Centrals and obstructive apneas in the same night — how to adjust pressure?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Selenium1%

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by Selenium1% » Fri May 25, 2018 7:59 pm

Great advice from palerider. I also have had some success with Mg. You are on the right track to good sleep. This forum is a good place to be for sound advice.

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TASmart
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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by TASmart » Fri May 25, 2018 8:07 pm

Another thought - there is quite a range of needed sleep amounts. Numbers I recall seeing is from 6-9 hours as generally the range, but there are also outliers. I seem o need 6 1/2 to 7, and if I sleep more than 7 I see a lot of transitional crap, as I am drifting in and out of sleep. What happens if you sleep say 10 hours for a week, or try 7 hours for a week and see how you feel?

The real issue is your SA appears to be well treated. Have you asked your Dr about UARS? That can cause some sleep disturbances that do not show up in the AHI spectrum. Also, If you continue to feel crappy, a lab test to look at how many disturbances you are having and relating them to movements or breathing abnormalities may be called for.
All posts reflect my own opinion based on my experience and reading.
Your mileage may vary
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nikkwong
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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by nikkwong » Fri May 25, 2018 8:17 pm

palerider wrote:
Fri May 25, 2018 7:49 pm
nikkwong wrote:
Fri May 25, 2018 2:06 pm
Hi, last night I had a bunch of obstructives, followed by a central which woke me up.

What would you guys do in such a situation? I am trying to adjust my pressure to improve my therapy, but not sure what to do now. I always seem to wake up at the 4-5 hour mark after a large apnea. Wisdom would tell me that centrals mean my pressure is too high, but higher pressure would more likely quell the obstructives.
I'd do nothing, actually, I might lower your min pressure a little, sneak it down a cm per week till something happens and you're not flatlined on pressure all night long. A bit less pressure might result in more restful sleep.... or it might not, but it's worth considering.

As to the central, it's *highly* unlikely that it woke you up, centrals aren't violent, centrals aren't disturbing... you just pause your breathing for a bit... it's much more likely that you were waking up, and during that process, you had a transitional central... they're fairly common when transitioning from awake breathing to asleep breathing, and back.... and absolutely nothing to be worried about. In fact, if it happened during a sleep test, they wouldn't count it.

Also, "wisdom" would be wrong, only about 1 in 7 people have centrals that are exacerbated by more pressure.... are you one of them? probably not, looking at your chart above.

Recently, there's been talk on the forum about magnesium helping with sleep, and a lot of people don't get enough in their diet. You need to get one that has high bioavailability... Magnesium glycinate is one of the better, plus someone unearthed something recently that said that glycinate also helps with sleep.. (you can search the forum for more info)... so magnesium glycinate is a double shot. It seems to be helping me sleep less restlessly, but maybe that's just the placebo effect... but I pop 400mg before crawling into bed.
Thank you! I've been ramping the pressure up slowly from 11 to now 14, when 11 wasn't giving me good relief. Maybe I will try lowering it again and seeing what happens. You don't think the pressure may be too low, could it be? Looking at the chart, i spent 1 minute in apnea last night. Is it possible that this is the cause of my sleepiness and that by increasing the pressure I can decrease the time in apnea and then feel better?

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by Julie » Fri May 25, 2018 8:23 pm

1 min. all night? That couldn't possibly affect anything... look elsewhere for answers.

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palerider
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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by palerider » Fri May 25, 2018 8:33 pm

nikkwong wrote:
Fri May 25, 2018 8:17 pm
Thank you! I've been ramping the pressure up slowly from 11 to now 14, when 11 wasn't giving me good relief. Maybe I will try lowering it again and seeing what happens. You don't think the pressure may be too low, could it be? Looking at the chart, i spent 1 minute in apnea last night. Is it possible that this is the cause of my sleepiness and that by increasing the pressure I can decrease the time in apnea and then feel better?
It's possible... but not something I'd hazard a guess about without examining the data closer, looking at breath shapes, etc.

You could zip up your sd card and upload it to here: https://www.dropbox.com/request/0LalWvEsijRIgX8sdM7H if you want... or, you can try higher pressure, if you're dealing well with it (not being bothered by leaks, no bloating, etc.

You're not having any real events of any sort, or your pressure wouldn't be so flat all night.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by nikkwong » Fri May 25, 2018 11:08 pm

palerider wrote:
Fri May 25, 2018 8:33 pm
nikkwong wrote:
Fri May 25, 2018 8:17 pm
Thank you! I've been ramping the pressure up slowly from 11 to now 14, when 11 wasn't giving me good relief. Maybe I will try lowering it again and seeing what happens. You don't think the pressure may be too low, could it be? Looking at the chart, i spent 1 minute in apnea last night. Is it possible that this is the cause of my sleepiness and that by increasing the pressure I can decrease the time in apnea and then feel better?
It's possible... but not something I'd hazard a guess about without examining the data closer, looking at breath shapes, etc.

