dream321 wrote:Is it common to have CA in the beginning?
Yes and no and depends on if the CAs/centrals are "real" or not.
First the cpap pressure triggering centrals...those would be real centrals and it can happen in 10 to 15 % of the people put on cpap.
Commonly thought of as maybe being related to higher pressures but it can happen just as easily with pressures as low as 6 cm.
Sometimes it will go away on its own but normally will take several months not a couple of weeks..if it goes away at all.
For those people cpap seems to trigger some breathing instability where they blow off too much carbon dioxide and the levels don't build up like they should to tell the brain to send out the "breathe" command. People often think it is the oxygen levels in the blood that dictate the brain telling the body to breathe but it's really carbon dioxide levels instead. The CO2 levels have to get to a set point before the brain wakes up and tells the body to breathe.
It's normal to see a few centrals on these reports...it's normal to have what we call a sleep stage transition central or sleep onset central.
These are real and normal and not usually a problem unless a person keeps having them so often they keep getting bounced out of sleep.
Hold your breath for 10 seconds...that's pretty much the way the central works...no air is moving but the airway is open.
When we are awake/semi awake and tossing and turning our breathing is much more irregular than when we are sleeping. These machines can't tell if you are awake or not....they just measure air flow so sometimes that awake/semi awake irregular breathing will cause the machine to flag some sort of apnea event and most commonly...central but it can get confused and call it OA sometimes.
We call these apnea flags occurring while awake or semi awake as SWJ...Sleep/Wake/Junk.
While it can sure mess up the AHI numbers and make it hard to evaluate things we have to mentally remove any SWJ numbers from our evaluation process. Problem being that sometimes it's hard to distinguish subtle differences between awake and asleep for some people.
I don't normally get too excited when a newbie comes here with some sporadic centrals like yours. Especially when they are so knew that they are still in the wake up easily fiddle with the mask part of things. Heck I think it took me 3 months to stop waking up 20 times a night just to feel the mask on my face.
We could go into a lengthy discussion about zooming in on the flow rate breathing pattern to see if it looks like SWJ or not but that's a lot of work and not always easy to spot and since we already know there's a good chance it's SWJ...wait and see what happens once you are sleeping more soundly is usually what I suggest. If those centrals are SWJ centrals once you are sleeping more soundly they will probably reduce considerably.
If they don't or they worsen then we have a different discussion but your doctor would still want to give it time anyway because sometimes even the real centrals will go away once the body doesn't respond with the unstable breathing that triggers the centrals in the first place.
So we don't totally ignore the centrals...but we don't panic either....we keep one eye on them all the while continuing working on treating the obstructive stuff optimally and cross our fingers that the centrals reduce on their own.
More pressure won't reduce your centrals and I don't know that you need more pressure for the obstructive stuff...might not hurt to try a little higher minimum since once your pressure goes up it tends to stay up there anyway...maybe reducing the obstructive stuff might impact the centrals IF (big IF) the centrals are related to an arousal caused by an obstructive event. I have seen it happen.
I don't know that your centrals are post arousal centrals...but it wouldn't be impossible.
