Sleepyhead results

zonker · Post by **zonker** » Tue May 21, 2019 10:45 am

dojiscalper wrote: ↑
Tue May 21, 2019 6:03 am
Your support network of doctors don't realize that this isn't like a prescription for a pill. It's like a prescription for an exercise program. It will take time and even a lot of time to get used to it and get the settings and gear right. Once you get it all working and comfortable you'll never want to sleep without it.

It took me nearly a year but I'm very sensitive to anything bugging me.

THIS-Hands.jpg

oh so PERFECTLY said! and i hope i remember this post down the line.

it took me a very long time as well. and it was just as you stated.

now that i'm treated, i'll never willingly sleep without it.

Huskers123 · Post by **Huskers123** » Tue May 21, 2019 10:58 am

This should be better. I think I am just paranoid that I have central sleep apnea rather than obstructive and that I am treat it incorrectly. The sleep study I did in home stated obstructive and not central. Sleepyhead has not reported really any OSA. Is this possibly due to the machine actually working? And maybe the centrals are just me struggling to sleep with the mask on? Not sure how accurate those in home studies are.I am assuming that I just need more time with the machine but it has been rough so far. Thank you again for helping to put my mind at ease.

Pugsy · Post by **Pugsy** » Tue May 21, 2019 11:52 am

Huskers123 wrote: ↑
Tue May 21, 2019 10:58 am
Sleepyhead has not reported really any OSA. Is this possibly due to the machine actually working?

Yes, the machine is doing its job. We don't know how many obstructive events it has prevented. All it shows is what it doesn't prevent.

Some of your centrals appear real and some are obviously related to arousal breathing.
I can't tell by looking at just these snippets what ration of awake vs asleep we are looking at here but it does appear that when you turned EPR off (which effectively increases the overall pressure average) that the centrals increased in number.
So apparently your centrals aren't related to EPR being the trigger.
If you do have some treatment emergent centrals happening...they might go away with time and they might not.

Since you are so new to therapy and probably not sleeping soundly I would bank on some of those flagged events not being real.
Need you to be able to report you slept soundly for the most part first so that we can better judge the validity of the centrals.

Which way is more comfortable...with EPR or without EPR?
I think I would reduce the pressure just to see if the centrals reduce or not and not let too many obstructives happen.
This would help you figure out if the centrals that are real are related to pressure being the cause or if maybe they are just a normal random central that doesn't mean anything to have.
Right now obviously more than we want to see and we really can't do much about them with this machine anyway except try different things to see if they reduce or not.

If it were me I would use EPR if I liked it and I thought it let me sleep better.
The main goal right now is good solid sleep so the data that is there can more accurately be evaluated.
And I would reduce the pressure also...don't do 2 changes at one time though. If you do that and there is a dramatic difference in something you won't know what change might have been the major factor.

So either add back in EPR if you like it or just drop the minimum pressure a couple of cm and keep EPR off...and see what happens both in terms of the AHI AND how you sleep. Sleep quality is critical. If you spend half the night awake then the data shown no matter what it is will be very misleading.

Huskers123 · Post by **Huskers123** » Tue May 21, 2019 6:37 pm

Thank you again for looking at these. So im assuming it is possible that this will all go away after time with cpap use?

Pugsy · Post by **Pugsy** » Tue May 21, 2019 6:45 pm

It is possible for real asleep centrals to go away with a bit of time as the person's body gets used to cpap therapy and no longer responds with the imbalance in exchange of gases.
So it is possible but not a guarantee and what a doctor might want to do about it will depend on just how many, if it is impacting oxygen levels or if a person can't sleep well because of them.

Something to have a chat with when you see your doctor for your follow up appointment.
There us no need for panic though. If you do end up with more than acceptable number of centrals or they are causing a problem it is easily dealt with....but there is a chance it can go away on its own.

What you need to do is learn to distinguish asleep from arousal/awake and work on sleeping more soundly and fixing whatever is causing you to wake often. So while you are "giving it time" hurts nothing to do your homework.

Huskers123 · Post by **Huskers123** » Wed May 22, 2019 12:42 pm

Once again, thank you for all of your help. I spoke with my doctor today and he stated that he is going to check my sleep study results again this afternoon but that he did not see any CSA in my results. Just OSA. So I am assuiming that i just need to keep toughing it out and possibly try new settings. I added EPR at level 1 last night and my results are still the same. AHI of 11 clear airway events. Any other ideas for me to try? Should I lower or raise my minimum pressure? I am just very confused because I feel great with the mask on when I go to bed. I just feel like I am not getting quality sleep at all. Thank you

Pugsy · Post by **Pugsy** » Wed May 22, 2019 6:15 pm

Your doctor needs to be looking at the software reports generated by your machine because that is what is going on now with cpap.
The sleep study without cpap isn't the same thing. There are people who end up having centrals pop up just because of cpap pressure and they didn't have any centrals during the sleep study. Just because you may not have had any centrals to speak of during the diagnostic study doesn't mean you can't be having some now.
I seriously doubt that reducing the pressure will reduce the centrals...I have seen people get a truckload of centrals just from 5 cm fixed pressure all night. It doesn't necessarily mean the pressure is too high like people tend to think.

