.1 Central Apnea?

gmsmith · Post by **gmsmith** » Sat Jun 25, 2011 7:40 am

I have been using my cpap for little over a week (5 days of actual data). Last night according to ResScan I had a .1 central apnea and .1 unknown apnea on the summary stats. However when I go to the detailed chart it shows 1 central apnea and indicates 11.0 and an unknown 1 apnea and indicates 10.

What does that mean? Should I be concerned about the central apnea event? This is the first time I have seen that. AHI for the night was 1.2 with a little over 7 hours of use.

I still feel like the pressure (12) is to high...I find myself waking up throughout the night because of it.

So Well · Post by **So Well** » Sat Jun 25, 2011 7:58 am

gmsmith wrote: Should I be concerned about the central apnea event?

No, not at all.

gmsmith wrote: AHI for the night was 1.2 with a little over 7 hours of use.

I still feel like the pressure (12) is to high...I find myself waking up throughout the night because of it.

Here is what I would do:

1. Tonight drop the pressure to 11.5 cm
2. Check the report tomorrow.
3. If the AHI is still satisfactory, drop the pressure to 11.0 cm the next night.
4. Continue to repeat as long as the AHI is satisfactory.

It may take a few weeks of experimenting like this to find the minimum pressure which yields a low AHI. Also keep a record of how you feel the next day. The machines are not capable of measuring everything. I seem to feel better with the pressure one cm higher than pure data titration.

Also keep an eye on your leak line. What did it look like for the night you refer to?

I recommend looking at the detailed report every day for a few weeks or even months until you feel sure you have found the proper pressure setting. After you have some confidence in your therapy it is not necessary to look at the report so often.

Pugsy · Post by **Pugsy** » Sat Jun 25, 2011 7:59 am

Random central event scoring is normal. Might not have even been a real central. Could be a turning over in bed holding your breath central.

You will get used to the pressure.

Do you use ramp or EPR.. if so at what setting? If you are having trouble exhaling against the pressure EPR can help depending on what is being used now.

LinkC · Post by **LinkC** » Sat Jun 25, 2011 9:01 am

What Pugsy said. A random single central is as likely to be a sensing/scoring error as a real event.

Lizistired · Post by **Lizistired** » Sat Jun 25, 2011 9:42 am

I usually only see unknowns if Itake off my mask before turning off the machine.
Keep in mind that 10th second is what flagged it or it wouldn't be counted.
On the others, Zoom into a 5 or 10 minute window and look at them in the "FLOW" line. You will be able to see if your breathing just stopped or if you had an increase just prior, which for me happens when I turn over.

ozij · Post by **ozij** » Sat Jun 25, 2011 10:38 am

No reason for concern at all.

ResMed machine let you increase and decrease pressure on 0.2 jumps - I like that conservative approach.

gmsmith · Post by **gmsmith** » Sat Jun 25, 2011 11:38 am

I am showing 0 leaks according to the summary data, some very small little bumps on the leak line.

The flow line intensified around the time of the central apnea.

I am using ERP (at 3), it isn't exhaling that is the problem it is just the amount of air being pushed that is waking me up. I fall asleep fine during the ramp (starts at 4).

So Well · Post by **So Well** » Sat Jun 25, 2011 12:03 pm

How was your pressure setting of 12 cm determined? In-lab titration?

What time do you go to bed and arise? What time are you being awakened by the pressure?

gmsmith · Post by **gmsmith** » Sat Jun 25, 2011 12:10 pm

Pressure was determined in the sleep lab...based on the titration, I was getting my AHI was 8 at 12 (and 9.2 with 13).

I am getting woken up, multiple times per night by the airflow.

GMS

Lizistired · Post by **Lizistired** » Sat Jun 25, 2011 4:42 pm

gmsmith wrote: I am getting woken up, multiple times per night by the airflow.

GMS

So back your pressure off a little and give yourself a little time to get used to it. It won't kill you. Beats not using it.

gopher897 · Post by **gopher897** » Sat Jun 25, 2011 5:12 pm

remember, if your insurance is paying for your treatment and you mess with your settings.. they may stop paying.

So Well · Post by **So Well** » Sat Jun 25, 2011 5:21 pm

gmsmith wrote: AHI for the night was 1.2 with a little over 7 hours of use.

OK, so I thought your AHI was 1.2 which is excellent. But now you write,

gmsmith wrote:Pressure was determined in the sleep lab...based on the titration, I was getting my AHI was 8 at 12 (and 9.2 with 13).

I am getting woken up, multiple times per night by the airflow.

GMS

But it could be that at a pressure of 12 you have an AHI of 1.2 one night and 8.0 another night. The way we sleep each night varies greatly due to many factors including how tired we are, how stressed we are, and what we ate and when.

On thing you should do is practice good sleep hygiene. Google sleep hygiene and look at one of the better known sites for advice.

We need to also clarify what your AHI is. An AHI of 8.0 would be 56 events in 7 hours which is potentially 56 arousals. The events awaken you and then you become aware of the pressure and assume it is the problem.

If your AHI is 1.2 that is almost normal breathing and it could be that the experience of sleeping with a pressurized mask is causing the awakenings. This is very common, in fact, it is normal - hell, who is used to sleeping like this when first starting CPAP? So it may just take some time and some excellent sleep hygiene to adapt to sleeping with CPAP.

Do you feel like you are relaxed at bedtime? Or do you have some anxiety (normal) over the process?

If you think it will take a long time to adjust to sleeping this way, you may want to ask your doctor about a low-dose sedative to take at bedtime for say the first thirty days.

If you are achieving an AHI of 1.2, I would not be afraid to drop the pressure to 11 cm and check the AHI the next morning.

So Well · Post by **So Well** » Sat Jun 25, 2011 5:25 pm

gopher897 wrote:remember, if your insurance is paying for your treatment and you mess with your settings.. they may stop paying.

What is your motivation for writing that nonsense? All the insurance companies check is compliance hours.

Besides, he is not going to "mess" with his settings. But he might change them and analyze efficacy data to find optimum settings for his particular condition.

gmsmith · Post by **gmsmith** » Sun Jun 26, 2011 8:09 am

Sorry for the lack of clarity.

During the titration study, they determined that 12cm was the proper pressure. During this time it achieved the best results with an AHI of 8 (any higher then 12, they were seeing more AHI events).

My AHI last night was .1 (obstructives) and a leak of 1.2 (my nose got stuffed up and I was breathing through my mouth at one point). It looks like my numbers are fantastic, why do I feel like such crap? I had about 6 hours of CPAP time last night.

Pugsy · Post by **Pugsy** » Sun Jun 26, 2011 8:47 am

gmsmith wrote:It looks like my numbers are fantastic, why do I feel like such crap? I had about 6 hours of CPAP time last night.

Because it often is not all about just the "good" numbers.

Hours of sleep... maybe you need more than 6 hours.
Were those those hours fragmented for any reason? That will mess with how we feel.
While some lucky people see a immediate remarkable improvement most don't. I didn't. It was so very gradual.
Sometimes the body simply needs time to heal from the damage and effects of long term untreated OSA.
Sometimes we have any number of other health conditions that affect how we feel and/or the quality of the restorative sleep.... Pain... meds... mattress.. insomnia..whatever...

Finally some people don't see marked improvement and have to be content with preventing further damage and stress to the heart and body.

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