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[Diagnosis] Newbie Sleep and Titration Results and the Success Part of the Story
#1
Question 
Hi,

I'm a newbie, and would love your input. I have results, questions, and then at the end, the "so far" happy ending.

THE RESULTS: Just had my sleep study and then titration study a few days later. It looks like all apneas except Central were eliminated using the CPAP. The central ones are a concern see questions. And my chart topping snoring which the tech thought was a microphone malfunction and went to check on, only to be almost blown away standing in the room next to mine, has been eliminated with CPAP as well.

My AHI dropped from 72.9 during the sleep study to 12.5 during the titration study. That looks promising. I've used the CPAP 3 nights at home, but only registered today, so I won't have updated at home numbers until tomorrow. I already feel much better though, which is great!

My 3 questions are:

1. I'm thinking that my AHI is going to continue to drop from the 12.5 during the titration study as I'm at home and getting more than the few hours sleep they allowed me during the titration study, and getting more benefits of using the CPAP built up. Is my thinking correct?

2. What about the deal that the only Apneas I had during the titration study were Central? Isn't Central the "worse" kind of apnea to have, and can I hope to have that number drop as well?

3. This question is a whole 'nuther can of worms. Am I totally unrealistic to think that once things get stabilized, with the blessing/guidance of my ENT, I can develop and successfully implement a plan with my shrink to get off these dadgum antidepressants? And I mean plan, as in it could take months.

The success story is that end of 2008, I was diagnosed with Sleep Apnea, and didn't know that I had anxiety at the time. So, I was unable to use the machines they had available at the time at all. Instead, I chose the "somewhat uncomfortable" PPP/Tonsilectomy/Adenoidectomy/Deviated Septum/Fix the Sinuses all in one surgery. After all that, I lost weight, things were great, snoring stopped woo ha. Then, 5-6 years went by, all the weight is back on, along with depression, snoring is worse than ever, and I am beyond exhausted. So, this time when I did the sleep study, I was properly medicated, and the mask is more comfy and not blowing a hurricane up my nose. I'm able to tolerate the CPAP like it's my long-lost [/font]best friend in the whole wide world, and am already having more energy, luciditiy, and feeling much better (day 3).

I am so excited, and HOPEFUL, yes I meant to shout, for the first time in a long time about this whole sleep deal. I can't wait to see my numbers in the morning, and report back later.

Any advice/response you have to any or all of my 3 questions would be greatly appreciated. Especially if it's advice that I might not like to hear. That's the kind I always need the most.

:rollSleep-well

Claire aka Baire which is how I will sign from now on.

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#2
Hiya ClaireBaire! (CareBear?!)
Total layperson here, but I agree with you that your results ought to get nuthin but better, once you are at home in your own bed and your familiar environment. Plus, it usually takes time to get really comfortable with your CPAP and mask ..... and possibly even to find which mask style works best for you. So it certainly seems probable that you will get better and better!!

#2 I will skip for lack of knowledge.

#3 -- That too seems like a "sounds probable to me" question. I was on anti-depressants for 15 years, and I finally weaned off of them. I didn't connect that with my CPAP usage, but now that you mention it, it *was* after I was getting a better sleep that I finally worked up a plan and went off the anti-depressants. So, you can certainly hope for those results!

Oh, and welcome to the forum!

BadGoodDeb aka bgDeb
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#3
Your machine can't actually detect "central" apneas, it can only tell that you stopped breathing while your airway was open, but that alone doesn't prove it is "central", that is caused by your brain forgetting to tell you to breath. Resmend calls these "Clear Airway" events, NOT "central apneas".

It is fairly common early in therapy to see a lot of what would otherwise would have been obstructive apneas showing up instead as "CA" or "clear airway" events. With time and getting used to exhaling against pressure these tend to clear up.

I'd leave things as they are for a week or so and see if that happens, as it's pretty likely to do.


Ed Seedhouse
VA7SDH

Your brain is not the boss.

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#4
Thanks for your answers. The Central episodes were recorded in my titration study. Could they have been mislabeled as well?

I'm absolutely not going to change anything for a month until I see my ENT for my one month follow-up.

And the Baire is for Claire Baire, a nickname I've had since 1963, way before the Care Bears Smile

Baire
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#5
Claire,

Central Apneas!

