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2 weeks on APAP. Inconsistent AHI
#1
Hi all,

I have just recently started on a ResMed S9 Autoset. Before treatment my AHI was 38, with the worst hour in my sleep study peaking at 58.

Since starting on the S9 I have noticed a world of difference in energy, mood (was suffering depression which is now gone!) and it has quite literally changed my life.

I have noticed though that my AHI is anywhere between 6 - 18, most nights around 8-10. When I plugged the SD card into SleepyHead it showed me that indeed my OSA had dropped to roughly 2-3 & the problem seems to be CSA.

Is this a problem? Should I worry that my brain isn't telling my body to breathe? I am overweight but otherwise have no other health issues. Is there something on the APAP that can treat CSA?

I am on a trial machine & haven't ordered my own yet. I am due to meet with the specialist in a couple of weeks but thought I would ask the question here. My settings are 4-16.
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#2
Hi Breaking Bricks, welcome to the forum
Was any CSA reported in the sleep study and are you taking any opiate pain medication?

I've read here on the forum that some people when starting CPAP, their AHI shows mostly centrals even their sleep study showed none but goes away over time and others said turning off EPR helps. CPAP/APAP does not treat CSA, show the data to your doctor he/she might have an opinion what needs to be done, also download ResScan as the doctor might not be familiar with SleepyHead

Whats leaks and pressure (median, 95% percentile and maximum)?
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#3
What zonk said. If none were seen during your titration study, then it is just CPAP induced which almost always go away in time. Usually in just a month or less. Go by how you feel and ignore the numbers for now. Your body and brain have a lot of adjusting to do, relearning, too.

Keep looking at the data so you get an idea of what is "normal" for you. Your "normal" may have a wide range but given time, you'll spot differences right off.
PaulaO2
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#4
When you had your sleep study, what did they recommend for your pressure settings?

Maybe you could tighten them up and not have such a large range.
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#5
Thanks guys.

No, no medication at all. I can't recall if there were central apneas in my sleep study & I don't have the results any more.

Leaks are low - the nasal pillows work a treat.

Feeling normal? I haven't felt this normal in years - it's amazing how much sleep apnea was screwing with me and even more amazing how much better I feel now. I dream now. I haven't had dreams for years.

After the initial sleep study I was referred to a particularly expensive respiratory specialist who recommended a CPAP setting of 14. The sleep specialist knowing I was going to order an APAP set it up at 4-16. I've changed that today to 5-16 as at 4 it felt like I was fighting the machine for air at times.

I'll see what they say at the clinic on my next visit when I order my machine and they assess my data for the first time.

Cheers,
BB
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#6
Hi Breaking Bricks,
WELCOME! to the forum.!
Just stick with it, it will get better.
Hang in there for more responses to your post.
trish6hundred
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#7
Thanks again all. I think my brain is beginning to re-wire itself to the APAP. The last few nights I have seen consistent AHI's at 4.8-4.9.
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#8
that is awesome breaking bricks
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#9
If Central Apnea (Mixed) were a concern, they should have mentioned it and probably would have set you up with an ASV machine.

CPAP induced Central Apneas are pretty common for new PAPers and often go away (or decrease dramatically) with time. My theory for this (may be right, may be wrong; but makes sense to me and I firmly believe it is what was happening with me) is that when the increased pressure makes you exhale more forcefully, you naturally inhale harder (let's face it, continuous positive air pressure isn't something our bodies have encountered much before). This heavier breathing causes a temporary depletion of CO2 (hyperventilation). CO2 depletion causes a cessation of breathing (more than 10 seconds) that isn't associated with obstruction so the machine marks a CA.

Would have to open up the data to see what's going on for sure. I think that PAP induced CAs are usually of short duration (10 - 15 seconds) and don't usually cause any significant SpO2 desaturation.

PAP induced CAs usually go away within the first couple of months of PAP use, but may temporarily return with any significant increase in therapy pressure.

I think that what probably happens is that our bodies naturally acclimate to inhaling less forcefully even though we have to exhale more forcefully with CPAP.

I hardly ever have a CA recorded now and I can feel my breathing pattern "change rhythm" when I first put the mask on.

Sleep-well
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