What am I doing wrong? Is it my machine?

I’m at a lost. My pressure is set at 4.8 and I’m getting centrals over 60. If I try auto they go even higher. On my sleep studies I get no centrals. OA's are always under 5. I’m using an S9 Auto start. Could this be my machine?





Jim

Jim,
If the snapshot is common to what you're seeing... I'd talk to both the doc and the DME.

This happen about every other day and why I requested a new sleep study. I seen the sleep Doc last month and when the report showed no centrals she said see you in a year. This was at the VA. I do have appointments with both my VA and insurance PCP’s. I got my S9 from CPAP.com so I don't know if I should call them or if the VA DME would look at the machine. I know my insurance won’t let their DME look at it since it was bought online.

Jim

It's definitely talk to your doctor time.. Probably a BIPAP/ASV candidate..

Do you have an pulse oximeter? You might want to think about regularly checking your SpO2 desaturations.. (a CMS50D+ is cheap and works well with SleepyHead.)

I also get a lot of clusters like this, and had no centrals were reported in my original PSG.
Mine are usually scattered with Hypopneas, but then again I have a different brand of machine, which reports differently.

What does the flow waveform look like while zoomed right in in the middle of these clusters?

Not suggesting your overweight, but If your BMI is over 30 (mine still is.. I can't seem to break the 30.0 barrier) it can cause havoc when your exposed to CPAP.. There is a type of complex sleep apnea/sleep disorder called Pickwickian Sydrome, (also known as Obesity Hyperventilation Syndrome) that worth reading up on if weight is an issue. (I still don't know if this is the official cause of my problems, but it was certainly a good motivator for me to try and lose some weight)

There are obviously many other potential causes, this is just one that I'm personally familiar with..

Thanks Mark,

My BMI is 32.5.

Here is the flow enlarged


and here is a O2 with flow from 11 Jan

Forgot to add that the Sleep Study was on ASV also with no change and no centrals on both CPAP and ASV. The report reads no OSA with a AHI of .6 but since I was diagnosed in 09 with a AHI of 60. They felt it was best to kept me on CPAP.

Neat, you've already figured out the Oximetery Stuff

Here is an old one of mine below.. this ones not as scary looking as yours. My AHI record with the mask on is only 26.6.
but interestingly you seem to get the same short breathing bursts as me.. (The PRS1 uses the pulse in the middle rather than the ripple like your S9)

It'd be sure nice to get to the bottom of what causes this.. I'm sick of feeling like a zombie all the time.

I would _love_ to know what stage sleep I was in during these kind of clusters.

Nice to know I'm in good company. I'm thinking on getting a Zeo myself to check sleep stage. I think I'm in stage 4 which I never hit when I have my sleep studies. I think that would explain why I get the centrals at home but not on the studies. What is your pulse? As your can see I go into bradycardia with a pulse of 45.

Mark,

I just found this "Awakenings": electrocardiographic findings in central sleep apnea.
http://www.ncbi.nlm.nih.gov/pubmed/20946562.

JimDB wrote:Mark,

I just found this "Awakenings": electrocardiographic findings in central sleep apnea.
http://www.ncbi.nlm.nih.gov/pubmed/20946562.

Too bad you have to pay to get this. Follow the link in the upper right to Wiley library. You can buy this with a 24 hour subscription. I've no idea what the charge is. You have to register to find out the price, but it might be worth it to you. If you have an association membership that subscribes to Wiley then you're in free, I think.

jedimark wrote:There is a type of complex sleep apnea/sleep disorder called Pickwickian Sydrome, (also known as Obesity Hyperventilation Syndrome)

I'm not trying to be picky here, Mark, but trying to help people who might misunderstand. It's hypoventilation, meaning you're not breathing often enough and/or deeply enough, leading to oxygen desaturation and all the fun stuff that goes with it.

The thing with this syndrome is that it's not just a sleep disorder. It happens during the day as well as during the night. For most, excess weight/fat simply makes it physically more difficult to breathe. (There are a few less common causes, as well). The most effective treatment for this most common cause is to shed weight. I purposely have stopped saying "lose weight" because, in the past, when I've lost weight, I always found it again. Like you, still trying to get that BMI down.

BTW, thanks for all the programming you've done to help so many others.