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[CPAP] New to OSA/CPAP's lots of Questions!!
#11
There is a key code at the bottom of 2 of your graphs - it looks like an open/white diamond is an unclassified apnea, likely a central apnea. In the absence of full polysomnography (EEG, etc) it can't determine if these are central apneas or not.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#12
The Novasom Sleep study is a home sleep study and it identified a significant obstructive and unclassified apnea index with some seriously bad oxygen desaturations. The results so far from the Dreamstation Auto suggest you have a serious complex apnea condition. Most sessions on the CPAP have been very short, and I can understand why with the high incidence of central apnea. Unfortunately, solving this is going to exhaust your deductible if you pursue normal studies and prescription to Bilevel ASV which is what is going to be required, or on the gray market, the machine that resolves this central apnea is going to cost between, $900 to $1300 based on the other members I have helped here.

Central apnea is when a signal to breath is not sent, and the airway is still open, not obstructed. The ASV uses a low pressure to cure obstructive apnea, and monitors each breath and can increase pressure on a breath by breath basis to resolve central apnea, hypopnea and periodic breathing. I don't see any way around it in this case. This individual has complex sleep apnea, not obstructive sleep apnea. The two major machines that treat this are the Resmed Aircurve 10 ASV (older version S9 Adapt), and the Philips Respironics Dreamstation BiPAP Auto SV Advanced (Older version System One 60 Series SV Advanced). This is not going to be easy, but is very important to maintain health.
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#13
Hi Daren2112,
WELCOME! to the forum.!
I wish your husband good luck with his CPAP therapy and also with getting the machine he really needs.
trish6hundred
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#14
Finally we got more than 1 hour of data!  He kept it on for over 4 hours last night!!
[Image: Q1mAD6q.png]
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#15
Yay for keeping it on longer; that's a good step towards documenting what is needed.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#16
A couple things that jump out are first the cluster of CA's around the 4:20 mark. When we see clusters like this it can indicate a positional problem. In particular your husbands chin could be dropping down (also referred to as tucking in) which would restrict the airway. Many have found the use or either positional pillows or soft cervical collars will eliminate this problem. The other thing is that being a fellow Dreamstation user I can see he has a flex option enabled at a setting of either 2-3. I would suggest turning off the flex option which will allow the machine to more quickly respond to events. If he finds he needs to have the flex for comfort make sure it is set to CFlex and not AFlex and try it at a setting of 1. The CFlex setting will provide a quick relief on exhalation only which will provide the comfort he may need. The problem with AFlex is it tries to provide relief for both exhalation and inhalation and that slows down the response of the Dreamstation and can allow events to happen.

Glad to see he is making progress. Keep up the good work.
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#17
(04-18-2017, 10:34 AM)Cranberry Ray Wrote: A couple things that jump out are first the cluster of CA's around the 4:20 mark. When we see clusters like this it can indicate a positional problem. In particular your husbands chin could be dropping down (also referred to as tucking in) which would restrict the airway. Many have found the use or either positional pillows or soft cervical collars will eliminate this problem. The other thing is that being a fellow Dreamstation user I can see he has a flex option enabled at a setting of either 2-3. I would suggest turning off the flex option which will allow the machine to more quickly respond to events. If he finds he needs to have the flex for comfort make sure it is set to CFlex and not AFlex and try it at a setting of 1. The CFlex setting will provide a quick relief on exhalation only which will provide the comfort he may need. The problem with AFlex is it tries to provide relief for both exhalation and inhalation and that slows down the response of the Dreamstation and can allow events to happen.

Glad to see he is making progress. Keep up the good work.

Thanks for the advice. I switched it over to C Flex with 1.  We tried without anything the first night and he couldn't handle it at all.  So we will see how he fares with this.  He also swapped out his puffier pillow for a more neutral one so hopefully that will help with the positional issue.
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#18
(04-16-2017, 07:36 PM)Sleeprider Wrote: The Novasom Sleep study is a home sleep study and it identified a significant obstructive and unclassified apnea index with some seriously bad oxygen desaturations.  The results so far from the Dreamstation Auto suggest you have a serious complex apnea condition.   Most sessions on the CPAP have been very short, and I can understand why with the high incidence of central apnea.   Unfortunately, solving this is going to exhaust your deductible if you pursue normal studies and prescription to Bilevel ASV which is what is going to be required, or on the gray market, the machine that resolves this central apnea is going to cost between, $900 to $1300 based on the other members I have helped here.

Central apnea is when a signal to breath is not sent, and the airway is still open, not obstructed.  The ASV uses a low pressure to cure obstructive apnea, and monitors each breath and can increase pressure on a breath by breath basis to resolve central apnea, hypopnea and periodic breathing.  I don't see any way around it in this case.   This individual has complex sleep apnea, not obstructive sleep apnea.  The two major machines that treat this are the Resmed Aircurve 10 ASV (older version S9 Adapt), and the Philips Respironics Dreamstation BiPAP Auto SV Advanced (Older version System One 60 Series SV Advanced).   This is not going to be easy, but is very important to maintain health.

I meant to add it in earlier (I'm feeling very overwhelmed Oh-jeez ) but the second night of the home test the results were fairly different?  I know the first night we put the nasal cannula like part on backwards, but we told the company and they said it was fine, because it wouldn't have registered anything if it hadnt worked?  Also I wanted to add that my husband has epilepsy and I wasn't sure if this adds to the picture of his type of apnea.  I REALLY appreciate all the help!!!!!  I'll post his second night study as well:  
[Image: CHzvN3k.jpg]
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#19
I'm sure y'all are sick of me by now, but I wanted to add another night of data, I think this makes it a week of data that we have so far... His AHI is up again from his lowest so far of 9.92 Sunday night. 
[Image: UJ7BG0B.png]

(04-17-2017, 10:29 PM)Beej Wrote: Yay for keeping it on longer; that's a good step towards documenting what is needed.

I try to keep remindining him of that!! DATA DATA DATA  LOL Laugh-a-lot Thanks!
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#20
G'day again Darren.

The percentage of central apneas remains stubbornly high. I think SleepRider is on the right track when he suggests that an ordinary CPAP / APAP device is probably not the way to go. As I mentioned in my earlier post, central apnea needs to be treated with an ASV machine, which is quite expensive.

The good news is that ASVs are wonderfully effective for the great majority of patients - in my case it got my AHI down from over 60 to typically around 1.0 or lower. I have the older version Resmed ASV (S9 VPAP Adapt) which is likely still available at a reasonable price. (Check out Supplier #2) I find that it is very conducive to restful sleep. I used to have chronic insomnia, but with this machine it just lulls me off to sleep in minutes.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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