Paul’s Treatment Thread

[pbrankin]

Hi,

I’m 2 weeks into treatment and my AHI is good: 0.35

The only thing that concerns me is the following pattern I’m seeing.

Almost every night, I experience a single central apnea that last 20-30 seconds during dreaming. It’s always the most emotionally intense part of the dream. This always results in a significant O2 drop down to around 80% for about 10 seconds, with the overall desaturation lasting about 30 seconds in total. I’ve now set my Wellue O2 ring to “buzz” me when it passes through 88%.

I see no indication of arousal or wakefulness before the apnea occurs.

I know that “having some centrals is normal” and I clearly don’t have central sleep apnea by any standard definition (AHI for centrals is 0.2!). But, I remain concerned about the depth of the O2 desaturation and the effect it could have on my health in the long term.

I’m also aware that it could be possibly treatment emergent. I have no way of knowing.

Am I just being a worry wart, or is it reasonable to question this?

I do not currently have a doctor I can go to about this as my diagnosis of mild OSA was done through a home test (PAT). I bought my own Airsense 10 AutoSet as a result and am finding my way. Pressure range is 8 to 10.6.

Thank you for your help.

Paul.

[Julie]

Any reason your max setting is so (relatively) low at 10? It could be keeping the lid on events that want to go higher (and be addressed) but can't because of the cap.

[pbrankin]

Any reason your max setting is so (relatively) low at 10? It could be keeping the lid on events that want to go higher (and be addressed) but can't because of the cap.

Hi Julie,

1 previously had it at 14 but I set it to the 99.5% figure. In any case, my understanding is that a central could be triggered by high pressure but probably not from too low.

Also, the pressure at the time of the apnea was only at 9 and not at 10.6. Therefore, I would assume that whatever the max was set to, it wouldn’t have tried to go about 9 anyway?

I guess it could theoretically by the EPR function?

I have that on 3 at the moment and could reduce.


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[MMcG]

There is no reason whatsoever to be worried about a single event of 20-30 seconds duration as far as I know, but perhaps the experts here will suggest otherwise. Just to put it in context, my own sleep study (before CPAP treatment) showed an AHI of 22.6 and a mean event duration of 28 seconds. And that is officially considered "moderate" sleep apnea.

[pbrankin]

There is no reason whatsoever to be worried about a single event of 20-30 seconds duration as far as I know, but perhaps the experts here will suggest otherwise. Just to put it in context, my own sleep study (before CPAP treatment) showed an AHI of 22.6 and a mean event duration of 28 seconds. And that is officially considered "moderate" sleep apnea.

Thanks MMcG.

I guess it’s the depth of the desaturation that bothers me. I accept that in terms of duration, a single event, even at this depth, is a mere fraction of my sleep time.

Just don’t see much guidance about desaturations, depth or duration, only that occurrences (AHI) are what matter.

That seems simplistic to me.


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[LSAT]

Your Central is insignificant. Pressure changes will not help Centrals. Leave everything alone..you are doing great.

[pbrankin]

Your Central is insignificant. Pressure changes will not help Centrals. Leave everything alone..you are doing great.

Thanks you LSAT.

I know these type of “central” questions repeatedly occur on here from newcomers. So, it’s greatly appreciated.

I guess I thought, due to the desat, my circumstance was “special” . Apologies.

It’s still a pain in the arse to be waking up gasping for air…even if it’s just once a night.

Maybe something that will resolve in time.


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[ChicagoGranny]

How many new threads will you start about this one issue?

https://www.cpaptalk.com/viewtopic.php? ... 7#p1401627

[pbrankin]

The previous thread was about an Obstructive Apnea that lasted over a minute.

This thread was about a Central Apnea with a significant desat.

Thanks.

[Julie]

Not relevant in that all your info (with history) might be important to someone helping even if you don't understand why - after all you're learning and wanting help, so make it easy for us to give it and not have to look at all your notes to see what's what. One 'patient', one history, whether or not every day or question is different.

[pbrankin]

Ah ok! Yes I understand now.

Will only add to this thread from now on rather than create new ones.

Thanks.

[Miss Emerita]

Even with the brief desat, this is not a cause for concern. I would suggest turning off the alarm. REM sleep is valuable, and interrupting it isn't a great idea.

[ChicagoGranny]

Even with the brief desat, this is not a cause for concern. I would suggest turning off the alarm. REM sleep is valuable, and interrupting it isn't a great idea.

+1

Almost every night, I experience a single central apnea that last 20-30 seconds during dreaming.

Several arousals during the night are normal as long as you quickly fall asleep again. I would suggest the Oura alarm could be counterproductive by causing a higher level of wakefulness resulting in a longer time to resume sleep.

[MMcG]

There is no reason whatsoever to be worried about a single event of 20-30 seconds duration as far as I know, but perhaps the experts here will suggest otherwise. Just to put it in context, my own sleep study (before CPAP treatment) showed an AHI of 22.6 and a mean event duration of 28 seconds. And that is officially considered "moderate" sleep apnea.

Thanks MMcG.

I guess it’s the depth of the desaturation that bothers me. I accept that in terms of duration, a single event, even at this depth, is a mere fraction of my sleep time.

Just don’t see much guidance about desaturations, depth or duration, only that occurrences (AHI) are what matter.

That seems simplistic to me.


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My mean O2 saturation was 87% in my sleep study. If you were in hospital and you dropped below 88%, you would be given oxygen. I dropped to 63% at one stage - that's hypopnea territory! My apnea was most likely undetected and untreated for years. And I'm still here (aged 65) and in reasonable health. So relax, you really have nothing to worry about.

[palerider]

Any reason your max setting is so (relatively) low at 10? It could be keeping the lid on events that want to go higher (and be addressed) but can't because of the cap.

Hi Julie,

1 previously had it at 14 but I set it to the 99.5% figure. In any case, my understanding is that a central could be triggered by high pressure but probably not from too low.

Also, the pressure at the time of the apnea was only at 9 and not at 10.6. Therefore, I would assume that whatever the max was set to, it wouldn’t have tried to go about 9 anyway?

There are several things at play here, first, more pressure won't do anything for centrals, unless it's a LOT of pressure, delivered in a single breath.

Two, a small percentage of people do have pressure emergent centrals, but *ONE* central, no matter how long it is, is completely insignificant.

Three, adjusting your max pressure based on anything to do with statistics is foolish and what is done by people that have only a superficial knowledge of APAP tuning.