(08-15-2021, 07:46 AM)Sleeprider Wrote: Did the 2018 sleep study evaluate your therapy under CPAP pressure (titration)? Central apnea can appear in sleep studies or as treatment emergent. We can see the flow rate line in your graph has periodic breathing typical of individuals with hypcapnea related centrals. This tends to be a feedback loop as the individual swings from hyper ventilation to hypoventilation depending on the CO2 levels in the bloodstream. This can often be reduced by turning EPR off or to a low setting to reduce respiratory ventilation. You need to try to get more hours on the CPAP, probably without EPR to determine if this is a trend. If the CA events continue, you will require a titration that evaluates CPAP and bilevel ASV to find what works.
So, I have two questions:
1) Where do you think I should start with the pressure setting and EPR?
2) I just want to be 100% sure that it's safe for me to proceed. I'm concerned that I won't be able to breathe out properly against an increased pressure. Is that possible?
To recap my issues are
A) ENT scoped recently and told me airway partly closed due to long term esophageal reflux (likely nasopharyngeal)
B) ENT scoped recently and told me airway partly closed due to excess bone growth in my cervical spine (this is characteristic of severe cases of Ankylosing Spondylitis). Note that I have limited range of motion in my neck.
C) Although it doesn't feel terrible, I know I have limited chest expansion due to fusion in my thoracic spine and rib cage (again, typical of Ankylosing Spondylitis). I have an upcoming appt with an Pulmonologist
D) I am not overweight
E) When I fall asleep in a chair sitting upright, or fall asleep supine, I almost immediately choke/stop breathing and wake up.
F) Deviated septum - docs say not too bad. I broke my nose twice a long time ago
Thanks for your help