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bphillus
Unread post  Post subject: Question about central events vs tidal volume & minute vent.  |  Posted: Mon Mar 08, 2021 2:32 pm

Joined: Sat Mar 06, 2021 1:55 pm
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PAP Mask: resmed N20 nasal medium
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Pressure Setting: 6.6 fixed

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I'm trying to classify these central apneas I'm seeing on my report and I see a relationship to increased minute ventilation & tidal volume prior to a central apnea, and a change in the flow (1st 2 screenshots). Are these real central events? Is an increase in minute ventilation / tidal volume prior to a central an indication of a 'false' central? This seems different than the 3rd screenshot, which appears to be a 'real' central event (no change or minimal decrease in MV & TV prior to an apnea).

I have a number of what I think are false centrals on my report and I'm trying to classify these to get a real AHI vs what the software is saying.

Thanks,


Attachments:
File comment: Real CA?
ca_3.jpg
ca_3.jpg [ 157.62 KiB | Viewed 1482 times ]
File comment: Fake CA 2?
ca_2.jpg
ca_2.jpg [ 140.07 KiB | Viewed 1482 times ]
File comment: Fake CA 1?
ca_1.jpg
ca_1.jpg [ 149.17 KiB | Viewed 1482 times ]
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DeltaBravo3.8
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Mon Mar 08, 2021 3:57 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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Welcome to the forum.

What's the regular Daily OSCAR look like? I would like to put it in context with the whole session. Were centrals an issue on the sleep study? Any medications to note? It would help define these CA, because I know of 3 types of Central. I have pre-existing CA that showed on my diagnostic study. If you've been on PAP for a while, treatment emergent CA aren't likely to be it. There's idiopathic CA meaning unknown cause.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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bphillus
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Tue Mar 09, 2021 5:50 am

Joined: Sat Mar 06, 2021 1:55 pm
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PAP Mask: resmed N20 nasal medium
PAP Machine: ResMed AirSense 10 AutoSet APAP
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Pressure Setting: 6.6 fixed

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I had centrals on my original sleep study, 6 obstructive, 10 mixed, and 38 central, and a lot of hypopneas. Medications are just Prilosec OTC but I was taking a supplement called Kratom that I've since quit and not taken for 2 weeks.

I started CPAP therapy on Feb 22.

Here is a screenshot of the full night, is that good or is there some way to send the full report?


Attachments:
full_night.jpg
full_night.jpg [ 683.23 KiB | Viewed 1449 times ]
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DeltaBravo3.8
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Tue Mar 09, 2021 11:42 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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OK thanks that helps clarify especially the sleep study info. Sorry for all the questions but just a few more. You're in the USA? Had your doctor discussed treating centrals? Or does doc want to "avoidance treat" with CPAP? Avoidance treat is attempting to treat CA by avoidance of possible causes like low pressure swings on CPAP like you have going on now. It's importance on US or not because of how Apnea is handled. It's a bit tricky for me to advise others from other countries. If your doc isn't considering CA treatment then you need a better doc.

Your pre-existing or predominant CA are not being treated as is on the CPAP. If you're in the US, I'll say you need to get an appointment or call in to the doc that scripted the CPAP. Tell him or her that you still have CA, that you're not well rested and are in bed of a ResMed AirCurve 10 ASV. That is is you're not well rested of course. But note that you'll have CA scattered in OSCAR charts continual until an ASV is used.

This latest post helps me to believe those first OSCAR events from post 1 are maybe all real CA. It's difficult to be certain, but with the report showing mostly CA and some mixed and a bit of Obstructive, then still your real treatment is with ASV.

Bottom line ask doc "are we going to consider treating my predominant centrals with ASV or not?" If no fire the doc and get another one.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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bphillus
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Tue Mar 09, 2021 1:19 pm

Joined: Sat Mar 06, 2021 1:55 pm
Posts: 4
PAP Mask: resmed N20 nasal medium
PAP Machine: ResMed AirSense 10 AutoSet APAP
Humidifier: Resmed HumidAir Heated Humidifier
Pressure Setting: 6.6 fixed

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Thanks, yes I'm in the US. I have a follow-up with the sleep medicine people. I have not discussed centrals with a dr. They didn't even mention it at all during my sleep study or titration just diagnosed me with severe OSA and wrote a script for APAP.


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DeltaBravo3.8
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Tue Mar 09, 2021 4:22 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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Ah yes OK that tells me they can't or won't see them. I'd suppose you should note down symptoms and complaints including elevated CA, not treated symptoms and etc. Call them about it and quiz them if they're going to address it. Any negative answers, then shop for a real doctor that can see them. If it does go that way, quiz new doc if they actually treat CA with ASV or not.

PS assuming it's applicable complain long and loud on the untreated CA. But quite serious you'll not be treated until you get ASV. Plain BPAP will be very very bad. I was there myself once and within a week I told my doc it needed to change ASAP.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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bphillus
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Tue Mar 09, 2021 6:53 pm

Joined: Sat Mar 06, 2021 1:55 pm
Posts: 4
PAP Mask: resmed N20 nasal medium
PAP Machine: ResMed AirSense 10 AutoSet APAP
Humidifier: Resmed HumidAir Heated Humidifier
Pressure Setting: 6.6 fixed

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Thank you! Glad to hear i'm not the only one going through this.


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DeltaBravo3.8
Unread post  Post subject: Re: Question about central events vs tidal volume & minute v  |  Posted: Tue Mar 09, 2021 8:14 pm
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

Offline
Glad to help. FWIW I've actually graduated from ASV due to my COPD/asthmatic issues. Not due to ASV issues just that my breathing needs time sync help that my ASV can't do.

Keep us updated ok.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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