questions bout OSA's, Mixed, and Central

I just revisited the results from my original study from Jul 08. I had "forgotten" that I had 236 OSA's, 46 Mixed and 7 Central, with an AHI of 46.4. I don't recall the doc saying that much about the mixed or central... and now after looking at results again and having read some posts here and other sites, I am wondering if I should also be concerned about the mixed and centeral - and if there is anything I should be watching for. I now realize that having some centrals means that my numbers may never get down to zero with pap, so now I am wondering if A) there is any way to tell which events in my AHI are central? and B) if tracking AHI will really tell me how well pap is working for me?

I know it is doing a lot - my 7 day average AHI now varies between 3.8 and 6.2 (ot three about), which i know is pretty darn good... i am just wondering if there is a way to tell what type they are.

Even after 6 months - I am still a newbie!

I know this probably sounds kinda stupid....

2flamingos wrote:I just revisited the results from my original study from Jul 08. I had "forgotten" that I had 236 OSA's, 46 Mixed and 7 Central, with an AHI of 46.4. I don't recall the doc saying that much about the mixed or central... and now after looking at results again and having read some posts here and other sites, I am wondering if I should also be concerned about the mixed and centeral - and if there is anything I should be watching for. I now realize that having some centrals means that my numbers may never get down to zero with pap, so now I am wondering if A) there is any way to tell which events in my AHI are central? and B) if tracking AHI will really tell me how well pap is working for me?

I know it is doing a lot - my 7 day average AHI now varies between 3.8 and 6.2 (ot three about), which i know is pretty darn good... i am just wondering if there is a way to tell what type they are.

Even after 6 months - I am still a newbie!

I know this probably sounds kinda stupid....

Not "stupid".
I didn't notice if you mentioned your pressure (or range), but if you don't have the Encore software (Viewer or Pro), I'd strongly recommend getting it.
"Centrals" on the Encore software MAY show up as "NR" (Non-Responsive) events. If you're using a range of pressures, the REMstar Auto will/may show "stair-stepping" pressure increases and then a drop-back in pressure if it can't resolve it. That would also be a possible flag for a NR/Central event. No guarantees as these machines use airflow to detect events, but at least it may give an indication.


Den

Thanks for your response.

Pressure range is 7-13, and 7 day average (90%) is 13, as is 30 day. occasionally it will go down to 12.4, but I think that is the lowest I have seen it.

Tried EP, but could not get it to load properly.... will be ordering viewer later this week. Once I have (and hopefully understand) another couple of months of data, will find a doc to get to (have not heard from mine since study - and even had a hard time getting copy of results). Why are so many doc's and DME's uninterested in following up and seeing how therapy is working?

Flamingos.....

It sounds to me like you need to move your pressure range up a bit....say, 9-cm to 16-cm.....and try to straddle the pressure that's best for you.

Be sure your mask isn't leaking......and try to make sure your mouth isn't leaking.

As to the question about the doctors and DME's not being interested anymore.......the answer is simple: "They got the money...and ran."

Gerald

have chatted with some folks about bumping pressure - and they had concerns since i did have central and mixed apneas - so i am not sure and that is why i am askign about this. As for mask and/or mouth leask, leak rate is around 27-28, which appears to be within rage for my settings - and I use a chin strap so no open mouth.

2flamingos wrote:have chatted with some folks about bumping pressure - and they had concerns since i did have central and mixed apneas - so i am not sure and that is why i am askign about this. As for mask and/or mouth leask, leak rate is around 27-28, which appears to be within rage for my settings - and I use a chin strap so no open mouth.

Good thinking but that may not be a big worry in your case. If you are having mixed apneas, it generally means the centrals are not being induced by the therapy & they may be typical benign centrals occurring naturally if you move a bit in your sleep (esp wake & move). The numbers of them aren't big & thus really not too big a concern.

The real bother is complex apnea where the centrals occur only when the sleeper goes on therapy & the higher pressures the worse the centrals. Complex apnea can be controlled with ASV type machines (as are centrals generally).

Re the setting of your lower pressure (7 IIRC) it seems an unnecessarily low starting point for an Auto where you spend a lot of time around 13. Perhaps 9 or 10 might be better but it seems it is not a big problem as the machine sorts itself out well above 7 & rarely stays low.

Good luck

DSM