One week in on CPAP and I'm ok with wearing the mask

soundersfootballclub wrote:

you wrote wrote:

I know that I am seeing many central apnea pauses showing up on these stats when I am not even asleep! She said they have their own way of assessing my AHI when they look over what I downloaded.

See here what happens when I test my events while taking an afternoon nap lasting less than an hour. The machine [S9 Elite in this case} does not know that I am not fully asleep. But, that's when the central apneas are clustering. Such an area of a graph should be taken out when evaluating a full night sleep.

archangle wrote:


Don't forget your AutoSet can do manual CPAP or auto with a narrow range. Don't change it for a manual CPAP if you can avoid it.

Complex apnea is a possibility, but don't assume that's what you have without careful investigation of actual flow waveforms. You don't want to be saddled with an ASV if it's not necessary.

archangle what would complex apnea look like in my flow waveform charts? Also it sounds like you believe a Resmed S9 auto could address this issue if need be? I am going to raise my pressure range tonight from 5-12 to 7-12 and see if it starts to drop my AHI. I have yet to see anything below 5 and I think it's time to start tweaking on my own ahead of my appt with my sleep doc next week.

avi123 wrote:


See here what happens when I test my events while taking an afternoon nap lasting less than an hour. The machine [S9 Elite in this case} does not know that I am not fully asleep. But, that's when the central apneas are clustering. Such an area of a graph should be taken out when evaluating a full night sleep.

Thanks for posting an example. I notice most of my clusters of apnea interruptions pretty much all happen between 4 and 6 AM. Many are right before or after times at night I remember being awoken as well. Since I started with my machine I have been getting up around 5 either from leaks or air pressure escaping from my mouth. Really makes me wonder what my real AHI is going to look like once I get settled in with treatment. I have a Liberty Mirage mask coming in the mail tomorrow that I hope will be "the one" for me.

archangle wrote:Try using a 3 inch non-adhesive Ace bandage for a chin strap. Wrap it over the top of your head, under the chin. I use one turn, trim it off and then secure with safety pins. You can experiment with tightness, more turns, etc.

It's softer and more breathable than some other chin straps. It's also cheap enough to just throw away if it doesn't work.

archangle I finally got around to trying this last few nights. Thanks for the idea, works really well so far. No pressure escaping from my mouth now when using nasal pillows. Works much better than the chin strap I bought.

When getting back on the hose I throw a lot of centrals for a few days. Not sure if its just "habit" for my brain to stop breathing or what. With me it goes away after a few days of hose.

soundersfootballclub wrote:
archangle what would complex apnea look like in my flow waveform charts? Also it sounds like you believe a Resmed S9 auto could address this issue if need be? I am going to raise my pressure range tonight from 5-12 to 7-12 and see if it starts to drop my AHI. I have yet to see anything below 5 and I think it's time to start tweaking on my own ahead of my appt with my sleep doc next week.

Sorry I didn't see this earlier.

I guess complex sleep apnea would simply be a lot of centrals. Or centrals and obstructive apneas. I would be a lot worried about long duration centrals than simply short centrals. If I were stopping breathing for 11 seconds but my SPO2 didn't drop, I wouldn't really be that worried, even though a CPAP may flag it as a "central apnea." If I'm stopping breathing for 60 seconds, I'd be worried even without an SPO2 reading.

I'd hate to see a doctor put someone on an ASV or a more complicated bilevel machine just because a machine said "central apnea" unless they really looked at the data, including flow waveforms. Especially for someone who has a machine like the AutoSet that records waveforms.

If you have "real" CSA, you do need a more complex machine. I'm just concerned about a "false positive" diagnosis.

As to your AutoSet machine addressing this: If too much pressure is giving you centrals, you can set the maximum pressure with the machine in auto mode. You can even set it to a fixed pressure. The question is "can you find a pressure that reduces your obstructive apneas without causing too many centrals?" If not, you may need a more complex machine.

archangle, I ended up bumping the thread but I was just trying to thank you for the ACE bandage idea. It is working pretty well for me since I decided to try it with my nasal pillows. I still am getting mostly "centrals" in my data but I am down to an AHI of 2 last night so not worried about it. My sleep doc says it is not possible for the S9 to distinguish between centrals and obstructive pauses accurately and to not focus on this. As long as I can keep getting my AHI lower I won't! Cheers.