A couple of newbie questions

[paulag1955]

The doctor has ordered the in-house sleep study and I am just waiting for them to call and cancel. After he has the results from that, we will see what he says. Until then, I am operating like a well-greased wheel. After...we shall see.

[Spy Car]

The doctor has ordered the in-house sleep study and I am just waiting for them to call and cancel. After he has the results from that, we will see what he says. Until then, I am operating like a well-greased wheel. After...we shall see.

By this do you mean he's ordered a sleep study in a lab? And, if so, is doing an ASV titration part of that study?

Bill

[paulag1955]

Yes, in a lab and I don't know, but I will ask him. Thanks!

[paulag1955]

My AHI continues to improve. Over the last three nights it's been 2.7, 2.56 and 3.15. Obstructive apnea is nearly non-existent, with one or two events on each of those nights. 

I have a lot of allergies and for the past couple of years have regularly taken Zyrtec every morning and two Benadryl every night. Also for the past year and a half I've been taking Lisinopril-HCTZ for high blood pressure.

The first consistent improvement I had came when I stopped the Benadryl and replaced it with a nightly sinus rinse (TMI, I'm sorry). Benadryl is a central nervous system suppressant. Then a week ago my doctor advised me to stop taking the lisinopril. I also decided to stop taking the Zyrtec. And now I've had another improvement in AHI that seems to be consistent. But there is a lot of sneezing, even though I've completely eliminated the foods to which I know for certain that I'm allergic. I'm wondering if the Zyrtec may also have some kind of effect on the central nervous system.

In addition, I'm hypothyroid. Even though I have been taking levothyroxine for several years, I've never felt that it alleviated my symptoms. These include preorbital and peripheral edema, intolerance to cold, weak brittle nails and hair loss. It appears that there's a strong correlation between apnea, including central apnea, and hypothyroidism. So I'm also wondering if my thyroid problem is related to poor T4 to T3 conversion, so even though my TSH falls within range, my hypothyroidism isn't being well treated. I've started monitoring my body temperature and it's consistently low, below 98. I'm going to be pursuing the thyroid issue with my PCP and see if I can FINALLY get a referral to an endocrinologist.

I'm starting to be able to feel the benefits of the APAP, as in I can manage to get out of bed before 9 or 10 hours of sleep.

[paulag1955]

My best results so far. I lowered my max pressure further to 7 and still had only 1 obstructive event. I also raised my min to 5 and lowered EPR to 1. Would there be a benefit to turning off EPR altogether?

[paulag1955]

If I were to get one of these oximetry modules, would Sleepyhead download and chart that data as well?

[direct link to commercial DME website removed, instead, do a Google search for "Air 10 Oximetry Module"]

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[pholynyk]

If you search for that module, you will find that it costs about $200, but requires more bits and pieces, which, bought as a kit cost nearly $1000 --- although I gather that it can be had for less. There was a thread discussing the ResMed oximeter kit not too long ago. It's quite convenient, as the O2 data is imported along with your CPAP data, no muss, no fuss. And the Nonin unit is one of the best. But it does cost a lot, IMO.

[Sleeprider]

Your results are markedly improved. I advocated reducing maximum pressure and suggested that ASV might ultimately provide the best results. Your diagnostic tests showed complex apnea. This recent results with maximum pressure at 7.0 shows very good results. I suspect flow limitation remains high, but at least apnea and hypopnea is reasonable. The remaining question is whether this result will be consistent, or show unpredictable increases in AHI at the same pressure. So far, so good, especially if you're feeling good.

This is typical of the case where CPAP may improve sleep apnea sufficiently to be useful in complex or central apnea resolution. If it's right for you then results should remain below 5 AHI and you will feel rested and alert during the day.

[paulag1955]

Pholynyk, yes, it was about $900, I think on the website I was looking at.

[paulag1955]

Can you explain what flow limitation is and what it means to me?

Not feeling rested and alert has never been an issue for me. Getting out of bed in the morning, yes, but once up I was pretty good. That's why I'm measuring my progress by being able to get up after 7 or 8 hours or sleep rather than 9 or 10.