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7 weeks in...
#1
7 weeks in...
I am almost 7 weeks in with using CPAP and will be seeing the sleep doctor for the 2nd time on the 18th of May and I am wanting some more opinions on what I should focus on.


I currently do not have the printout of the sleep study I did but I will be getting one as soon as I can, though it was a basic at home sleep study so no respiratory effort belts where used, but I was diagnosed with sever sleep apnea with AHI of 83 and desaturation to 81%


The information I am seeing on oscar seems almost always have CA being flagged more than OA and H while also generally a cluster or two of them with some sort of periodic breathing.


I do feel a little bit better on the CPAP but no where near 100%, if the CA clusters keep happening like they have been I will of course bringing copies to the doctor, and I am probably going to ask the doctor about doing a more thorough sleep study.

any advice on what I should bring up or any changes on my settings would be appreciated

Attaching graphs for the 22nd and 23rd with a zoomed up area on the 23rd which was one of the better days if more is needed I will add more,and the one for the 24th I can not add since I forgot to put my SD card back in.


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#2
RE: 7 weeks in...
I was able to get a copy of my sleep study if its needed but still doesn't help about the central apnea flags I am seeing to know if its caused by the cpap or preexisting issue.


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#3
RE: 7 weeks in...
I'm not seeing evidence of centrals in the sleep test, I strongly suspect they never checked.
The zoomed chart clearly shows a pattern typical of CO2 Induced Central Apnea consistent with Treatment-Emergent Central Apnea. Most likely it will go away in the next few months on its own. Always keep in mind that Central Apnea is typically consistently inconsistent. Your two charts show this.
I would normally suggest starting with lowering EPR but you are not using it.
Your Flow limits are borderline high, for that, I would suggest increasing EPR.
I suspect that you already noticed that these are two opposite actions. That's the problem that we face, it is literally a balancing act on your APAP between Obstructive events and central events. What helps obstructive events generally hurts Central events.

SO . . . . we will limit the high end of pressure to 10, so set your Max Pressure =10 that should somewhat help the centrals without hut=rting the obstructive events too much by limiting pressure excursions, limiting the variability of pressure, both of which should help minimize the Central events.
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#4
RE: 7 weeks in...
The sleep test was a very basic at home one still no idea why they couldn't have something to show respiratory effort.

I sorta had a feeling is was treatment emergent but as just starting out still didn't know for sure even after reading so much when I first got diagnosed

If it wasn't for the central events I probably would have already tried EPR

I will go ahead at set max to 10 and report what happens after a few nights to let things settle
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#5
RE: 7 weeks in...
Lowering the max pressure to 10 seems like it helped some but seems some of it was just a shortening of the time on events so they don’t get flagged.

Its still where I only feel like I had a good sleep only when central events are below 1.0 and very little to none of the periodic type breathing is happening like last night while the night before felt like a really bad night to me.

I have also started getting that air starved feeling at the start of sleep so I'm raising the minimum pressure to 6


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