are these real CSA events?

[JimW159]

I saw an NP who was covering for my sleep doc today. ... I asked if raising the pressure would make the centrals even worse and she shrugged her shoulders and said maybe....not exactly a confidence booster but I guess I need to try something

A somewhat simplified explanation can be seen at:
https://www.youtube.com/watch?v=1OQFESwNXm0

[FrederickRose]

I saw an NP who was covering for my sleep doc today. She acknowledged my AHI numbers were much worse, all CSA and I was having alot of hypopneas,

My current settings are
Max IPAP-15
Min EPAP-4
PS -4

she said to change the settings to
Max IPAP-20
Min EPAP-4
Minumum PS -4
Maximum PS- 8

I am confused because I only see one PS setting- I do not see a minumum or maximum PS? Also, I asked if raising the pressure would make the centrals even worse and she shrugged her shoulders and said maybe....not exactly a confidence booster but I guess I need to try something

[FrederickRose]

I we assume that they are real central apneas (CAs), and most likely they are, then I agree with Pugsy - lowering the PS or changing back to CPAP would make sense.

Do you remember what your prescription was for when you were on CPAP? What pressure level?

[sue60]

https://imgur.com/a/dZp90

I know, I know its only one night, but its hard not to be excited....what a lovely way to start the new year, THANK YOU PUGSY!, keeping my fingers crossed, will update end of week
I'm off to get that lotto ticket!

[Pugsy]

OMG no way was that supposed to have much chance of working.
Get a ticket for me too.

Obviously a little more pressure is needed...probably both in the EPAP min and the max.
But I am very pleasantly surprised to see that the obstructive stuff was better prevented that I thought it would be. I really expected a much higher obstructive component to be left over but the main goal of the experiment was to see if the centrals would reduce with the elimination of PS...and that was an obvious success. I couldn't be happier.

Go slow with further changes...this alone is so much better than what you were having so you have the time to fine tune things slowly.

You have more than one option...if it were me I think I would raise minimum EPAP to 8..and increase max IPAP to 20....keep PS to 0
and see what happens. If the centrals return with more pressure then we back up a bit.
I would like to see you keep the EPAP minimum low enough that you are comfortable and won't need the exhale relief that PS offers since apparently PS and bilevel situation it creates seems to be the central trigger.

Of course one night doesn't a trend make but man is this ever a good sign. If this holds...there's no need for ASV discussion.

Hot damn...this is a great start to the New Year.