Re: newbie questions
Posted: Sun Mar 22, 2020 11:30 am
Treatment emergent central apnea can sometimes simply go away once a person has been on cpap for a period of time...and no...there is no set given amount of time where it would/should go away IF it is going to go away on its own.
Weeks...and even months...and maybe never. We just don't know.
If the centrals aren't horribly numerous ...like running 5 to 10 per hour then maybe the docs are more apt to "give it time" than if the centrals number in the 20 per hour range. There's always a lot of "it depends" involved with any of this.
The machine doesn't really retrain anything but your brain/body does seem to learn to adapt in its own right. So maybe a person might consider that a form of "retraining" but I don't necessarily look at it that way.
You don't necessarily change the way you breathe but your brain no longer will make that big of a deal about it when the machine gives you a burst of air for whatever reason. The brain and body adapts to the new normal more so than the body making changes so that the machine doesn't do what it normally does.
Eventually the brain/body will learn that this is the new normal way of doing things and won't bug you about the bursts of air so much.
One night at a setting doesn't necessarily a trend make and you have to look at trends and patterns more than just one night's results.
We all can have off/fluke nights but they get absorbed by "normal" nights and you need lots of nights at any given setting to figure out what is normal for you.
I am going to assume that some of your flagged events are false positives. Most likely the first cluster of hyponeas right at the beginning of the night because I am betting it took a little bit of time to fall asleep.
That big leak time....there's a cluster of UAs and Hyponeas...and I am betting those are most likely false positives as well.
If those are removed from the AHI evaluation...that makes for a much lower AHI even if all the rest of the flagged events are real asleep events.
This is where it comes in handy to take a stroll through the flow rate graph zoomed in to see for sure if those are real asleep events or arousal related false positives. If not nothing more than your own peace of mind.
You are new to cpap in general and that alone means you are likely to wake more often just from the external changes of sleeping with the mask and machine on. Then you have added in the extra stimulus of the way ASV goes about doing its job which can be sleep disrupting even for seasoned veteran cpap users. The more you wake up or take a while to fall asleep...the greater your chance of having false positives and if you aren't asleep...they don't count in the AHI evaluation in terms of effectiveness of the therapy.
Remember the machine doesn't know if you are awake or asleep....so it can and will try to fix your awake breathing if it senses an irregularity because that's its job.
Some centrals are normal to have...sleep onset centrals...when transitioning from awake to asleep...those are normal but to the machine it's an air flow irregularity that it is designed to try to "fix". With time your brain will come to accept this as its new normal and instead of waking you up when it gives you a burst of air for that sleep onset central the brain will let you sleep right through it.
My recommendation for now....give these settings a week and then see if we are able to spot any trends and also give the brain a chance to adapt...mainly see if you can sleep more soundly...fall asleep quicker and not spend much time awake in the middle of the night kind of thing.
Weeks...and even months...and maybe never. We just don't know.
If the centrals aren't horribly numerous ...like running 5 to 10 per hour then maybe the docs are more apt to "give it time" than if the centrals number in the 20 per hour range. There's always a lot of "it depends" involved with any of this.
The machine doesn't really retrain anything but your brain/body does seem to learn to adapt in its own right. So maybe a person might consider that a form of "retraining" but I don't necessarily look at it that way.
You don't necessarily change the way you breathe but your brain no longer will make that big of a deal about it when the machine gives you a burst of air for whatever reason. The brain and body adapts to the new normal more so than the body making changes so that the machine doesn't do what it normally does.
Eventually the brain/body will learn that this is the new normal way of doing things and won't bug you about the bursts of air so much.
One night at a setting doesn't necessarily a trend make and you have to look at trends and patterns more than just one night's results.
We all can have off/fluke nights but they get absorbed by "normal" nights and you need lots of nights at any given setting to figure out what is normal for you.
I am going to assume that some of your flagged events are false positives. Most likely the first cluster of hyponeas right at the beginning of the night because I am betting it took a little bit of time to fall asleep.
That big leak time....there's a cluster of UAs and Hyponeas...and I am betting those are most likely false positives as well.
If those are removed from the AHI evaluation...that makes for a much lower AHI even if all the rest of the flagged events are real asleep events.
This is where it comes in handy to take a stroll through the flow rate graph zoomed in to see for sure if those are real asleep events or arousal related false positives. If not nothing more than your own peace of mind.
You are new to cpap in general and that alone means you are likely to wake more often just from the external changes of sleeping with the mask and machine on. Then you have added in the extra stimulus of the way ASV goes about doing its job which can be sleep disrupting even for seasoned veteran cpap users. The more you wake up or take a while to fall asleep...the greater your chance of having false positives and if you aren't asleep...they don't count in the AHI evaluation in terms of effectiveness of the therapy.
Remember the machine doesn't know if you are awake or asleep....so it can and will try to fix your awake breathing if it senses an irregularity because that's its job.
Some centrals are normal to have...sleep onset centrals...when transitioning from awake to asleep...those are normal but to the machine it's an air flow irregularity that it is designed to try to "fix". With time your brain will come to accept this as its new normal and instead of waking you up when it gives you a burst of air for that sleep onset central the brain will let you sleep right through it.
My recommendation for now....give these settings a week and then see if we are able to spot any trends and also give the brain a chance to adapt...mainly see if you can sleep more soundly...fall asleep quicker and not spend much time awake in the middle of the night kind of thing.