New New guy needs some clarification

Hey all,

I have been lurking on this forum for a few weeks, ever since I knew I was getting a CPAP. You guys are awesome for always helping us newbs out with a million repetitive questions.

Mine has probably been answered a million times but I couldn't find it using the search.

I am on a Resmed Airsense 10 for 2 nights now and it's AMAZING! But my question is about the Central AI number. I know what Central Apnea is, and I know the machine can give a false central easily. My Central AI is at 1.0 for the 2 nights and my AHI is at 4.7. I know that's pretty low, but at what number do you take the Central AI seriously?

In my opinion..If your AHI is high and almost all events are CAs in clusters, Central Apnea would be a possibility.

Lambo915 wrote: ↑

Wed Mar 06, 2019 7:40 pm

My Central AI is at 1.0 for the 2 nights and my AHI is at 4.7. I know that's pretty low, but at what number do you take the Central AI seriously?

Somewhere between 8 and 10 an hour, on average.

Centrals aren't stressful like obstructives, their main worry is if you have so many of them that your O2 levels start dropping.

I've held my breath for a minute, wearing an oximeter, it barely registered.

Your primary drive to breathe is caused by the levels of CO2 in the blood, and has nothing to do with oxygen.

With your CAI of 1, that's totally inconsequential, but your obstructives need work.

Welcome to the forum. It is very common for people to have a few central events. While doctors consider anything under five events per hour as being properly treated, most of us consider under two events per hour as being properly treated. Right now, your brain is adjusting to that strange alien thing on your face while you sleep. Give it a few more nights and see how things look.

Appreciate the answers guys. I know 4.7 isn't ideal but my sleep study showed 50+. So for 2 nights in, 4.7 is magical and I feel like a million bucks in the morning.

I can't wait to see how it works a few weeks in.

Follow up question. I downloaded Sleepyhead, and then found that there was no SD card in the machine, so I inserted one, and it wrote information on it for the last 3 nights. Because the card was not there, there is no chart to show, only the Daily stuff. BUT, within that daily, it showed an AHI that is much lower than what my machine shows me.

My machine tells me that on Tues 3/5 my AHI was 4.1 but SH shows 0.81

Do you all find the machine or SH more reliable when it comes to ACTUAL numbers for AHI and such? Seems strange as SH gets the info FROM the machine, so I do not see how it can come to a different conclusion, and without the graphs, its limited data to go on.

SleepyHead summary for AHI isn't accurate without the files that also contain the detailed information needed for the graphs.

So just take what SH is saying now with a grain of salt.

Now if you used ResScan it would be accurate but SH needs some other files to do accurate calculations and those files aren't stored in the machine's internal memory....they go directly to the SD card which of course you didn't have until now.

See what it shows tomorrow after the SD card has been in the machine all night tonight.

That makes perfect sense Pugsy thanks! As soon as I read your reply, it clicked. The machine does not store the graphs so they don't exist until written on the card. I work in IT, I probably should have known this LOL.

Thanks for the quick response!

So my first full night of data (Which I understand is too small to really know anything) but, my AHI have hovered around 4 since I started on the CPAP ( about a week ) and though I feel a MILLION times better, I know there is room to improve, so my question is, how? A lot of this data makes sense to me, but a lot does not, and I know a lot of you are great at reading this data.

I got into the clinical settings to change my ramp pressure, as 4 was not working for me, other than I have not changed much.

For reference, I am pretty overweight ( 5'7" and 330LBS but going down ) and the only medicine I take is BP medicine, other than that, I am fine.

S0... How can I get under 4?

From the looks of your Sleepy Head data graph at the beginning, you’re struggling with OSA events while your cpap unit is running through its ramp cycle. You have a distinct cluster of them. A lot of OSA events can be followed right behind by central events that are related to arousals after the OSA happens. I would suggest shortening your ramp or turning off altogether, unless you can’t tolerate the high pressure at the moment you turn it on. And DO NOT start off the night on your back, use your side to get to sleep. It’s easier on the airway. What mask do you use?

I use the Airfit F30. My ramp is set at 15 minutes, should I shorten it or just turn it off and see if I can handle the pressure?

If I understand correctly, without ramp, the pressure goes straight to its minimum therapy level correct?

Which means mine would jump to 5 immediately ( 5-20 is my range ) My ramp pressure is already 5, so why ramp?

This is the mask, for reference.

A lot of new users struggle to tolerate high pressure while awake. The idea behind the ramp is that as the patient drifts off, the pressure starts to increase, and since they are asleep they aren’t aware of it. Problem is, while the ramp is low, therapy is being ignored and not enough pressure is being utilized to stop the apnea. Essentially, your pressure is too low at the outset. If you can tolerate the high pressure while awake, and it doesn’t bug you psychologically, then turn off the ramp so you get maximum therapy value at the onset of sleep where that huge cluster of OSA events is happening. And try to stay off your back as much as you can. Gravity works against the sleep apnea patient, because the jaw falls backwards occluding the airway more. The more you sleep to your side or belly, the more gravity becomes your friend and your jaw pulls away from your face, opening up your airway.

If I can not handle the pressure of Ramp Off, would it make sense to raise the ramp pressure to as high as I can handle? And shorten Ramp?

That way as I drift off, I am already at a higher pressure, which may help that initial cluster.

I didnt even quite realize that all of my OSA last night really came in 2 clusters, 1 was falling asleep, the other was probably related to a move on my part, maybe to my back? If I can clear that first cluster, I will be a long way towards getting under 4.0

Thanks for the advice Dreaming!