight that it really hurts. Ive put it on a bit too loose just for comfort but am getting leaks.

Any advice is very welcome!

A starting pressure of 4 is not realistic when your MED is 11 and 95% is 15. I would raise your Min pressure to 10. You only hit 18 once during the night and 95% of the time you were at 15 or below. It wouldn't hurt if you reduced your Max to 15. Forget the Centrals for now and concentrate on getting comfortable with your mask.

[Pugsy]

I looked at the most recent report. It's actually a little improved...not quite so many breaks in therapy.
The first little set of cluster are associated with the large leak flagging...if it didn't totally wake you (which I suspect it did) it could still cause enough arousal for us to be able to blame it on SWJ (sleep/wake/junk where awake or semi awake breathing irregularities) earning the flags.
The second little cluster is obviously right before you turned off the machine...a known wake up and there a high probability those are SWJ centrals.
Then there's a few little random centrals...nothing obvious to blame those on but could be awakenings or semi awake again...not really troublesome even if they were all the real deal because sometimes we have a central here and there and it's not anything bad going on and not worth treating.
The last couple of small clusters...again very close to awake time and the break in therapy...so very possible SWJ again.

Are you using the mask fit feature on your machine when you fit the mask so that you are fitting at higher pressures or are you just fitting at the starting point of 4 cm? A mask fit at 4 cm for good seal is going to blow that seal at pressures in the mid teens.

Can you get me a shot of the Flow limitation graph? Let's see if those pressure spikes are from the flow limitations.
Resize the 4 graphs you are showing so that you can get 5 graphs on an image. To resize hover your mouse cursor over the bottom line of each graph and click and drag to change height.

Your machine is pretty much what we call wide open and no pressures have been set. It's the way these machines comes from the factory. 4 cm minimum and 20 cm maximum and while those settings can work just fine if the most pressure you are going to need is 9 or 10 cm it doesn't work so great for people needing pressures in the teens and apparently you do.
That minimum needs to be higher....at least 8 or 9 and very likely 10.
I would suggest start with 8 and see what happens...going from 4 to 8 starting point is going to be a substantial leap in pressures for some just starting all this cpap stuff. Might be a bit uncomfortable and if it is then I would utilize the ramp feature like I mentioned above.

Are you up to changing that minimum yourself or would you prefer your medical care team did it? It's not hard at all..the manual I gave you the link to explains how to get into the clinical setup menu where you can change things.
If you aren't up to changing it yourself...at least talk to your medical care team and have them do it.
You might get lucky in that with a better, higher, more optimal minimum pressure that the machine won't need to go to 18. I can't promise you that will happen but there is a chance...I have seen it happen often with other people having reports like yours.