You could zip up your sd card and upload it to here: https://www.dropbox.com/request/0LalWvEsijRIgX8sdM7H if you want... or, you can try higher pressure, if you're dealing well with it (not being bothered by leaks, no bloating, etc.

You're not having any real events of any sort, or your pressure wouldn't be so flat all night.
I uploaded it! Thanks so much.. not sure where else to look. Hope this works.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by palerider » Sat May 26, 2018 2:14 am

nikkwong wrote:
Fri May 25, 2018 11:08 pm
I uploaded it! Thanks so much.. not sure where else to look. Hope this works.
The file that was uploaded wasn't the full contents of the SD card...just one of the directories on it. SH needs all the files.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by nikkwong » Sat May 26, 2018 3:12 am

palerider wrote:
Sat May 26, 2018 2:14 am
nikkwong wrote:
Fri May 25, 2018 11:08 pm
I uploaded it! Thanks so much.. not sure where else to look. Hope this works.
The file that was uploaded wasn't the full contents of the SD card...just one of the directories on it. SH needs all the files.
Fixed it, sorry!

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by D.H. » Sat May 26, 2018 10:55 am

So the problem in a nutshell is that the report says that you're doing great, but you still feel lousy. Is that correct?

If it is, you should seek additional medical help for potential other medical issues.

One other thing. If you're taking medication for your blood pressure, your blood sugar, or some other conditions, the medications may be working too well (i.e your blood pressure or blood sugar may be too low). You should not reduce the medication without speaking to a doctor.

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palerider
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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by palerider » Sat May 26, 2018 12:49 pm

. wrote:
Sat May 26, 2018 10:55 am
So the problem in a nutshell is that the report says that you're doing great, but you still feel lousy. Is that correct?

If it is, you should seek additional medical help for potential other medical issues.

One other thing. If you're taking medication for your blood pressure, your blood sugar, of some other conditions, the medications may be working too well (i.e your blood pressure or blood sugar may be too low). You should not reduce the medication without speaking to a doctor.
The first thing to do is ignore all posts from this person. They actually have almost zero knowledge.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by palerider » Sat May 26, 2018 12:53 pm

nikkwong wrote:
Sat May 26, 2018 3:12 am
palerider wrote:
Sat May 26, 2018 2:14 am
nikkwong wrote:
Fri May 25, 2018 11:08 pm
I uploaded it! Thanks so much.. not sure where else to look. Hope this works.
The file that was uploaded wasn't the full contents of the SD card...just one of the directories on it. SH needs all the files.
Fixed it, sorry!
The only thing that I see in the report is a little flow limitation, which shows up in the report... but if you zoom all the way in and look at the breath shapes, they're often a bit ragged... not badly, but it might be enough to increase your breathing effort, and reduce your restfulness.

Trying a higher min pressure may help... how much? that's something you'll have to experiment with.

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Selenium1%

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by Selenium1% » Sat May 26, 2018 4:56 pm

I respect pale riders expertise. He is one of the most knowledgeable forum members. Follow his advice. DH, however, should not be summarily dismissed. His present post is common sense and offers some benefit. Thanks to both pale rider and DH.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by kiteboy » Sun May 27, 2018 6:24 am

I know when I was tested I couldn't sleep so my MD prescribed a mild sleeping pill. That knocked me out and made me tired all the next day. I never took another sleeping pill but may take an over the counter allergy pill that just helps those issues. If I had to take sleeping pills I would have symptoms as you describe. Good luck with finding your sleeping pill or actual problem. Your on the right track with posting to this forum.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by palerider » Sun May 27, 2018 1:35 pm

Selenium1% wrote:
Sat May 26, 2018 4:56 pm
DH, however, should not be summarily dismissed. His present post is common sense and offers some benefit.
DH *SHOULD* be summarily dismissed.

He's like a broken clock... yes, he *IS* right, twice a day, but he's often wrong, sometimes dangerously so.

Without the knowledge (which newbies don't have) to know when he's spouting garbage and when he occasionally has a brain fart and says something worthwhile, his ramblings are dangerous and misleading.

Nobody is perfect, but he's the opposite of perfect, he's read some things, and has some snippets, but he has no clue how they fit together, he has no concept of 'the big picture', he consistently tries to apply the wrong answer to any particular issue. He's the kid in kindergarten that spent his days trying to put the square peg in the round hole.

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Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Post by nikkwong » Sun May 27, 2018 7:50 pm

Hi. Thank you for the advice! My blood pressure is fine BTW. :)

Any idea as to why the breath shapes might be ragged? I tried a lower setting of 12 for the CPAP last night (as opposed to 14), and feel kind of eh. My apneas are relatively short (10s each), and low in frequency, so maybe by investigating why my breathing isn't consistent can help me better configure the machine. These look like RERAs to me, which could describe why I feel unrested? How can RERAs be treated? Thank you!

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