[Equipment] New to all this need advice

[Gideon]

Do you have a lanyard like for an ID badge that happens to have a clip on it? Tie the lanyard to the end of the hose then clip to your pillow

[Sleeprider]

James I use a lanyard attached above the headboard, and many members use hose supports. Be careful not to attach to something you can pull down.

[JamesRyan]

I would treat your doctor as a partner in your health care.

I see in the diagnostic study (have a screen print in hand with the centrals circled, hand it to him) and I see I had a good amount of Centrals, CAI of 13.05 representing 42% of my AHI.
I also see in my nightly charts (Have a few in hand, circle the CA summary in the left sidebar and hand them to him) I know that you likely want to view the data on your software, I have my SD card with me.  
How can WE address this, what do you suggest/recommend?  Should WE slowly back off the pressure and EPR and see if that has a positive impact?  Or should we look at ASV (just to mention it) or is it too early to consider this option?  When would it be appropriate to consider ASV?

What are your goals:
To treat your Sleep Apnea that is a combination of both Obstructive Events and Central Events.
Knowing that your current machine cannot "treat" Central Apnea, only avoid some of it.
Knowing that lowering Central apnea requires almost the exact opposite of what you need to treat your Obstructive events.

The key is to come away with a direction for your treatment.

For this to work does the central apnea index need to be over 5 on the nights I show? Most are 3, but that still leads to not restful sleep(as i'm sure you know)

James I use a lanyard attached above the headboard, and many members use hose supports. Be careful not to attach to something you can pull down.

The hose attached to the shelf lamp works good but I will look I'm sure from all my years of work I have a lanyard somewheres. 


I've been afraid but I will be calling today to talk to the dr, though I suspect i'll have to talk to the nurse pract. It gets depressing to feel eh in the morning. I'm ready to feel normal and it's still a mental struggle having to use a machine.

[JamesRyan]

I finally made it over to the Dr and he wasn't there so I spoke to a nurse. I told him I am still tired during the day and don't feel like sleep is restful and I wake up a couple times every night.He printed and showed me a graph from the machine and noticed the pressure doesn't go above 12 95% of the time, so he adjusted ramp so it'll detect when I fall asleep and it automatically goes to 9. He moved pressure up to 9 from 7. He thinks that will help but said to call Monday if not.

I didn't tell him but I turned epr down to 1 last night. Will his changes made a difference or is it more guessing?

[Crimson Nape]

It might clear up some of the Hypopneas. . . . The proof will be in the data. (pretty original, huh)

[JamesRyan]

He chart he printed had my ahi at 6 which isn't great. I'm really glad I at least started treatment and wonder how I functioned at 39 ahi.

[Sleeprider]

Based on your last posted chart, the increase in minimum pressure looks like a good idea. It will stabilize pressure overall and in your case, there are not many flow limitations that warn of impending obstruction. Without that warning, the Autoset can only respond after the event, so increasing minimum pressure is the right approach. Turning EPR down may increase flow limitation and hypopnea, so keep an eye on that; however it also increases EPAP pressure which by itself may reduce OA events.

[JamesRyan]

Last night seemed a little better but still unclear. One thing he told me kind of sounded wrong, that I may never get fully restful sleep. That doesn't seem right to me.

[SarcasticDave94]

Great machine, it is the CPAP that we would recommend.
Download OSCAR to be ready.

We can help you starting day one, and we can often ID mask issues, so post as soon as you can.  Important that you make a habit of posting any and all issues that you are having, Apnea symptoms and any issues you perceive with the machine.  We, collectively, have been thru it all before.

So I've got a question. I'm 35 and not obese but I am overweight. Would losing weight mean I don't need a cpap? If it's something I need to ask the Dr I understand, just curious.

Losing weight with any form of apnea will only promote a healthier life. That's great but unfortunately it won't eliminate apnea.

At one time I was at 300 lb. and already diagnosed with mixed (central and obstructive) apnea. That combo placed me in a comorbidity situation, qualifying me for the bariatric sleeve surgery with my health insurance paying 100%. I'm now at 189 lb or thereabouts after the surgery which I've had done in 2016. I still have mixed apnea and I still have my ASV, CPAPs big brother.

[SarcasticDave94]

Last night seemed a little better but still unclear. One thing he told me kind of sounded wrong, that I may never get fully restful sleep. That doesn't seem right to me.

Sounds like overall you're on the right track. Fully restful sleep might be elusive for a bit, but after dialing in the machine and having the right mask for you, it is actually attainable rather consistently. No offense intended towards those sleep techs, but us hoseheads can actually set our machines to assist in better sleep that is restful.