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PatOnCPAP
Unread post  Post subject: Are these really Centrals?  |  Posted: Tue May 07, 2019 6:35 am

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Hi Everyone,

I'm reading through all the info and links that Pugsy posted when starting CPAP (thanks Pugsy), and trying to understand how to read proper Centrals on the Oscar software. My data each morning is filled with recorded Centrals that always seem to start around the 3am mark. They are truely killing my restorative sleep at the moment. The OSAs are under wraps thanks to my machine.

Before I get into all the pressure settings etc, firstly are these proper CA's? I've watched a ton of Jason's videos and I remember on one of them he said that if there is a "noise" before the recorded CA then its not a real CA. If its not, what the heck is this that keeps waking me up like this? I'd really appreciate some help. Thanks.

Attachment:
CA's.jpg
CA's.jpg [ 162.32 KiB | Viewed 612 times ]


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Pugsy
Unread post  Post subject: Re: Are these really Centrals?  |  Posted: Tue May 07, 2019 8:17 am
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Those all look like awake or arousal related centrals to me...not asleep.
I think that whatever is causing the arousal in the first place is wrecking your sleep and the centrals flagged are nothing more than a symptom or byproduct of whatever is causing the arousal in the first place.

As to what is waking you up....no way to know for sure.
Might be nothing more than a normal wake up that occurs after a REM stage cycle is completed.
Might be something externally...pain, dog, cat, noise, medication side effects, medication wearing off (I get them when the pain meds wear off).

3 AM mark...that's about the time we tend to normally have more REM...comes on more frequently and lasts longer in those wee hours of the morning.

Not easy to figure out for sure and that makes it harder to fix because we don't know what is the cause of the problem. Can't fix a problem until you identify it.


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Pugsy
Unread post  Post subject: Re: Are these really Centrals?  |  Posted: Tue May 07, 2019 8:23 am
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PAP Mask: Bleep/DreamPort nasal mask
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I don't have a good example of a real asleep central handy but I will look for one.
I did find this handy....you can see the obvious asleep breathing and then the mess of flagged events some central and some obstructive and none of them are real asleep flagged events.

Image

Now here below is probably real asleep flagged OAs...no "noise" or irregular breathing right before the flags. A "real asleep" central will look the pretty much the same but have the central flag.

Image


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PatOnCPAP
Unread post  Post subject: Re: Are these really Centrals?  |  Posted: Tue May 07, 2019 9:22 am

Joined: Sat May 04, 2019 3:35 am
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PAP Mask: Fischer & Paykal
PAP Machine: Resmed Autosense 10
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Thanks so much Pugsy. This is a great help!

So now the 2nd sleep study I had done (polysom instead of the home study) said that I have UARS and snoring, and that I should see an ENT. So this could quite possibly be arousals from UARS then, although they should be showing throughout the night then I would think. Or from as you mentioned, meds wearing off etc. When I was recording my sleep a while back on the Snorelab app I remember hearing a sort of very light snort before each awakening.

I've since seen 2 ENT's here in my country and they both stared blankly when I mentioned UARS. So hence why I thought it wasnt something to be pursuing and that they were CA's that needed treating.


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Pugsy
Unread post  Post subject: Re: Are these really Centrals?  |  Posted: Tue May 07, 2019 3:31 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1247
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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You know if it is an arousal related to UARS....it wouldn't be impossible for it to be worse simply from the usual stuff that can make OSA worse....REM sleep or supine sleeping or maybe a combination of both happened.

More minimum pressure would be the plan of attack to try if you want to try something if that is what you might be thinking is going on....that your problem might be more UARS and not so much OSA.

Wouldn't hurt to try more pressure just to see.
People with UARS often need more pressure than what might be thought to be needed based on what is seen on the data from the machines.
You can't let the machine auto adjust for UARS stuff because the auto adjusting algorithm wasn't designed for those very minor differences in air flow that make up UARS. The machine won't do much on its own because it wasn't designed to fight UARS stuff.
So we force it with more minimum pressure or if using a fixed pressure...more fixed pressure.


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PatOnCPAP
Unread post  Post subject: Re: Are these really Centrals?  |  Posted: Thu May 16, 2019 5:53 am

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Thanks again Pugsy!


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