New to this - Questions On Centrals?

Hi,
I Started on a Bipap 1/11/2019. At the sleep study (Nov..2018) I was diagnosed with obstructive sleep apnea. A the Titration study (Dec, 2018)some Central apneas showed up that weren't seen at first study. Tech said it could be due to the CPAP/BIPAP. The Tech was unable to get a good setting on CPAP or BIPAP, saying I didn't have enough sleep time. So the doctor prescribed a BIPAP with a setting of 9 (exhale) 11 (inhale). Tomorrow is my 6 week follow up appointment. So I have been doing a lot of reading here to get as much knowledge as I can before the appt. I have only viewed my data that is provided by the DreamMapper app. I will try the SleepyHead app after my appt. and knowing what the doctor has to say about my numbers.

My biggest concern is the number of Clear Airway Apneas I am having. The Centrals range all over the place. I tend to have more when I'm having a bad night - can't go to sleep right away, wake up and can't go back to sleep, having to adjust the mask a lot, and just getting frustrated or agitated. I have noticed I do tend to hold my breath somewhat during this time. So I'm wondering if I'm having true centrals.
Thanks for any input!

Here are my numbers from the past week:
Feb. 19 7.6 AHI 34 CA 6 OS 3 Hypo Usage 5:41 hrs
Feb.20 3.5 AHI 8 CA 2 OS 6 Hypo Usage 7:34 hrs
Feb. 21 1.2 AHI 3 CA 0 OS 6 Hypo Usage 7:27 hrs
Feb.22 0.6 AHI 2 CA 0 OS 2 HYPO Usage 5:47 hrs
Feb.23 3.1 AHI 16 CA 1 OS 6 Hypo Usage 7:16 hrs
Feb.24 8.2 AHI 51 CA 6 OS 12 Hypo Usage 8:25 hrs * Bad night with mask, couldn't sleep, just got up for a few hours
Feb.25 2.6 AHI 8 CA 2 OS 4 Hypo Usage 5:30 hrs
Feb, 26 4.9 AHI 34 CA 2 OS 4 Hypo - Usage 8.11 hrs

From Jan.11 - Feb.26
AHI:
Highest Day: 38.1 (First day of use)
Lowest Day: AHI 0.6

I have noticed that the OSA is higher if I sleep on my back. So I try to sleep on my side through the night, which I am a side sleeper mostly. Also breathe through my mouth at times and really trying to breathe through my nose more, which I am. Still trying to get pillow adjusted so mask doesn't leave such an imprint on my face. Definitely a trial and error with this whole BIPAP therapy but I will get there

I see nothing to be concerned about, just ignore them.

alww wrote: ↑

Wed Feb 27, 2019 10:13 am

So I'm wondering if I'm having true centrals.

No. The machines are quite accurate at reporting events when you are asleep. When you are awake, the data makes little sense.

alww wrote: ↑

Wed Feb 27, 2019 10:13 am

So I'm wondering if I'm having true centrals.

You're having 'true centrals', but they may not be true "central *sleep* apneas", the machine doesn't know if you're awake, or drifting in and out of sleep, or holding your breath while you're moving around in the bed, it just knows you're not breathing, and your airway isn't blocked.

But, the number of them that you're having recorded is insignificant.

Focus on obstructive events, not centrals.

palerider wrote: ↑

Wed Feb 27, 2019 12:29 pm

I see nothing to be concerned about, just ignore them.

Thank you for your response. Sorry my numbers ended up all jumbled together. So even 51 Clear Airway events is no concern?
I really do feel these are to do with what kind of night I'm having, as far as restlessness, agitation etc. Sometimes I put the mask on and not many problems at all. Other nights it seems like its one thing after the next with it.

ChicagoGranny wrote: ↑

Wed Feb 27, 2019 12:32 pm

alww wrote: ↑

Wed Feb 27, 2019 10:13 am

So I'm wondering if I'm having true centrals.

No. The machines are quite accurate at reporting events when you are asleep. When you are awake, the data makes little sense.

Thank you!

palerider wrote: ↑

Wed Feb 27, 2019 12:36 pm

alww wrote: ↑

Wed Feb 27, 2019 10:13 am

So I'm wondering if I'm having true centrals.

You're having 'true centrals', but they may not be true "central *sleep* apneas", the machine doesn't know if you're awake, or drifting in and out of sleep, or holding your breath while you're moving around in the bed, it just knows you're not breathing, and your airway isn't blocked.

But, the number of them that you're having recorded is insignificant.

Focus on obstructive events, not centrals.

