Are "events per hour" on the MyAir App the same as AHI ?

[theMezz]

Good luck Mezz. I hope you learn something useful from the next evaluation.

Dr Office just called to remind me about appointment tomorrow.

Interestingly she asked if I happened to ever put a SD CARD in the ResMed. (it came with none)
I said - yes - I had one in since day !
She said GREAT! - please being the card.
At least they seem interested

[Walla Walla]

I would copy your card to your computer before you take it into the Doctor. There have been cases where the data on the card has been erased by the office help.
Not saying it will happen but it's better to be safe than sorry.

[theMezz]

Great idea 
Thanks for that

[theMezz]

Met with Dr today and he has no clue why CPAP and APAP fails but a pressure of 9 worked during titration test. 
He is sending me to an ENT and wants me to consider an INSPIRE implant. 

Before all that he is swapping out my Resmed10 for a new machine to rule out a defective machine. 

So that's the story ! 

INSPIRE would be done out of town, no one does it in my city

[Sleeprider]

Did you ever get the report from the study? As the titration progressed, were events determined to be obstructive or central? I never thought 9.0 cm was somehow a magic number, but I hoped for insights on what triggers you apnea at any pressure and whether they show up in polysomnography as central.

[theMezz]

Did you ever get the report from the study?  As the titration progressed, were events determined to be obstructive or central?  I never thought 9.0 cm was somehow a magic number, but I hoped for insights on what triggers you apnea at any pressure and whether they show up in polysomnography as central.

I forgot to ask for a copy and I forgot for patient portal access too ..  ugh...
He did say it was not central for sure

Think I should ask for a copy tomorrow?

[Sleeprider]

You're being referred for ENT follow-up, so it seems to me you need to have this report for your records. As best I can tell you may not end up under the care of your current sleep doctor again. An ENT may offer a clue on the nature of any obstruction, but be very careful about surgical options that might be suggested.

I have not seen obstructive apnea that is so unresponsive to positive pressure therapy, and I think we even tried the cervical collar. You have used moderate pressures, high pressures, EPR up to 3 and none at all and still have an AHI higher than your diagnostic sleep test. Since your untreated AHI is in the moderate range, maybe a non PAP therapy like Inspire is an answer. I dunno?? I hope you will keep us informed of your progress and any diagnosis you get from an ENT.

If you're still open to experimentng, I'd say try a low pressure with EPR 3. I mean why not? Maybe 9 at EPR 3.

[theMezz]

You're being referred for ENT follow-up, so it seems to me you need to have this report for your records.  As best I can tell you may not end up under the care of your current sleep doctor again.  An ENT may offer a clue on the nature of any obstruction, but be very careful about surgical options that might be suggested.  

I have not seen obstructive apnea that is so unresponsive to positive pressure therapy, and I think we even tried the cervical collar.  You have used moderate pressures, high pressures, EPR up to 3 and none at all and still have an AHI higher than your diagnostic sleep test.  Since your untreated AHI is in the moderate range, maybe a non PAP therapy like Inspire is an answer.  I dunno??  I hope you will keep us informed of your progress and any diagnosis you get from an ENT.

If ENT wants to do surgery than I am going to another Sleep Clinic.

I had uvula removed 1985 and deviated septum surgery and it did NOT fix anything.

It was *very* painful and I lost 17 pounds in 5 weeks. Water and jello was painful and nose packing 
hurt like hell.

Yup.. if ENT wants to do even an endoscopy I have to think about that - might just try another sleep clinic and hope its not a waste of time.

[theMezz]

Titration study images attached.

   
   
   
   

[Sleeprider]

What I'm really looking for is the page (you may have to ask for it) that shows the pressure, time at pressure, OA, CA, H, and index. this chart often shows sleep stage and position. Even better is a complete PSG graph that shows the respiratory wave-form and pressure along with EEG, and other channels with events noted. It should start from a lower pressure and show the progression at least through 9.0 and probably higher. This is the actual titration results and will give us a clue how this test was performed and your results at each pressure. This summary report is good enough for elementary school, but tells us nothing but the results. Request the detailed report.