G'day Kevin, welcome to Apnea Board.
The first target of CPAP therapy is to get your AHI under 5. This is the average number of events (apneas and hypopneas per hour). It sounds like you've achieved that already, so now the thing is to optimise your therapy to give you an AHI as low as reasonably possible but importantly to make you feel rested and refreshed. The fact that your AHI is low enough to be regarded as "clinically treated" indicates that your heart is not fighting for oxygen, unless the apneas and hypopneas are coming in clusters which could cause desaturation. The other thing you should consider is whether you're experiencing a lot of RERAs, which aren't counted in your AHI but will cause broken sleep.
As to the proposed pressure change, I'm not sure what you're actually asking - if I'm reading it correctly you want to change to 7/ 12 EPAP / IPAP but you're already on those settings? Or have I misunderstood? Given that you have an imminent sleep test (which I assume is a titration test) I'd hold off making any changes until the test. Make sure you arrange time to talk over your entire experience to date with the doctor or therapist to ensure the whole picture is taken into account in any new prescription.
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04-29-2016, 04:39 AM
(This post was last modified: 04-29-2016, 04:40 AM by Asjb.)
Hello Kevin M,
I'd echo DeepBreathing about not changing anything until you can discuss the results of your next sleep test with your doctor, and echo DB's comments about how encouraging your results are right now.
The 'heart pounding' and 'winded' you describe might just be due to you maybe not being entirely fit yet (heart and lung stamina) - an underactive thyroid gland can make one very tired, difficult to keep active and fit. There's every chance that this will improve soon now that you have started treatment for the thyroid but you could maybe ask if there are any exercise programmes that your doctor can recommend.
A pounding heart can also sometimes be due to temporary changes in the speed of the heart rate - but I guess that would have been ruled out if your cardiology tests included the Holter test - wearing a continuous electrocardiogram (ECG) recorder during normal daily life for 24 hours (sometimes for three days). An overnight sleep test at home will not record the ECG, a sleep lab test will. Which type are you scheduled for? And both types of sleep test measure the overnight oxygen levels, so again, something to discuss with your doctor after the test.
And if you have any reason to remain a bit concerned about your overnight oxygen levels and pulse rate you could always buy (or get a loan from your doctor or equipment supplier) a little finger-tip pulse oximeter. There's lots of information about them on this forum. I use a Contec CMS50F which I can personally recommend.
Just a small point but you might want to bring it up with your doctor when you discuss the new sleep test results - your proportion of central apnoeas is coming near to 50% of all your events. This could be due to CPAP/BiPAP treatment itself, and then will later settle spontaneously, but you might want to ask if an ASV machine might suit you better - and if your test is in a lab, they might be able to try you out on ASV that night. And although 'shallow breathing' is not an indication for a change to ASV, my experience is that that is one of the many things that my ASV has improved a lot. But, ASV machines are more expensive and most healthcare systems are very reluctant to prescribe them unless absolutely vital.
Please come back to the Forum if you'd like to once you have your new test results.
PS - forgot to add. Welcome to the Board!, great that you've found the forum - members have helped me enormously since I started CPAP.
My current settings: Auto-ASV. EPAP 12-15 PS 3-9