Sierra

One of the strategies I use is to keep each health issue in isolation from each other. I just look at them one at a time, and only work on the ones that need attention. I have my diabetes (AIC), blood pressure, cholesterol, and now apnea (AHI - 1.8) all in good control. My weight needs some attention though. I put in about 1 hour of cardio six days a week for exercise, so no room there for more. I just need to exercise the pushing away from the meal table muscles a little more! At some point I'm sure I will have to do the hearing aid thing, but I'm holding out on that one for as long as possible.

The only real worries I have about aging is that it is becoming harder to get reasonably priced travel insurance. And I also wonder how I will fare with the technical issues associated with diabetes insulin management, and apnea as my cognitive skills start to slip. Bridges to cross when I get to them. Nothing I can do about it now...

There is a condition known as emergent central sleep apnea that affects about 10% of those undergoing new treatment for apnea with a CPAP. In about 75% of these cases the CSA goes away or is reduced to acceptable levels in about 2 months. In the other 25% it remains a problem. These numbers vary depending on the study, but these ones are in the ball park. So perhaps in 75% of the cases the brain does retrain itself to control breathing better as is suggested in your article. Here is a link to one of the articles on the subject.

Emergent central sleep apnea during CPAP therapy-clinical implications

I was one of the ones in the 25% where emergent CSA did not reduce after 2 months. However after 9 months now, things are starting to get better. Yes, it could be the brain being retrained finally, but I think it is more due to a change on my part to a fixed pressure CPAP mode for machine setup. I think my machine was chasing hypopnea events with more pressure, and the higher pressure was causing central apnea events. The problem with the machine is that it cannot tell the difference between a hypopnea event that is obstructive in nature or central in nature. If it chases central hypopnea with more pressure it just makes things worse. At least that is my theory, and the results I am getting seem to verify it. I was running pressures as high as 15 cm in auto mode, but now I am using a fixed pressure of 11 cm and getting much better results.

Hope that helps some. If you can post more detail on your issues I could give you my thoughts. I find SleepyHead to be invaluable in figuring out what is really going on.

" 36 stops ahi was 36"

I'm not sure what you mean by that phrase? Can you explain more?

Sleeping on your back does tend to cause more apnea, but your machine should report it in the AHI. When you get an AHI of 0 with only 5 cm pressure, it would seem apnea is very mild. I understand from your other comment that the machine was set in auto mode up to 8 cm pressure but it only used 4 to 5 cm pressure? If so a fixed pressure of 5 would seem appropriate.

You can get a lot better idea of what is going on if you copy the data from your SD card with a card reader and use SleepyHead to view it. SleepyHead is a free download that runs on a PC or Mac. Here are some links. I believe it can be set up in your language, but the only manual I know of is in English.

SleepyHead Download

Basic Manual

Central sleep apnea is difficult to deal with, and there is no simple, one size fits all solution. It depends on underlying causes. One of the better articles I have found on the subject is at this site. See link below.

Complex Sleep Apnea

It is not uncommon for someone diagnosed with OSA to develop CSA on treatment. Normally it resolves itself in a few weeks. It did not for me. I think one of the issues is that in auto mode a CPAP can use too much pressure. I have improved my AHI by going to fixed pressure CPAP and by limiting the pressure.

It took me a while to figure it out, but yes I think more pressure that the auto CPAP was using, not me, was causing CSA too. I have moved to fixed pressure CPAP mode with my machine, and my AHI and CSA has come down. For some, the auto mode is not all good.

If it is a nasal pillow type, gently pull the mask away from your nose a bit, with the pressure on. If that improves things, then the mask straps may be too tight.

When you first turn on your AirSense 10 machine the display should show two numbers in the top right corner. They are your minimum and maximum pressures for the auto range. The number you see in the middle of the circle is the current pressure. It will increase to the start pressure. Telling us what those three pressures are would be helpful. Sometimes the start pressure and even the minimum pressure are too low which will make the mask feel uncomfortable or somewhat suffocating. Here is an image of what the screen should look like. This machine is set to a minimum of 12 cm, and maximum of 20 cm. The machine is currently at 4 cm when the shot was taken. However this pressure increases quickly when the machine is first turned on and will stop increasing at the start pressure. The icon on the lower left means the ramp is in the Auto mode (that is preferred). The humidity is in manual at a level 4. Ideally for comfort one would have it in auto and while using the heated ClimateLine hose.

Your mask looks like a DreamWear nasal pillow type. I think it is a pretty good mask. About the only complaints I have heard about it is some noise from those two tubes that go up to the top of your head. I have a friend that uses one and he likes it.

I think it varies by person. It probably took me 5 months before I started to think the benefits of CPAP outweighed the annoyance of using it. For my wife the benefits were almost immediate.

If you post the specific mask you have and the specific machine you have (ideally with pressure settings), I may be able to make some suggestions on how to improve the comfort factor.

Check out this video by a doctor. Just skip to the 2:40 mark. I think that is a little over the top...

https://www.youtube.com/watch?v=Dr2TLn4JkVU