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Consistent Clear Airways
#1
Consistent Clear Airways
TL/DR: Seeing an average of 5.5 Clear airway events for over a month. Sometimes averaging as high as 10 per hour, some as long as 30 seconds. Given my provided data, are there changes I can make to reduce this? Next meeting with sleep doctor is in late August. I'm using stock settings from my doctor, and a full face mask (I was using a nasal pillow but it was causing my nose and lip skin to crack and bleed).

Story:

Hi all, I'm new here! I'm 34 yo male with symptoms for about ~5 years. Symptoms started as daytime fatigue, weight gain (30lbs in that 5 year time, considering a significant atrophy of muscle), vision loss (very slight nystagmus), cognitive issues (poor memory, slurred speech, and overall difficulty concentrating), increased heart rate and declining physical performance. I sleep around 9-10 hours a day, more on the weekend if I can fit a nap in. I have no difficulty sleeping, I am generally so tired I feel like I can sleep anywhere, anytime; of course when I wake up I feel like I haven't slept at all. Have seen every kind of doctor under the sun. Had brain MRI's revealing a pituitary adenoma, and primary immune deficiency disorder. I never considered sleep apnea a possibility as I was under the impression it was something caused by being obese, or generally something that older people experienced.

I'm 5'6" inches, and prior to symptoms weighed around 127 pounds. Am normally very active, and prior to symptoms getting bad was a half-iron distance triathlete. Always tried to eat well and perform physically. A colleague mentioned sleep apnea, got an at home test from a sleep doctor and found positive for moderate OSA, oxygen ~89, AHI ~22. This finally felt like I had some answers.

I've been using an AirSense 11 for one and a half months. I felt significantly better for about the first week, then a pretty dramatic return to baseline. On average I see around 1.5 OSA per night, and between 6 and 10 CSA per night, for as long as 30 seconds. They seem pretty scattered throughout the night and not localized to any time. I'm new to the machine and just looking for some experience to gauge if I should be looking for treatment for the CSAs. With the pituitary adenoma, I'm worried there might be an endocrine or thyroid issue underneath that might be exposing itself, or if this is just Therapy Emergent CSA and will just resolve on its own. Unfortunately the trend seems to be somewhat stable, with some dips, but ultimately events are slowly increasing.

I've been using OSCAR for the last 7 days. I use my machine every night, for the full duration of sleep. The attachment is a pretty accurate average night for me.

Any help is greatly appreciated, and let me know if there's more information I can provide.
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#2
RE: Consistent Clear Airways
Hi guybrush! - Welcome
I see you have OSCAR. A screenshot of your Daily Screen (in the Standard view mode) would really help. Please use the F12, or Fn+F12 if you're on a Mac, to take the screenshot. The graphs are organized in the order of importance, so please do not rearrange them for the screenshot.

This will help in understanding what is happening while you sleep.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Consistent Clear Airways
(07-18-2022, 10:09 AM)Crimson Nape Wrote: Hi guybrush!  -  Welcome
I see you have OSCAR.  A screenshot of your Daily Screen (in the Standard view mode) would really help.  Please use the F12, or Fn+F12 if you're on a Mac, to take the screenshot.  The graphs are organized in the order of importance, so please do not rearrange them for the screenshot.

This will help in understanding what is happening while you sleep.

- Red

Thanks, @Crimson Nape. Seems I forgot to activate the "Add Attachment" button! Please find a daily OSCAR image attached.


Attached Files Thumbnail(s)
   
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#4
RE: Consistent Clear Airways
You are using an EPR of 3. This can induce CAs by causing CO2 washout. Turn the EPR off and see if the CAs are reduced. Your flow limits are low enough that it shouldn't pose any problems. At the same time, this will increase your minimum exhale pressure that may reduce/eliminate the hypopneas and OAs.

Also, Please use the F12 key to take your screenshot. It will allow the version of OSCAR you're using to be displayed, as well as free up valuable real estate taken up by the calendar.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Consistent Clear Airways
Thanks, Red. I've turned off "Pressure Relief." I'll update tomorrow with more data.
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#6
RE: Consistent Clear Airways
Hi again,

Results attached after removing ramp and turning off EPR (Pressure Relief) on the AirSense 11. Almost completely eliminated the obstructive events and halved the clear events, even halved the total time in apnea!

I think this was the solution, and I'm hoping my body adjusts to the new settings.

I even feel quite a bit better. 

Thanks Red!


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