central apnea

[jefe2018]

You folks have been extremely helpful in the past. I've been on the CPAP for 4 months, and it is feeling normal now.

I'm using the ResMed Airsense 10 with dreamwear nose piece. I had a lot of problems earlier with gulping air and bad stomach aches, so with your help, dialed my ramp up, low pressure up, high pressure down, and turned my EPR on. I'm currently running 6 on the ramp-up and 8.4/10.4 (low/high). My 30-day AHI is about 1.7, although in the last week I've had a some AHI scores between 2.0 and 2.6. I'm not sure why, but hope it calms down again, as I haven't changed any variables on my end.

My clear airway events, or centrals, are running over half of my events. I can see that the machine doesn't respond to these, as I think it tries a test blast to see if it can eliminate the event, and then backs off if it senses no blockage in the airway. I know I'm choking off some therapy with my high setting at 10.4, but I also know I can't function at the higher pressure levels, as I end up with stomach aches that take hours to relieve in the morning. Basically, if I run high-10's or over 11, I'm in trouble. It seems like I have found a good balance of a decent AHI, without discomfort, and I'm feeling pretty restful during the day; don't have to take naps like I used to.

Is there anything else I should be doing to try to nudge the centrals down, or do I seem to be finding a good balance with everything?

Thanks!

[LSAT]

Leave everything alone...you are doing fine

[ajack]

I think less than 1CA an hour isn't an issue, if they are under 30sec in length. I think you are doing well. You could turn down the EPR,as that often helps CA. Without seeing the chart, you could bump the min up to 9.4 and see if it clears any oa/h

[Pugsy]

Reducing EPR or turning it off won't likely help reduce the centrals unless EPR was causing the centrals in the first place but it will increase the overall pressure a bit and that might make the aerophagia issues return.
Increasing the minimum will also increase the chance of the aerophagia issues returning.

I wouldn't change anything if it were me.

An occasional central is entirely normal anyway and doesn't necessarily need any sort of addressing. They are only a problem when present in large numbers or disturbing sleep and less than 1 per hour certainly is no where near where we would start worrying about them.
How many before we worry? It depends but most doctors won't worry until a person is seeing an average of 5 per hour...every night for the bulk of the night.

My clear airway events, or centrals, are running over half of my events. I can see that the machine doesn't respond to these, as I think it tries a test blast to see if it can eliminate the event, and then backs off if it senses no blockage in the airway.

There is no test "blast" at all. There is very small FOT used to try to help the machine decide if the apnea event is central or obstructive so that it can then decide what to do. It does NOT ever "blast" anything. It can't increase anything that fast.
These apap machines don't respond to centrals at all..can't.
They do respond to obstructive stuff depending on how many, how frequent and if the other stuff associated with obstructive apneas happens to be present and the response takes over several minutes...not seconds.

FOT used for event identification...barely a blip in the pressure line.

[palerider]

Is there anything else I should be doing to try to nudge the centrals down, or do I seem to be finding a good balance with everything?

Thanks!

The occasional central just means that for some reason, your body didn't feel the need to breath..

At the low level you say you're having, the best thing you can do is ignore them.

[jefe2018]

I think I may have fixated a bit too much on squeezing the AHI down to below 1.0, and that might not be realistic, given my tendency to get aerophagia at certain pressure levels. Some days I wake up to and AHI of .5 and others to 2.4, and I don't know why but probably shouldn't stress it.

This site is awesome. It made the difference between my first month of getting beat up by high pressures with no rest and a couple of months now with 8+ hours of sleep and sub-2 AHI.

You guys are awesome!

[fnlrun]

As long as your AHI is under 5, you'r fine

[palerider]

As long as your AHI is under 5, you'r fine

We're not the medical field, we don't ascribe to the arbitrary (and too high) "under 5 is fine"... an AHI of 5 is *CRAP*. it's like being poked with a sharp stick every 12 minutes all night long.

See how you feel after that.