Huskers123 · Post by **Huskers123** » Wed May 22, 2019 6:41 pm

So what are you recommending I do? My doctor said he is going to pull my sleep study again. He wants me to give it another week and he will then look at the data from my machine. But until then I need to be trying something new. Is it possible that I am still just getting used to the machine and that these centrals are false? Thanks

Pugsy · Post by **Pugsy** » Wed May 22, 2019 7:16 pm

There's no amount of tweaking your machine likely to help reduce the centrals.

You have some centrals that aren't real...you weren't asleep when they got a flag but some are real and you were asleep.
It's impossible to know exactly what the ratio is unless someone goes through and manually evaluates each flagged central and keeps a score card to figure out just how much of the Central Index pertains to real asleep centrals. The awake centrals simply have to be ignored.

The best thing you can do, and I know it is easier said than done, is do whatever you can to make it so you don't have many awakenings so you have less chance of having awake/arousal centrals muddying up the evaluation process. You need to sleep more soundly and that's hard to do when just starting cpap. It took me about 3 months for my brain to quit waking me up just to tell me there was an alien plastered on my face blowing air up my nose. The first month...easily had 20 to 30 of those awakenings...no discomfort or problems...just the brain not knowing if it liked that alien or not.

Even if a sizable chunk of the Central Index is real....sometimes with a bit of time those centrals will go away just with time as your body gets used to cpap therapy. Doesn't surprise me one bit that he said give it a week...wouldn't surprise me if he said give it a month.
So there is a chance they will reduce on their own...so doctors and insurance companies will opt for easy and cheap approach first because sometimes it does work.

If 75% of your centrals are SWJ arousal/awake false positives....that doesn't leave enough centrals being real to be a problem or need anything to be done about them.
Now if it was the other way around...they still will want to "give it time" first before they start looking at a different machine.
Lots of hurdles to jump to get the high dollar machine that will breathe for you when you have a central apnea and don't breathe on your own.

Huskers123 · Post by **Huskers123** » Sat May 25, 2019 3:15 pm

I will have some more results to post come Tuesday. Thanks again to everyone that has chimed in with advice. Keeping me positive throughout this whole deal.

Huskers123 · Post by **Huskers123** » Thu May 30, 2019 9:02 am

UPDATE:

Once again, I appreciate all of your help. I don't know what I would do without this forum.The last week or so has been interesting. It seems to me that my OSA can be eliminated with pressure as low as 6. I have been trying to get a full night with the mask on but the last two I have taken it off in the night unknowingly. Is it possible that low of pressure is enough to get rid of my OSA? The centrals are definitely lower with low pressure but I am not sure how accurate those are because I may not even be reaching deep sleep with the small sample size I have attached. Can you tell what exactly has made me take the mask off these last two night? Possibly a leak? Or maybe an event of some sort? It looks to me like my flow looks a bit better with EPR 1 that I added last night. Before I had the EPR off. I obviously need to try to log more full nights with the machine but I have been struggling and not feeling the greatest. Let me know if you have any questions and thank you so much for the help.

Huskers123 · Post by **Huskers123** » Thu May 30, 2019 9:04 am

Centrals or just SWJ?

Jas_williams · Post by **Jas_williams** » Thu May 30, 2019 1:48 pm

Huskers123 wrote: ↑
Thu May 30, 2019 9:04 am
Centrals or just SWJ?

Looks like a short period of periodic breathing not enough to worry about even if all genuine. Ignore and move on

Huskers123 · Post by **Huskers123** » Thu May 30, 2019 5:17 pm

Thank you for the reply. I am just surprised that it seems such a low pressure is able to handle my OSA. Makes me wonder when my doctor said my sleep study showed 156 OSA events and around 15 centrals throughout my night.

palerider · Post by **palerider** » Thu May 30, 2019 5:34 pm

Huskers123 wrote: ↑
Thu May 30, 2019 9:04 am
Centrals or just SWJ?

I'd call it swj, since it started after a breathing disturbance.... then you were moving around, or something, most likely.

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