High CA with one mask and not another

This is a continuation of another post viewtopic/t154496/Change-pressure-setti ... 3b6ecad2c7.
I started a new topic since we moved to a different one in that thread.

My sleephead CA reading using the Resmed P10 pillow mask was around 7 AHI. Last night I slept with a Resperonics Wisp nasal mask that I got at the sleep study, and my CA went down to .5 AHI.

Does anyone know why there would be such a discrepancy? I want to continue to use the P10. I find the Wisp nasal mask to be uncomfortable.

MY experience with the P10, size medium, was initially my AHI was about 2-3 higher than when using a Espon 2 (Size small and medium). I really liked the feel of the P10 so I kept messing with it, but finally when I changed from a medium to a small I stated getting AHIs just slightly less than I get with the ESON 2. So I am using a small P10 now with good results, except last night which was a leak nightmare, but that's a different post. This is at odds with most of the folks experience here who generally do better moving up a size, not down. But it is what it is for me.

dream321 wrote:Does anyone know why there would be such a discrepancy?

What did your leak lines look like on each of the two nights?

It's really hard to do more than speculate because we don't know what was causing those centrals in the first place.
Plus we don't know if there were even real.

I can't see the nasal pillows causing too much carbon dioxide to be blown off but I suppose maybe out there on a long skinny branch it might have. What size P10 nasal pillow?

You need to try to figure out if the centrals are real or related to SWJ or arousals.

Go to the Events tab on the previous night's report with a lot of centrals....then click on the ClearAiray section and you will see the list of CA flagged events and the time each happened.
Pick one that has a couple of other flags close by in time frame...click on it...the graphs on the right will change and zoom in on the air flow.
Get a screen shot of the report zoomed in at this level.
Let's see if the breathing looks like SWJ or asleep breathing.

When you have some time to do some reading take a look at this thread and in it there links to other useful discussions.
viewtopic.php?f=1&t=114600&p=1110933#p1110933

TASmart wrote:MY experience with the P10, size medium, was initially my AHI was about 2-3 higher than when using a Espon 2 (Size small and medium). I really liked the feel of the P10 so I kept messing with it, but finally when I changed from a medium to a small I stated getting AHIs just slightly less than I get with the ESON 2. So I am using a small P10 now with good results, except last night which was a leak nightmare, but that's a different post. This is at odds with most of the folks experience here who generally do better moving up a size, not down. But it is what it is for me.

I tried using the medium and it was too small for me. The large, that I've been wearing, feels like the right fit. Hopefully I can continue to wear this mask.

ChicagoGranny wrote:
What did your leak lines look like on each of the two nights?

Here are the 2 graphs. Night 1 and 2

Pugsy wrote: What size P10 nasal pillow?

You need to try to figure out if the centrals are real or related to SWJ or arousals.

Go to the Events tab on the previous night's report with a lot of centrals....then click on the ClearAiray section and you will see the list of CA flagged events and the time each happened.
Pick one that has a couple of other flags close by in time frame...click on it...the graphs on the right will change and zoom in on the air flow.
Get a screen shot of the report zoomed in at this level.
Let's see if the breathing looks like SWJ or asleep breathing.

I missed your post when I was on the tread earlier. I'm new to this so I'm getting used to mechanics of the forum. I appreciate the help you and everyone are giving me. I'm finding that the DME's at the sleep clinic aren't very well educated, and the sleep physician won't talk to me on the phone; I have to have an office visit for any adjustments from him.

I use the large P10 nasal pillow.

Here is the graph of a cluster of CA's:

Those CAs look like they are being flagged after some big gulps of air and not during sleep.
Look to be SWJ to me.
If you had zoomed in a little closer it might show things a little better but look at the flow rate at about 4:10:00 and 4:14:00
and even at the very beginning of the flow rate graph 3:58:00 for a very short period of time.
See how it is nice and smooth? That's what the flow rate for sleeping soundly looks like. Now compare that nice smooth air flow to what you are seeing all around the flagged CAs...much more ragged with some gulps of air.

I don't think those CAs are real centrals. I am not even sure that the first 2 OAs are real...they might be I suppose and they caused you to have an arousal or wake up slightly (you may or may not remember) and then the irregularities of awake/semi awake breathing got flagged.

Now as to why you didn't have many with the other mask...dunno unless you simply had less arousals for some unknown reason. We don't sleep the same from night to night even with no changes in anything.
To establish a correlation you would need more nights to evaluate. It could have simply been a fluke.

I will see if I can find a good example of a real central for you to see. Give me a little bit.

I couldn't find a good central flag but here's a good example of an OA...now don't let the UA flag fool you...my machine does that for OAs.
It's a good example because you can see the asleep breathing prior to the flag and then the arousal breathing afterwards and then the nice smooth back to sleep breathing.

why I don't see the flow rate on my sleepyhead software? I have a lot of nights of AHI, just have the "Clear Airway" index.

ok, I found it. Now I need to figure out how to post the graph to here so if someone can explain a little bit for me if those central apnea is real or bcz of the arousal or something else?