Newbe with Complex Apnea

Regarding PB/CSR....see my thoughts in this thread so I don't have to type them all over again.
Particularly the rather general loose definition that Respironics uses to flag PB I copied below. Not all PB is CSR.
viewtopic/t88773/Periodic-Breathing-Wel ... pment.html
Now with your history of centrals your PB very well could look like CSR. We would expect it actually. You are already on the machine that would be prescribed if this was what was indeed going on.

This should improve as time goes on and your body relearns how to breathe to avoid this from happening. This is where time becomes a major factor. Often it takes weeks and months for changes in breathing to occur so that the centrals don't rear their ugly head so much. When using the ASV machine people tend to expect overnight rather quick results (like they might see from a cpap user's report with a minor change) but it doesn't always work that way. That's why dial a wingin based on last night's results (and doing it every day) is not the usual suggested way to go about ASV treatment. It's not nearly as easy with ASV machine to see any desired results with a change in the settings as it is with our other machines that treat mainly OSA. ASV use is where it is especially important that a person give it time and avoid daily dial a wingin.

This is the rather simplicity definition of PB. Not all PB is Cheyenne Stokes Respiration. CSR is fairly commonly seen with Complex Sleep Apnea though. SleepyHead's author elected to stick CSR as the flag name for the PB that the PR S1 machines gathers and flags. It's not always CSR but even if it is...the ASV machine is the desired treatment modality.

As with any one concerned with PB or CSR (real or not)...if it is a great concern this is something that a person needs to discuss with their doctor if it worries them no matter how much or how little is seen.

PB

Periodic Breathing is a Respironics data feature defined as a persistent waning and waxing breathing pattrn which repeats itself between 30 and 100 seconds. The nadir of the breathing pattern is characterized by at least a 40% reduction in airflow from an established baseline flow. The pattern must be present for several minutes before it can be identified as periodic breathing. No therapy adjustments are made in response to periodic breathing.

Also, please remember that I've been harping that it can take a couple MONTHS before you see full success. Why? It takes time to train our unconscious bodies. Changes in your activity, stress, you name it ... ALL can contribute to changes during your sleep. So, if you see change in one night, don't tweak .. Wait a few nights before you decide to change anything.

Current settings are:

Min EPAP: 6.5
Max EPAP: 15.0
Min Pressure Support: 0.0
Max Pressure Support: 10.0
Max Pressure: 18.0
Flex Setting: 2
Backup Rate: Auto

As I was unable to have a good talk with my Doc:

In fact at one point he said if I was not going to do as he tells me to do I can find another Doctor…

When he saw I was not falling apart and crying "forgive me please" he then tried to convince me he was right and I loved this one."You cannot come in here with one night's results and say you settings are better… "

Funny as he prescribed from one nights study and from one 18 minute run at the pressures he prescribed, where I had 6 + hours of data. And I had 6 days of data clearly showing a lower EPAP pressure caused a lower CA events.

As well as all the other events. AND my CA were of much short duration to boot. As were the others.

We left things at: I am to not change anything for 60 days and see him then....???

Well that was for only two nights, things fell apart last night:

AHIApnea / Hypopnea Index 53.54
HypopneaHypopnea 10.01
ObstructiveObstructive Apnea 3.88
Clear AirwayClear Airway Apnea 39.64
RERAResp. Effort Related Arousal 0.00
Flow LimitFlow Limitation 0.00
VSnoreVibratory Snore 14.51
PB/CSRPeriodic Breathing 10.10%

So unless you see something really wrong or bad for me I plan on leaving the settings alone for at lease a week.

Rich

I would keep things "as is" for a bit. But if you continue to have lots of central apneas, I might consider dropping the EPAPmax down to 12 or so. Also, I see that you have PSmin set to 0.0 .. thus it acts as a CPAP more than a BiPAP. You might find it easier if you have PSmin set to at least 3.0. This will make your inspiratory breath a little easier and might not trigger the central apneas. But again, I would wait another few days before tinkering with anything.

Sorry got a answer...

Rich