Centrals been on the rise a bit.. Lower pressure?

Starlette wrote:Good morning Lazer.

One thing I may suggest is to keep some type of journal so you can track the changes that you're making and to visually see what is and what is not working.

Starlette

Thanks, Yea, I've been kinda relying on the machine's daily data and indicating the pressure settings but I should probably start trying to think of any other factors and make notes in SleepyHead or something. I'm not sure if it's stress or what but I haven't felt as rested in the past several days again. and since dropping the pressure.

lazer wrote: 3 Nights with min. dropped to 7cm. Not sure what to make of things..:

The data says your doing very well, your pressure is still higher than you really need. But your AHI is down and there is improvement in the CA's without any ill effect on anything else.

If you can breathe and feel comfortable, I'd suggest dropping the pressure to 5 for a couple of days. Otherwise there's really not much more you can do

Burkebang wrote:

lazer wrote: 3 Nights with min. dropped to 7cm. Not sure what to make of things..:

The data says your doing very well, your pressure is still higher than you really need. But your AHI is down and there is improvement in the CA's without any ill effect on anything else.

If you can breathe and feel comfortable, I'd suggest dropping the pressure to 5 for a couple of days. Otherwise there's really not much more you can do

There-in lies the problem. I feel mildly suffocating at 7cm now. I wish there was a "backwards" ramp feature. Maybe I could actually fall asleep at 5. Right now I notice some added struggle with it down to 7

If 7 is as low as you can go, use that. Your data looks good and I think you'll get used to the lower pressure after a few nights.

I go to sleep at 4 every night. I lay down for a couple of minutes to let my breathing calm all the way down before I put on the mask. Then the breathing feels very comfortable and natural. If I'm stressed or don't calm down first, I can feel a bit suffocated at first, but I normally calm down quickly.
But we are human, some of us probably need more air than others

I am beginning to wonder if the pressure (up) or (down) is the cause of what centrals I have and if I should even lay any concern with them even in relation to any possible sleep disruption.

And I wonder if sampling STRAIGHT CPAP vs. Auto would be of any benefit to me - could the pulses from the PRS1 be causing centrals with my possible sensitive UARS condition presumably.

Hrmmm,.... I know my numbers show good. I just want better more consistent sleep and not find myself slipping back into that pattern of never wanting to get out of bed in the mornings.

After my initial adjustment to PAP months back after that first week or two, it was like night/day the way I felt better and a bit more energetic to get out of bed. Now it's like I'm used to it or something too much and I'm slipping back into wondering wth is wrong.

This may be a bit out of the box but... you mentioned that you switched from nasal pillows to a full face mask and then back again right? Does your machine have a mask select feature? On my S9, I can choose which type of mask I'm using and the machine adjusts accordingly. If your machine has this feature it may still be set to full face rather than nasal pillow. Just a thought.

Have you thought about lowering your Aflex setting now with the lower min?

Pap365 wrote:This may be a bit out of the box but... you mentioned that you switched from nasal pillows to a full face mask and then back again right? Does your machine have a mask select feature? On my S9, I can choose which type of mask I'm using and the machine adjusts accordingly. If your machine has this feature it may still be set to full face rather than nasal pillow. Just a thought.

I think I've heard what you're talking about regarding the S9 but don't believe my PRS1 has that feature or if it does, I know I never touched it but you're correct in the switching back n forth between masks and ever since that venture, something doesn't seem to be quite right.

DoriC wrote:Have you thought about lowering your Aflex setting now with the lower min?

Good poing Dori. I did think of that the other night but haven't bothered to experiment. Didn't want too many things to evaluate all at once but we'll see how things progress and I'll keep that in mind.

And I'm still not feeling as good as treatment as before. I can't stand lower than 8cm pressure. What to do if anything or just ignore. Switch to straight Cpap? HELP!!!

Have you ever tried straight cpap?
The pressure changes are very minor now...no wild fluctuations but maybe even the small changes are a disturbing factor to your overall sleep quality.

Pugsy wrote:Have you ever tried straight cpap?
The pressure changes are very minor now...no wild fluctuations but maybe even the small changes are a disturbing factor to your overall sleep quality.

Nope, Haven't tried that yet. What is the best way. Go into the "Clinical" and set both upper/lower the same OR switch it somewhere to STRAIGHT CPAP???

Any suggestions on the straight pressure setting = 8 or 9...

I wonder if those pressure pulses are triggering any of my events. I take it those go away in straight cpap mode

What is RDI Lazer?

Starlette wrote:What is RDI Lazer?

respiratory disturbance index

http://en.wikipedia.org/wiki/Respirator ... ance_index

RERAs are arousals from sleep that do not technically meet the definitions of apneas or hypopneas, but do disrupt sleep. They are abrupt transitions from a deeper stage of sleep to a shallower.

This ^^^^ seems to be my major culprit to my sleeping disorder.

It's a setting you can switch to within SH. This is what actually got me covered through my insurance and DME since my tested AHI never met the required limit of 5 apparently.

Starlette wrote:What is RDI Lazer?

SleepyHead has an option to include RERAs in the calculations and gives RDI....Respiratory Disturbance Index.
Sort of what someone might see if UARS was suspected.

lazer wrote:I wonder if those pressure pulses are triggering any of my events. I take it those go away in straight cpap mode

Pressure pulses are what is used to differentiate between central (clear airway) and obstructive. Those won't go away.
Now the spikey probes...those would go away. They could be a disturbing factor. That is what you are seeing ^^^^^...the pressure pulses are the red dots in the flow graph.

Yes...to mimic cpap mode...minimum and maximum set to the same pressure. That way flow limitations will still be flagged. If you switch to cpap mode flow limitations (if any) aren't flagged at all.

Given your history...I think 9 cm would be where I would start if it were me.

How is your sleep quality...did you wake up often or at all?

Pugsy wrote:Given your history...I think 9 cm would be where I would start if it were me.

How is your sleep quality...did you wake up often or at all?

Thanks Pugsy and for your explanation. I don't remember awakening but ZEO indicates some bounces out of REM to "Awake" so not sure. Just mainly haven't been feeling my best for awhile and contributing some of my data showing these pesky "centrals" being elevated still just has me a bit puzzled. I think the ones after say 6:30 AM are/could be related to being partially awakened as during the week days, that's when my first alarm sounds. Otherwise, the ones throughout the middle of the night, I have no idea. But they don't even seem "Pressure induced" since they aren't occurring during a rise or spike in my auto-pressure necessarily either so I'm at a bit of a confusion as to if they are to be noted or brushed aside but still where has my perceived quality of sleep taken a bit of a dive meanwhile?.... (sigh)