Understanding min pressures

jnk... wrote:

TedVPAP wrote:The only way to avoid those clusters is through a higher minimum pressure.

Not to be overly picky--oh, heck, who am I kidding? I AM being overly picky -- I can't quite sign off on that statement. Just too universal for my blood.

Some clusters, although reported as obstructive by home machines, are actually set off by a form of central dysregulation, a variation of the old overshoot/undershoot problems of the body's attempting to sense CO2 clearance in different stages of sleep. Those events may be reported by home machines as fully obstructive, not mixed, because the airway closes too soon, at the instant of the pause, but they may still have central aspects at their root. In those cases, a high minimum may actually make those clusters more likely to occur, not less likely. True for all? Of course not. True for most clusters that occur during APAP use? Probably not. But possible and occasional? Yes. Those sorts of difficult-to-label events were a large part of my residual events after starting PAP therapy. They eventually resolved themselves after my body relearned to gauge it's clearance of waste gasses. But it took months for me, and it may never change at all for some people whose brains and sensors get "rewired" from years of untreated OSA. And that is why personal experimentation with what settings lower weekly-averaged AHI are often the key. Not everybody and every body is the same. A higher min may help some clusters, sure, but a lower min may help some clusters for some people too. And home-machines cannot report the deeper nature of all events that can start a cascade of more events that--although lacking the classically spaced waxing-and-waning patterns that would otherwise make their central nature recognizable--have central dysregulation as a significant contributing factor. Sometimes we forget that years of untreated OSA itself can cause central-apnea problems. Long-term untreated moderate-to-severe OSA makes for central events before and after treatment for some of us, and that can take time to resolve with successful PAP treatment, if it does resolve. But during the resolution, those mixed apneas can be reported by home machines as purely obstructive for those of us with an airway that is ready to shut completely at the slightest pause.

But hey, I ain't no expert. I did, however, draw some conclusions based on personal research into what I was going through early on myself with my breathing at the time, with a lot of help from some very wise forum experts back in the day. Not saying I was or am correct, but I felt it necessary to speak up here based on my personal beliefs and experiences.

TedVPAP wrote:. . . If the topic of this thread was about clusters, . . . context of the threads topic. . . .

AMK wrote:. . . apnea fests . . . one of these nightmare clusters . . .

TedVPAP wrote: . . . to avoid those clusters . . .