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

I would drop the pressure slowly - what's the hurry? your numbers aren't bad. I found that at a pressure of 10.6 I had an ahi of around 2 with 100% centrals. at 10 I had an ahi of 10 and it was 50:50 centrals and everything else

Your "centrals" don't appear to be related to pressure at all. They never have.
Now they might be the real deal centrals or they could be simply sleep stage transition centrals which are still centrals but normal. And they might be awake/semi awake centrals that you don't remember.
If they are the real deal centrals they still aren't in great enough numbers to worry about...if they are awake/semi awake centrals maybe figuring out what you can do to maybe improve sleep overall might help reduce them.

I know you recently changed some meds.....could that be a possible cause?
Also...you have been playing with pressures...I can tell you that the brain is a funny little guy...he likes stability and predictability...when you change things on him he gets kinda confused. This is why we say limit changes as much as possible and give things time to settle down before putting a whole lot of stock in what we see on the reports.. Keeps the brain happy.

johnthomasmacdonald wrote:I would drop the pressure slowly - what's the hurry? your numbers aren't bad. I found that at a pressure of 10.6 I had an ahi of around 2 with 100% centrals. at 10 I had an ahi of 10 and it was 50:50 centrals and everything else

That's the problem. When I drop the pressure from 8, I am just more miserable (suffocating feeling) and insomnia kicks in and I struggle more to get to sleep.

Pugsy wrote:I know you recently changed some meds.....could that be a possible cause?
Also...you have been playing with pressures...I can tell you that the brain is a funny little guy...he likes stability and predictability...when you change things on him he gets kinda confused. This is why we say limit changes as much as possible and give things time to settle down before putting a whole lot of stock in what we see on the reports.. Keeps the brain happy.

I don't know but the only meds I have changed in the recent month(s) have been going from xanax to Clonazepam. I ran out of the generic Ambien just 3 days ago and have replaced it with 5-HTP which I've taken in the past at night. I see my phsyc Dr (Med check) tonight and am going to see about getting back on the "generic" Ambien because I'm having more difficultly falling asleep but this has just been recent and my "centrals" have been elevated for some time now along with the perception that my sleep hasn't been as restful - not wanting to always get up on alarm in morning, ect...

Regarding pressure changes, I really haven't swung around too much with them - maybe dropping to 7cm briefly which felt stifling and then up to 9 some time ago (I think)... Lemme check SH quick on that:

Unless a change causes a significant problem (like your dropping to 7 cm minimum) we need to give a change at least a week before we start evaluating it with the microscope. Preferably 2 weeks with no other changes.
And "changes" include external changes as with meds or whatever.

I don't know if your minor machine changes are related to you general feeling of less than optimal sleep quality. Though just something else to put on the back burner when evaluating things.

Heck, maybe the change in the weather plays a part. Maybe it isn't related to anything with the machine at all.
Since we can't really put a finger on something...then try something else. Since you haven't ever tried straight pressure then by all means try it. It would not be impossible for you to have your sleep disturbed slightly by the pressure variations.

Have you considered trying vpap/bipap? I'm totally biased and a bit of a fanatic about it since my experience on it is SOooooooo different than the respironics system one apap that I was never able to get to work for me in 3 and half months of trying. Vpap worked from the first night out. It's such a different sleeping experience, on the apap i used to think that there was NO WAY that i could keep this up every night for decades while that thought doesn't bother me at all now. But why not try dropping your pressure by .5 cm per night until you either get to 8 ( where it is uncomfortable) or you don't see an improvement in AHI scores?

johnthomasmacdonald wrote:Have you considered trying vpap/bipap? I'm totally biased and a bit of a fanatic about it since my experience on it is SOooooooo different than the respironics system one apap that I was never able to get to work for me in 3 and half months of trying. Vpap worked from the first night out. It's such a different sleeping experience, on the apap i used to think that there was NO WAY that i could keep this up every night for decades while that thought doesn't bother me at all now. But why not try dropping your pressure by .5 cm per night until you either get to 8 ( where it is uncomfortable) or you don't see an improvement in AHI scores?

I actually picked up a bipap some weeks ago from a local seller which I'm awaiting to give a whirl but right now since I finally got my insurance to kick in and on board, I have to meet compliance 90 (day) with my current "Rent to own" machine and in order to get continued coverage on supply renewals and such so I'm in a bit of a predicament with that.

I think Todzo believes I need ASV or whatever since my brain damage ala a different thread.

Just trying to make my poor old APAP work best for me atm but all options I consider open. Thanks!