Thanks. This makes sense and thought from all my reading on Centrals that's what it meant. I just got concerned when there were 51 Central Airway events one night, even though it was one of those nights. I will focus on the obstructive.

alww wrote: ↑

Wed Feb 27, 2019 1:29 pm

palerider wrote: ↑

Wed Feb 27, 2019 12:29 pm

I see nothing to be concerned about, just ignore them.

Thank you for your response. Sorry my numbers ended up all jumbled together. So even 51 Clear Airway events is no concern?
I really do feel these are to do with what kind of night I'm having, as far as restlessness, agitation etc. Sometimes I put the mask on and not many problems at all. Other nights it seems like its one thing after the next with it.

Centrals don't cause any stress, hold your breath for 10 seconds... That's a central. No biggie, you actually do it all the time when awake.

Now, pinch your nose closed and try to breathe, try hard, that stress you feel, that's an obstructive.

Centrals are really only an issue if you're having them one after another, and they start causing your o2 to drop.

Now obstructives, they are stressful, cause spikes in blood pressure, knock you out of sleep, and more physiological problems.

That's why I say not to worry about centrals till they're regularly close to 10 an hour. (Talking about the total number you had is pretty meaningless without mentioning how long you actually slept, since 50 in an hour is bad, 50 in 10 hours isn't a big deal.)

That's why I say to focus on the obstructives. Make sense?

alww wrote: ↑

Wed Feb 27, 2019 1:36 pm

palerider wrote: ↑

Wed Feb 27, 2019 12:36 pm

alww wrote: ↑

Wed Feb 27, 2019 10:13 am

So I'm wondering if I'm having true centrals.

You're having 'true centrals', but they may not be true "central *sleep* apneas", the machine doesn't know if you're awake, or drifting in and out of sleep, or holding your breath while you're moving around in the bed, it just knows you're not breathing, and your airway isn't blocked.

But, the number of them that you're having recorded is insignificant.

Focus on obstructive events, not centrals.

Thanks. This makes sense and thought from all my reading on Centrals that's what it meant. I just got concerned when there were 51 Central Airway events one night, even though it was one of those nights. I will focus on the obstructive.

If you zoom in on them, you'll probably find signs of disturbed sleep, and irregular breathing before the centrals, meaning that they probably wouldn't be counted on a monitored sleep test.

Here's a segment of time with a bunch of central flags...but they are NOT real asleep centrals....meaning the person was awake when they were flagged. You have to be asleep for them to really matter...awake flagged anything simply has to be mentally removed from the evaluation process. When people have "bad" nights in terms of not being able to sleep well/solidly...it's quite common for the machine to flag little pauses in our breathing as a central because be do actually pause our breathing all the time and not realize we are doing it.



Here's a segment of nice rhythmic normal asleep breathing....see the difference?



Watch the videos here to learn how to zoom in and figure out asleep breathing vs awake/post arousal breathing.
http://freecpapadvice.com/sleepyhead-free-software

Then you decide if the centrals you are seeing flagging are happening when you are asleep or awake.
A few centrals flagged when for sure asleep...not a big deal...it's normal to have a few.

Thanks Pugsy. Is this Sleephead data? I'll be downloading the app tomorrow to check out all my data. From what I can see the Dream Mapper app just gives you basic data. Not sure if the SD card would provide more information on it, than what I get on my phone daily.

Can't wait to see how the doctor thinks the BIPAP settings are working for me after 6 weeks of use. Thanks again for the info!

Yes...that is SleepyHead data...and it's all on the SD card right now.
SD card contents is totally independent of DreamMapper.
You can use SleepyHead right now and it changes nothing on the machine or with DreamMapper...

Thanks again! So we downloaded sleepyhead and put the card in. It looks as if it is downloading the data, then says no data available. My daughter is very computer smart but can't figure it out. We are giving up for tonight and read up more on sleepyhead tomorrow.

alww wrote: ↑

Wed Feb 27, 2019 6:29 pm

Thanks again! So we downloaded sleepyhead and put the card in. It looks as if it is downloading the data, then says no data available. My daughter is very computer smart but can't figure it out. We are giving up for tonight and read up more on sleepyhead tomorrow.

What version of sleepyhead, and what is the REF number on the bottom of your machine?

palerider wrote: ↑

Wed Feb 27, 2019 7:23 pm

alww wrote: ↑

Wed Feb 27, 2019 6:29 pm

Thanks again! So we downloaded sleepyhead and put the card in. It looks as if it is downloading the data, then says no data available. My daughter is very computer smart but can't figure it out. We are giving up for tonight and read up more on sleepyhead tomorrow.

What version of sleepyhead, and what is the REF number on the bottom of your machine?

I'm not sure which one she did. I'll check all this out later and get back with you. I did get good news from my 6 week follow up with the BIPAP. The doctor was pleased with how I've done and said she would see me in a year, sooner if needed.