Central Apneas are no worse than obstructive apneas they are just different. If one has persistent central apneas, one will need a different type of machine from what is used for obstructive apnea. Often people with obstructive apnea will have some central apneas and often when changes are made to your therapy you may get some centrals that may go away.

Let your doctor guide you and do not let the centrals bother you unless they stick around for a long time.

Best Regards,

PaytonA
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#6
Hi cbrfoltz,
WELCOME! to the forum.!
Hang in there for more answers to your questions and much success to you as you start CPAP therapy.
trish6hundred
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#7
(05-11-2015, 06:26 PM)cbrfoltz Wrote: . . .
My 3 questions are:

1. I'm thinking that my AHI is going to continue to drop from the 12.5 during the titration study as I'm at home and getting more than the few hours sleep they allowed me during the titration study, and getting more benefits of using the CPAP built up. Is my thinking correct?

2. What about the deal that the only Apneas I had during the titration study were Central? Isn't Central the "worse" kind of apnea to have, and can I hope to have that number drop as well?

3. This question is a whole 'nuther can of worms. Am I totally unrealistic to think that once things get stabilized, with the blessing/guidance of my ENT, I can develop and successfully implement a plan with my shrink to get off these dadgum antidepressants? And I mean plan, as in it could take months.

. . .

Claire aka Baire which is how I will sign from now on.

Hi Claire,

#1: It might happen as you describe, or it might not. Every night is different, and what you are looking for are the trends. When I was starting out, I had no idea that my apnea was highly positional, meaning that it was about twenty times worse when I was on my back. Since I wasn't taking any measures to avoid bad position, my AHI was all over the place, and I had a hard time getting it below 10. Now that I avoid back sleeping, my AHI is rarely as high as 1 - normally about 0.5. Until you have been doing this long enough to understand what affects your results, you will likely see statistical variations.

I highly recommend that you download and start using the Sleepyhead software to monitor your results. You have a great machine, that delivers full data, so take advantage of it. Otherwise, you are flying blind.

#2: It is common to have some Clear Airway events, especially in the early going. For many, there can be a period where the xPAP treatment seems to "induce" some CA events, while your body gets accustomed to a different level of oxygenation. Often, those CA events diminish or disappear over time.

#3: I have no opinion or experience to offer here. I will only say that one member of this forum has had cardiac damage repaired by xPAP treatment, such that his resting heart rate is nearly down to half what it was before. However, it took years for this healing to occur. The damage has typically accumulated over years, or decades, and it often takes substantial time to reverse.

Good luck on your journey.

A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#8
My machine came with a modem, and it sends the numbers to myair/resmed. I'm waiting for last night's numbers to post. This modem thing is new from what they told me, so I can get my own results on a daily basis, and I don't have to take my SD card or machine to the sleep center to have it read. So, do I need to download the Sleepyhead software too?
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#9
(05-12-2015, 06:41 AM)cbrfoltz Wrote: My machine came with a modem, and it sends the numbers to myair/resmed. I'm waiting for last night's numbers to post. This modem thing is new from what they told me, so I can get my own results on a daily basis, and I don't have to take my SD card or machine to the sleep center to have it read. So, do I need to download the Sleepyhead software too?
The info that MyAir provides is very limited. Sleepyhead gives you detail about what happened each night.

If you compare your MyAir report to a SleepyHead report you will see a lot more info. this is useful if you are having issues during the night but can't figure out what when the basic info from MyAir just gives you a recap without any detail.

Example Chart From SleepyHead:
[Image: csUEAKfl.png]
Click to see larger version

WiFi SDcard
Oh and you can use a WiFi SDcard so you don't have to take the SDcard out of the machine at all to get your data. I pull my data every morning without pulling the SDcard out. You can find more info on that from: https://sleep.tnet.com/resources/sleepmaster or http://www.sleepmaster.org/
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
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#10
You say that centrals were recorded during your titration study, and that was in a lab environment. Therefore, these are likely to be "real" central apneas. If your sleep study (no titration) showed central apneas, then there might be anxiety or central nervous system reasons. However, if you had no central apnea in original study, the centrals that were logged in the titration study are likely caused by the pressure itself and not something that will last, therapy onset central apnea generally goes away as your brain recognizes everything is ok with this new setup (pressurized airway and extra clear lungs).

Keep us posted.

I think you would like the sleepyhead data, though initially too much data and confusing.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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