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First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
#1
First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
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Hi Everyone - 

This is my first post.  Looking forward to optimizing my CPAP therapy and one day helping other people with theirs once I'm feeling better.

I got diagnosed in February after being chronically tired for a few years and extremely fatigued over the last year. 

I have a very full , busy, successful life.  However, I can't keep up with it with oscillating energy levels.... 

My AHI in the @ home test was an average of 19, although I only kept the thing going until about 5 am.  I now suspect it may be higher. 

I have a resmed air sense 10 with P10 nasal pillows and a chin strap to keep it on my head. 

They started me at 4-20 and have since moved me up to 8-16.

A few weeks ago I had a septum button installed in my nose for a perforated septum.  This caused some additional congestion initially but over time should help me breath better through my nose because it plugs up the hole that was through my septum. 


While I have a primary care DR, ENT, Online respiratory therapist, and counselor - I really don't feel like Im getting the help I need to get this under control.  

Anyways - Im including my Oscar Data so perhaps someone can help.   Hopefully you can see them.  I spent a while trying to reduce the file size for uploads.  Any tips in this arena would be appreciated as well.
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#2
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
Welcome you have come to the right place to get help 

You have 2 major problems - first central apnea - there are great people who have these and will help. I’m sorry I am not one of those but they will be by soon. 

The other is positional apnea. NO SETTINGS on your pap machine can help! Positional apnea is just what it sounds like, you are getting in a position where you have cut off your own airway. 

Sometimes it is as simple as stop sleeping on your back or changing to thinner pillows. 

It is caused by “chin tucking” - that is when your chin drops to your Sternum cutting off your airway. You need to find a way not to do that. If you can’t, many people have found the use of a collar a huge help in eliminating the problem. I have a link to a collar at the bottom of the post. In it the post contains charts of the same people without and with a collar. Please look at that post. 

You can tell positional apnea by looking in the O and H row and seeing GROUPED” events.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
I would like to see your diagnodtic sleep study, redact your personal data please.
I would like to see 5 minute view of a couple of your ca events to judge their 'character'.
and I would like you to reduce your EPR to 1 as higher EPR tends to lead to higher ca in a few 'lucky' people,

All this will tell us more about your apnea.

You are 2 months into CPAP, treatment-emergent apnea tends to diminish after 2-3 months as your body adapts to treatment. At this time, while I suspect, I don't know if this is you.
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#4
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
thank you.

regarding central apnea - I was told by the home sleep study company that I had "Obstructive Sleep Apnea" with an AHI of 19. I did notice on my resmed that I was having some central apneas and the respiratory therapist told me that central apneas can be caused by adapting to a cpap.

I do notice that my oscar data shows a lot of centrals.

Thank you for your notes on chin tucking. I'll get a cervical collar and see if that helps.

What portion of my events are positional, vs obstructive, vs central?
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#5
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
You asked “What portion of my events are positional, vs obstructive, vs central?”. That is really hard to tell but any that show 1 instead you can believe it is obstructive and if you see several grouped together you have positional apnea. 

Centrals are determined by the machine. It gives a number of small bursts of air and if there is no resistance it flags it as centrals.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
Positional, a good portion of your obstructive events. See where they are 'Clustered" together? That is the tell. If you sleep with two pillows try 1. Keep it simple. Be aware and think if you are doing anything that would tend to tuck your chin. That fails then consider the collar.

Central and obstructive events are stated in your stats as an 'index' or number per hour.

I could get much more technical then your RT did but I agree.

Almost all sleep studies are used to officially diagnose OSA, even when it is obviously not. Thus I'd like to see your sleep studies, full copies including the tables and charts. I, and others here have seen a diagnostic study that diagnosed OSA with one event all night that was obstructive and the rest was central. IMHO a great misuse of the doctors authority and many would consider malpractice. Thus we like to see the study. Also it provides us an indication of what you had pre-CPAP.
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#7
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
Here are 3 screen shots from my sleep study, will post the rest next

3 more pages from my sleep study


Attached Files Thumbnail(s)
   
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#8
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
last page from my sleep study


Attached Files Thumbnail(s)
   
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#9
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
That is a summary, It doesn't even mention central apnea. You were having a lot of flow limitations as evidence by detected RERAs and your AHI. RERAs = RDI - AHI
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#10
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
(04-07-2021, 11:03 AM)Gideon Wrote: I would like to see your diagnodtic sleep study, redact your personal data please.
I would like to see 5 minute view of a couple of your ca events to judge their 'character'.
and I would like you to reduce your EPR to 1 as higher EPR tends to lead to higher ca in a few 'lucky' people,

All this will tell us more about your apnea.

You are 2 months into CPAP, treatment-emergent apnea tends to diminish after 2-3 months as your body adapts to treatment.  At this time, while I suspect, I don't know if this is you.

Ok here is a 5 minute view of a few of my CA events

1 more

(04-07-2021, 11:29 AM)Gideon Wrote: That is a summary, It doesn't even mention central apnea.  You were having a lot of flow limitations as evidence by detected RERAs and your AHI.  RERAs = RDI - AHI

unfortunately, this is the only data I have.


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