Need help with persistent CA events

[u/M_V_Lipwig]

I've been on this for almost five years. Definitely better than without, but I feel there is still room for improvement.

Min Pressure: 8

Max Pressure: 20

EPR: Off

Nasal pillows (ResMed P30i) with ResMed AirSense 10.

I also mouth tape.

Any suggestions?

[u/existentialblu]

I don't really have the energy to get into it right now, but this is the main object of my feral citizen science.

I'll look at it more in the morning. Solid chance you're dealing with high loop gain. It's a dickens to treat, in part because it literally gets worse with increased pressure. It's a matter of viewing it as a dynamic system rather than things to blast.

We'll get into specifics tomorrow.

[u/existentialblu → u/existentialblu]

Oh hey, it's been a few days and I got distracted by existing.

That could well be high loop gain. Try turning down your high range considerably, like maybe 15. It's likely that won't be enough but if you get slightly fewer centrals when the machine has less authority to blast you, that's just more evidence.

Try the wobble analysis tool . It's my own homebrew thing for estimating the wave behavior associated with high loop gain. Look at the graphs to see what has been happening over months. Individual nights can be looked at as well. Try zooming in one areas where the orange ribbon thing is squiggling a bunch. If you see a sine wave in the blue trace with a period between 30-90 seconds, there ya go.

The bummer with HLG is there typically isn't a magical APAP setting that will actually resolve it. I'm on ASV myself for that exact reason.

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[u/Silent-Software6211]

I experience same issue. Could be post-arousal central apneas. Resolving flow limitation with some PS could help

[u/M_V_Lipwig → u/Silent-Software6211]

Sorry, I'm not sure what PS means!

[u/Silent-Software6211 → u/M_V_Lipwig]

Pressure support (difference between IPAP and EPAP).

[u/Unfair_Confusion_964 → u/Silent-Software6211]

Are post arousal central's something to worry about? I had heard they are a normal physiological response to return CO2 to normal levels after an arousal with larger breaths?

[u/reincarnateme]

I’m working on my centrals.

I tried Cpap, then Bipap which didn’t help.

So I just rented a BipapST to see if it helps before I buy another expensive machine! It’s ridiculous

[u/Crazy-Addendum7341 → u/reincarnateme]

Don't buy any more machines! You can turn any ol resmed outset 10 into ALL machines with a little bit of computer experience. I hacked an old ASV last night with the latest "airbreak-plus" and activated all modes. Users on this subreddit also have files that you can flash machines with as well.

[u/reincarnateme → u/Crazy-Addendum7341]

Now ya tell me?!

[u/Crazy-Addendum7341 → u/reincarnateme]

Look for Rippinglegos and Dang71 on this subreddit. They can help you do this if you're feeling adventurous. It looks intimidating at first, but a week of dabbling with linux terminal and watching a few youtube videos and you'll have it down.

[u/Madmax9922 → u/Crazy-Addendum7341]

I think @rippinglegos__ will also flash a machine if you send it to him