CPAP machine results?

This is my fourth night using my cpap. Last night I used it 7.6 hours. The first three nights were around 4. The clear air events were way up also.




Could anyone help me interpret the changes?

Your graphs show mainly a tiny zoomed in section. Can you back out so it shows the entire night on the graphs...like pressure and leaks? This one shows only about a one minute section at 1:24:45....

I don't know what to make of your centrals. Did you sleep well for these hours of sleep? Wake up often? Anything that might explain some of those centrals as maybe awake/semi awake centrals?

I just remember waking once to go to the bathroom and 3 or 4 times for a few seconds, adjusting the pillow etc. I am still tired, but a bit less than I had been and don't have a morning headache.

The time 22:15 to about 23:15 seems to be time with worst leak (some spikes) and a particularly large cluster of centrals...so maybe you were partial awake during that time and some of those we might could explain away with sleep transition centrals or semi awake centrals. Some of the centrals seem to occur at the peak pressure levels.
But you have some at the lower pressures also...so not sure if pressure is the sole cause.

In other words...really hard to tell if these are maybe the real deal or just sleep transition centrals.
Some are likely for sure sleep stage transition but we can't tell how many we can discount.

I know the first knee jerk reaction is to see the centrals and go "OMG I have way too many centrals" "OMG what am I going to do"....."I may have complex sleep apnea"...and go into panic mode.
You have only been on the machine 4 nights now. Even if there were all "real" centrals most often you will get the "give it time" thing and this is true. As long as you remember some wake ups even for a few seconds..that means your sleep onset transition stage thing is going to kick in and when that happens the chance of those centrals (which would be discounted in a sleep lab setting) is going to increase.

So what to do? We work on the leaks because you are fiddling with the mask during the night....work on what ever is waking you up and having you fiddle with the mask. We give it time and hope that you can report finally sleeping through the night without any fiddling with the mask or maybe other wake ups...then we look at the centrals that are remaining. Sleeping with a mask attached to our face is not normal and it does take a while for the body to accept the mask as something that should be there every night. Hopefully as you are able to sleep "better" the centrals will decrease to the levels that we shrug our shoulders and don't go into panic mode. Almost everyone will have a few centrals every now and then.

You do need to make sure that you get copies of your sleep studies so that you can see for sure if you had any centrals noted in your sleep study. You do need to make sure that you have an appointment with your doctor for proper follow up (30 days or whatever he set up) so that he can evaluate these "centrals" to see if he thinks they are of a concern. He won't want to do it right now...it is simply too soon and you aren't having enough of them anyway.
I know it seems like you are having a truck load of them but it isn't nearly the number that would cause immediate alarm.

This is going to be the hard part...you have to give things some time to settle down. You do need to work on whatever is causing the wake ups. If you remember 4 or 5 even for a few seconds...I bet there are more that you don't remember.
Are these centrals cause for alarm? Maybe a small alarm right now as they stand but they maybe are not a cause either. We simply cannot tell for sure if we need to be alarmed at this stage. So we don't totally write them off and totally ignore them...we keep an eye on them and work on the things that need to be worked on...like mask issues...and see how things are going after a couple of weeks when hopefully most of the adjusting is in the past.

Do make plans for proper follow up though. Just in case these centrals stick around and the doctor's input is really needed. Yours is one of the situations where you will need your doctor's input...for peace of mind if nothing else.

You had 30 CAs from 9 p.m till 2.20 a.m., it comes out to about 6 per hour. The OAs were less than half. I bet that what drove the pressure up to 16 cm was either Snore or Flow Limitation. Such hi pressure is bad for the CAs. I would put the machine in CPAP mode with a pressure of 10 to 11 cm [re-edit] and try to get graphs of Event Flags, Snore, Flow limitation, and Leak. The lower pressure might reduce the CAs.

avi123 wrote:Such hi pressure is bad for the CAs.

Sometimes yes, sometimes no. I see 18 cm often and I don't have any more centrals than at the other pressures.
So higher pressures don't automatically equal centrals popping up as in complex sleep apnea. Some people have centrals at 8 cm that are pressure induced and come up with Complex Sleep Apnea diagnosis. Doesn't just happen to those at higher pressures.

Switching to CPAP mode for the OP might help for any number of reasons including the fact that the pressure changes themselves might be a disturbing factor in general.

OP has been on the machine 4 nights now...I would assume that the pressure settings were prescribed by the physician and while you know I often will offer my ideas on pressure adjustment...I try to find out if the person is
1. working directly with a physician ....don't want to ruffle feathers unless I had to.
2. why the current settings....there may be a reason for these settings
3. who made the choice for those settings...was it a doctor or is the OP doing this on their own
4. is the person with only 4 nights of use comfortable with making adjustments on their own...assuming DME and doctor input is going to be impacted. If self pay, self titrating...different story.

We do know for sure that there is some fragmented sleep...that needs to be addressed...mask leaks and fiddling are mentioned so we know for sure mask is a possible cause of fragmented sleep. It needs to be worked on anyway.
Once leaks aren't an issue...if sleep is still fragmented then we look at other possible culprits.
Can't go changing everything all at once after only 4 nights of therapy. If we do we don't know which change fixed what problem. We don't learn anything.

It is strange that the machine showed anthinng at 9:00. I did not put the mask on until 11:15 pm. I am scheduled to see the sleep doctor again in about 10 days. I have the evaluation and I had 52 obstructive and 5 mixed apneas

There is a clock on the machine that is likely not set to your local time.
It is in the clinical setup menu. You can go in there and correct it if you wish.
When you see the doctor...make sure that he looks at the detailed graphs and not just the summary reports.
Talk to him then about your concerns about the centrals.

Thanks. I just spoke with the respiratory therapist from the sleep center. He pulled up my sleep studies and Dr notes. The doctor was not concerned about central apneas. The respiratory therapist said that he wouldn't be concerned about my numbers so early in the process as my body has to get used to the machine. I guess next week I will have the chance to really go over everything

Zoom in on the centrals and see how long and how severe they are. While we tend to think about AHI which counts the number of events, the duration and completeness of the apnea matters to your health, too.

You can also go to the events tab and it will tell you how long they were.

Majority of events ranged from 10 to 20 seconds. Is that considered long?

Roxy wrote:Majority of events ranged from 10 to 20 seconds. Is that considered long?

No, that is probably pretty much common. They have to be at least 10 seconds long to even be flagged.
Most of mine are in that range also. Every now and then I get a stinker that wants to last 45 seconds but that is not very often. I will go back and check some averages to see where they tend to run but I believe that probably 90 % will be less than 20 seconds. This is assuming that they were the real deal anyway.
Last night or rather this morning the last hour before I got up...a large truckload of centrals got flagged. I was in and out of sleep during that time for sure...I was having leaky mask issues.
Just wanted to let you know that even cpap veterans have some whacko nights too.
You should have seen my reports my first 2 weeks on the machine...my AHI was in the double digits every night and I felt every one of them.

My mask liners just came today so I will see if they help with comfort and leakage tonight. Fortunately, my insurance also picks up the cost of the mask liners. I guess that this is one thing that they got right. It will cost a lot less to control the apnea than to pay for diabetes, heart issues, blood pressure etc,

I went back through a week's worth of events...all kinds...real or not real.
I had a handful in the low 20s range...all the rest of them were below 20. Funny thing..of the ones that were over 20..all were hyponeas. I don't have many hyponeas at all. Many nights none and occasionally maybe 2 over the entire night.

what are hyponeas? I had a few