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[CPAP] Really new, left in dark by doctors
#1
Really new, left in dark by doctors
    Hi, I know a lot of people are left in the dark by their doctors to simply figure out their machine and troubles with CPAP so I really hope someone can offer some help/peace of mind.

AHI readings are super low, waking up feeling shattered still. I know something's amiss. Min Pressure 7, Max 10 on Resmed autosense 10 APAP. I'm new to Oscar so just need some advice as to whether I'm having a bunch of readings from Reras that are going amiss on Oscar/APAP machine, also want to know if my breaths look healthy and normal to anyone. Couple screen shots, one of the general daily view, a close up of what I think looks like a gasp after a Rera? (there are a lot of this 'gasps' throughout the night) Lastly just a screenshot of my normal breath to see if it seems fine, i'm no expert on what the waveform should look like.

I HAVE to add I've recently come off sleeping pills too, which I was on for a while before I was diagnosed then whilst attempting CPAP, so it could be a possibility that my body is just trying to figure out how to get natural sleep again after years of apneod sleep/sleep architectural changes because of pills and nothing to do with what you see in my charts. This is the reason I'm here, to cancel out an option. My doctors advice was 'let's start you on another pill'.

Any advice would be amazing.

Thankyou


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#2
RE: Really new, left in dark by doctors
A couple things to help see what is going on.

Zoom out for the whole night. To do that click in the top chart and press and hold the down arrow. Up arrow zooms back inn

Take off the pie graph. I’m not at my computer now so I can’t remember which menu it is in but look around and get rid of it.

Make sure the flow limits are on the charts you show. You can move and change the charts order by clicking on the left side of the chart you want to move and hold down the mouse key- drag it to the position you want. I have a link in my signature on which charts and order we need.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Really new, left in dark by doctors
Gotcha, new attachment attached


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#4
RE: Really new, left in dark by doctors
Your therapy looks like it is working!  Good for you.  There are a couple things I would change/try.

First turn off the ramp.  All the time you are on the ramp you are not getting therapy.  If you turn it off to get up for anything and turn it back on it starts the ramp again, at 45 minutes you lose a lot of time in therapy.  If you can't turn it off completely then reduce the time as much as possible.

Next your main events are centrals.  These are treatment emergence I believe and you will have less and less as your body gets use to the cpap therapy.  You will get more with EPR.  I would try setting it to 2 and see if that helps and if you still have a few go down the next night to 1.  After a few weeks at a lower amount and your body has adjusted you can add them back.

EPR lessens your exhale so there will be a little more resistance to your exhale but decreasing it by 1 should not really be much difference. BUT one thing you have to watch are the flow limits, they will increase when you lower EPR. It becomes a balancing act between the Flow Limits and Centrals.

Again, congratulations you a great start!!!
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Really new, left in dark by doctors
Okay good to know about the ramp, I'll cut it down. So truly looking at my screen shots my waveforms look good and not limited? You don't see any Rera's? That screen shot of a gasp wasn't a Rera? Seems to be so many of them.

I wonder why I'm waking up feeling so rubbish if my therapy seems to be working data wise?

Maybe my body really is just trying to adjust after being on pills for so long.
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#6
RE: Really new, left in dark by doctors
Gedoen may come and look and give you a much more informed opinion but I don’t see much.

It does take a while for you to start feelin changes hang in there
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#7
RE: Really new, left in dark by doctors
Honrestly thankyou so much. It's really making me think that it is more my body getting used to doing CPAP without being sedated by the drugs I was on. Long story short I managed to get some 'refreshing' sleep on Trazadone and CPAP. Was on medication for like 8 months before the diagnosis. Decided to come off drugs because it's just an endless cycle and thought I needed them (wasn't diagnosed with apnea at the time).

So all of these questions were basically me making sure my sleep looks good on Oscar to you guys and ruling out that it's anything to do with Reras or anything like that.

Thankyou
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#8
RE: Really new, left in dark by doctors
none of the close up pictures shows RERA, and the waveform looks like completely unmolested sleep. During such, you'll see a inhale, an immediate exhale, and then a gap (delay). The delay is your body feedback system to trigger the next breath, you only take a breath when the lungs signal the CO2 has reached the appropriate level.

Really good from those perspective, and just keep it up.

QAL
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#9
RE: Really new, left in dark by doctors
Apnea looks treated and no obvious reras. There are some signs of disturbed sleep but it doesn't appear to be caused by your breathing.

Breathing wise the only thing you can really try is EPR of 2 to see if that makes you feel any better otherwise good as is. Takes months to get full benefits of CPAP so may still see some improvements over time.

That example you posted was probably a twitch or something like a hiccup. Both can cause random one breath spikes.

Depending on how long been off the tradazone may still be adjusting to not being on it. If you want to try something before going back on tradazone or something similar could try low dose melatonin (like 3 mg) and/or a magnesium supplement. Both are quite safe and can help sleep quality.
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#10
RE: Really new, left in dark by doctors
I see minor flow limits but nothing I would address. IF you had a BiLevel I would explore a higher PS, being mindful to watch the Centrals.

Reducing EPR to 2 is a good trial, be sure to note which feels better.

Another change, and please only one at a time, is to raise Min Pressure (to 8), with you it is solely as a comfort issue. Possibily higher.

What did your sleep test say about central/Mixed/Complex Apneas?
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