"I think Todzo believes I need ASV or whatever since my brain damage ala a different thread. " - i have a feeling that longterm that is the same situation for me - I can't seem to get the ahi below around 1.5 ( all centrals ) no matter what i do including adding the use of dental appliance built for me to treat the apnea . I have the advantage of knowing that the therapy is working for me since i had a ridiculous level of nocturia prior to treatment - I was getting up like 6-8 times every night and the urine was like water - clear and odorless. Now i sleep through the whole night without ever having to get up and the urine is concentrating normally- so this is a huge plus. On the downside i don't really feel any less tired during the day - not that before therapy i felt all that tired to begin with. I'd love to able to test a few nights on an ASV machine to see if it makes a difference before spending all that money to buy one.

johnthomasmacdonald wrote:"I think Todzo believes I need ASV or whatever since my brain damage ala a different thread. " - i have a feeling that longterm that is the same situation for me - I can't seem to get the ahi below around 1.5 ( all centrals ) no matter what i do including adding the use of dental appliance built for me to treat the apnea . I have the advantage of knowing that the therapy is working for me since i had a ridiculous level of nocturia prior to treatment - I was getting up like 6-8 times every night and the urine was like water - clear and odorless. Now i sleep through the whole night without ever having to get up and the urine is concentrating normally- so this is a huge plus. On the downside i don't really feel any less tired during the day - not that before therapy i felt all that tired to begin with. I'd love to able to test a few nights on an ASV machine to see if it makes a difference before spending all that money to buy one.

Funny you mention about getting up to go to the bathroom XXX times a night prior to treatment. I had been experiencing the same and blamed it on my "low-carb/higher water intake" diet which I had begun back in February of this year about 3 months prior to xPAP. Post xPAP, I rarely, and I mean rarely... like once every 2 or 3 weeks EVER get up during the night to take a leak any longer. Hrmmm,, something I oft forget about mentioning or thinking about.

Yea, I would love to test drive ASV myself, I think...

lazer wrote: Yea, I would love to test drive ASV myself, I think...

That's one expensive test drive. It's way beyond my "experiment" budget plus the dynamics of how ASV machines give you a nice big burst of high pressure forcing you to breath is not something that is easily adjusted to. Just ask JohnBFisher. DIY ASV machine use is NOT for the faint of heart. It can take months to get adjusted to using one.

But if someone has the budget for it...there is one for sale.
viewtopic.php?f=1&t=84304&p=769164&hili ... le#p769164

Older models are cheaper but accessing the data is more difficult because they will use the smart card technology which requires special card readers.

Pugsy wrote:

lazer wrote: Yea, I would love to test drive ASV myself, I think...

That's one expensive test drive. It's way beyond my "experiment" budget plus the dynamics of how ASV machines give you a nice big burst of high pressure forcing you to breath is not something that is easily adjusted to. Just ask JohnBFisher. DIY ASV machine use is NOT for the faint of heart. It can take months to get adjusted to using one.

But if someone has the budget for it...there is one for sale.
viewtopic.php?f=1&t=84304&p=769164&hili ... le#p769164

Older models are cheaper but accessing the data is more difficult because they will use the smart card technology which requires special card readers.

Oh believe me, I'll pass on that but thanks for the heads up!

Only way I'll ever try one is if a little birdy drops one out of the sky on me...

What does this snippet of my flow-rate tell me as it includes both a flagged Central and Obstructive?

I can't see the full breath right before the CA flag but it appears to me that it is a big gulp of air....so maybe a turn over in bed "central" or big breath and then stop breathing for a few seconds "central".

Now if your flow rate was nice and smooth right before that CA flag (similar to what you see after the flag and up to the OA flag) with no big gulp of air involved then I would be more inclined to think of the central as a "real" central. Though even if real...you still aren't having enough of them for the doctors to want to do anything about.

So as suggested. Went with STRAIGHT pressure. Upped it to 9cm across the board. Interesting first night results. Centrals down quite a bit and throw out at least the last two because I was awaking early to the alarm (had bloodwork before work)...

I've read through the entire series of posts and, it appears you are sleeping well, but you are experiencing CAs, which don't appear to respond to lowering of pressure, and you would like to reduce them. I agree with you that 7 cm or so is as low as you'd want to go without feeling like you're not getting enough air. But I don't understand why you think you need to lower your CAs. They aren't doing any harm to you as long as you are sleeping well and you aren't suffering from any other physical ailments. On the other hand, obstructive apneas are harmful. You become hypoxic during those events, awaken briefly, gasp a few times, then resume sleep. Wash, rinse, repeat.

Centrals are usually not a problem, though they can be an indication of other underlying problems such as congestive heart failure, and they are frequently associated with Cheyne-Stokes breathing patterns, particularly in obese patients sleeping on their backs. But unless there is some other reason that you think you need to address the CA events, maybe leave well enough alone, and bring up the matter with your doc.