[CPAP] Start with APAP or go directly to BIPAP?

[Salchicha]

Hi everyone,

Thank you so much for your advice earlier this year. I still suspected sleep apnea so I got another sleep study done at a private clinic and this one showed up with AHI 15 and RDI 16. For the past couple of months I have been trialling APAP and BIPAP. However, I haven't been having much success. In fact I cannot fall asleep with them at all. The BIPAP makes breathing easier than the APAP definitely. However, when I am using BIPAP and about to go to sleep, I get the feeling like my airway (behind the tongue) has narrowed a lot and there's a lot of resistance and the breath is not deep enough. This kind of keeps me awake and eventually I lose my sleepiness trying to sleep and get out of bed. 

I have attached OSCAR screenshots here. Any help is appreciated!

[Gideon]

Please set your PS to a fixed value
PS=4-4

And repost just your 1st chart and minimize your calendar so we can see your statistics.

[Salchicha]

Hi Gideon,

Sure. Let me know if this works.

[clownbell]

Chart format looks good now that calendar is gone. Content is another matter.  I notice that the machine was for only 19 minutes - wow. That will be job #1.

[Salchicha]

Hi Clownbell, if you read my first post from yesterday, that will explain why that is so. Thanks!

[clownbell]

@ OP, I did read your earlier post but did not absorb the meaning. Apologies.

One other question. I realize you are in Singapore. In the USA the law provides that the data and reports are YOUR PROPERTY. You can request/demand them to keep them in your personal medical files. The medical establishment may resist giving them to you, but at the end of the day that are legally required to do so. Do you suppose thigs are similar in Singapore? Would that help you get copies of your sleep studies? Just a thought.

[Salchicha]

Hi Clownbell,

So I got two sleep studies done - one at a public hospital where the doc refused to provide the report to me. I had to go through the administrative department and request a copy for which I paid SGD 10 . I had to tell them I was seeking care elsewhere and therefore needed the report. So basically I did manage to get the report and it said AHI 0.7. When I consulted the private clinic, I was given the report right away with AHI 16 and RDI 16. I am guessing the public hospital messed up the scoring or perhaps it was a bad night. I have no idea. All I know is that I will not be going back to that hospital even if it is subsidised heavily. Summary is attached.

[Salchicha]

Would appreciate everyone's thoughts and help with this! Thank you! I have posted my OSCAR charts and sleep study above.

[Salchicha]

@SleepRider @SarcasticDave94 Ok doesn't seem like I can tag people here but would love your help. Thank you!

[Sleeprider]

What we know from your posted sleep study is that you do not have obstructive sleep apnea, but experienced a CAI of 6 events and a CAI of 1.1 per hour during your diagnostic test. It appears CPAP may make your central apnea problem worse, however, basing any conclusions on 19 minutes of data is tenuous. Your first post discusses an AHI of 15 and RDI of 16, but without any data or identifying the types of events, that is a pretty meaningless statistic.

I see no point in analyzing a 19-minute segment of data that may or may not be during any form of sleep stage. Gideon suggested revised settings to ensure the pressure support would be delivered consistently at 4.0, and I would further suggest you might do better with fixed pressure in BiPAP-S mode with EPAP 4.0, IPAP 8.0. At least if you collect a reasonable amount of data, we can make some judgements and recommendations on therapy with that.