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

Guest · Post by **Guest** » Wed Dec 12, 2012 2:29 pm

Slartybartfast wrote: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 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. 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.

Only since I started feeling not as rested and refreshed and comparing my data to prior months and before transitioning back and forth with the FFM ordeal, then my "centrals" on my reports seemed to be more pronounced, thus I associated them with the poorer feeling of sleep quality basically. They never really alarmed me to the point of being terribly worried, I just feel like I'm going through a phase of "re-dialing in" my pressures to be optimal and feel better rested and thought the centrals may actually be disruptive to my sleep stages which has been my ongoing battle. I sleep but don't always reach the quality sleep stages and most noticeably "Deep" which is also reflected via my ZEO and again, my overall feel.

Slartybartfast · Post by **Slartybartfast** » Wed Dec 12, 2012 2:45 pm

Ah so desu ka. So it's a matter of tweaking in order to feel better. Some people seem to just be prone to CAs while others are not. What I would pay attention to is the threshold at which you start seeing an increase in snores and flow limitation. I have no data to cite to support this, but it's my suspicion that flow limitation and snores are stressful to some extent, so I'd try to keep the pressure just above the level at which you start seeing VS and FL creeping in, and see if that makes any difference.

Guest · Post by **Guest** » Wed Dec 12, 2012 2:51 pm

Slartybartfast wrote:Ah so desu ka. So it's a matter of tweaking in order to feel better. Some people seem to just be prone to CAs while others are not. What I would pay attention to is the threshold at which you start seeing an increase in snores and flow limitation. I have no data to cite to support this, but it's my suspicion that flow limitation and snores are what you get just before you start seeing an increase in obstructive events, so I'd keep the pressure just above the level at which you start seeing VS and FL creeping in.

That's what is so odd. Last night with the increased min/max set 9cm, I seemed to experience more FLs and VSs than recent past. I just can't seem to win...

Slartybartfast · Post by **Slartybartfast** » Wed Dec 12, 2012 2:56 pm

Yes, but one point does not a trend make. Give it some time. I had dinner out with a troubled friend a few nights ago and drank two light beers before dinner and my AHI was 1.7 that night, up from my usual which is < 0.5. Whether that was real or just a fluke is unknown. Only way to tell would be for me to drink two light beers every night before dinner for a week and see if that moves the average. But I don't like beer that much, so I'll just live with that little mystery.

Guest · Post by **Guest** » Wed Dec 12, 2012 3:07 pm

Slartybartfast wrote:Yes, but one point does not a trend make. Give it some time. I had dinner out with a troubled friend a few nights ago and drank two light beers before dinner and my AHI was 1.7 that night, up from my usual which is < 0.5. Whether that was real or just a fluke is unknown. Only way to tell would be for me to drink two light beers every night before dinner for a week and see if that moves the average. But I don't like beer that much, so I'll just live with that little mystery.

True, True, Sometimes it's too easy to get all wrapped up in the numbers so soon. I will give it a good week or two at this constant pressure to monitor and evaluate things better.

Slartybartfast · Post by **Slartybartfast** » Wed Dec 12, 2012 3:43 pm

Don't be influenced by the bias on this forum for APAP in preference to CPAP. My sleep doc says CPAP is still the gold standard. Whatever works.

lazer · Post by **lazer** » Thu Dec 13, 2012 8:39 am

Slartybartfast wrote:Don't be influenced by the bias on this forum for APAP in preference to CPAP. My sleep doc says CPAP is still the gold standard. Whatever works.

More sporadic centrals made up the night again last night. But I will continue on with the experiment of straight pressure set at 9cm. Overall RDI was 1'ish something. Feel so so rested. Not good, not bad.

Probably more to do with stress lately so hard to gauge by the the data.

lazer · Post by **lazer** » Fri Dec 14, 2012 7:51 am

Went to bed a bit early last night. Depression was setting in.

And so I guess my Centrals and "Flow Limitations" pretty much set in AND lined up throughout the night...

Any way to understand that?

PS: Yea a 12 hour in bed night and feels more like 6...

Pugsy · Post by **Pugsy** » Fri Dec 14, 2012 8:00 am

If you zoom in on those "centrals" what do they look like? Are any of them preceded by a gulp of air?
I am thinking out loud...wondering if the Flow limitation caused a little mini arousal and maybe a little "mini" semi awake central.

lazer · Post by **lazer** » Fri Dec 14, 2012 8:04 am

Pugsy wrote:If you zoom in on those "centrals" what do they look like? Are any of them preceded by a gulp of air?
I am thinking out loud...wondering if the Flow limitation caused a little mini arousal and maybe a little "mini" semi awake central.

Here's one.. Would that be that jump in the flow rate just prior to the event and if so, does this indicate anything?

Pugsy · Post by **Pugsy** » Fri Dec 14, 2012 8:18 am

Yeah, that jump in flow rate just prior to the reduction...sort of a big gulp of air but the FL came after it so there goes that theory of mine. I was hoping they were before. Are all your centrals followed by the FL? If so I have no idea what it means. I am not very good at analyzing the flow beyond very simple stuff.

Refresh my memory....what meds are you on now? I remember the Ambien but forget the others.

lazer · Post by **lazer** » Fri Dec 14, 2012 8:37 am

Pugsy wrote:Yeah, that jump in flow rate just prior to the reduction...sort of a big gulp of air but the FL came after it so there goes that theory of mine. I was hoping they were before. Are all your centrals followed by the FL? If so I have no idea what it means. I am not very good at analyzing the flow beyond very simple stuff.

Refresh my memory....what meds are you on now? I remember the Ambien but forget the others.

Actually I've been off the Ambien for about 5 days now (ran out) Have a script to replace it and get re-started but haven't filled it yet. So I have replaced it for now with the supplement 5-HTP 100mg at night.

My others are:

Gapapentin 300mg 3x daily
Clonazepam .5mg 3x daily
Risperidone 1mg 2x daily
Escitalopram 20mg 1x
Atorvastatin 20mg 1x

----

Others OTC:

Vitamin D-3 1,000IU 2x
Aspirin 81mg 1x
Vitamin C 500mg 1x
Niacin 500mg 1x
Cranberry 4200mg 1x
MultiVitamin - MultiVites Gummy w/ D 1x

Pugsy · Post by **Pugsy** » Fri Dec 14, 2012 8:54 am

I have to leave the house for the day. I will try to do some research this evening when I get back on any possible side effects on sleep with the meds you listed.
No time now...I am late already but you might start looking deep in the side effects for each one of them.
Anything that might translate into poor sleep....or messing with sleep architecture along with daytime feelings like drowsiness, fatigue, etc.

lazer · Post by **lazer** » Mon Dec 17, 2012 11:43 am

Pugsy wrote:I have to leave the house for the day. I will try to do some research this evening when I get back on any possible side effects on sleep with the meds you listed.
No time now...I am late already but you might start looking deep in the side effects for each one of them.
Anything that might translate into poor sleep....or messing with sleep architecture along with daytime feelings like drowsiness, fatigue, etc.

The side effects I see listed seem to vary. Seems my best course would be to diminish as much of my meds in the long term as possible, I dunno?

lazer · Post by **lazer** » Tue Dec 18, 2012 7:57 am

Another Cluster last night. This time not "Centrals" but rather:

I'm thinking straight 9cm might not be the best possibility for me and since we are pretty much convinced my centrals aren't pressure induced, what about taking the APAP top limit back up to like 12 or 15 and leaving the bottom on 9?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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