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First Post - would like your opinion
#1
First Post - would like your opinion
I was diagnosed with mild sleep apnea at the end of September and started CPAP in early October.  I use nasal pillows and I get a consistently good seal.  My AHI on my initial study as 12.5, but it was a home study and no mention was made on CA vs OA on my report.  The initial prescription was for 4-20 pressure on an auto CPAP.

I had a bit of trouble getting used to it, but I am more comfortable.  I can't say that I feel any better since starting treatment though.  I went back to the doctor and she changed by setting to 5-20, and it looks like my OA events are well controlled.  She told me to make an appoint with her again in February.

I continue to have >5 CA events each night.  I have no heart problems (other than a low pulse) and am in pretty good shape for a 58 year old.  Is there any advice this group can give to me? I am concerned with the centrals, and have an AHI over 5 almost every night still, but usually less than 10.  I've attached the reports from the last 2 nights and a summary.

Thanks in advance for your assistance.


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#2
RE: First Post - would like your opinion
Do you have a copy of your sleep report? Did it include a value for "pAHIc"? The "p" stands for PAT -- peripheral arterial tonometry, and the "c" stands for central. PAT provides fairly good guesses about apnea events, though a full work-up would provide more solid information.
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#3
RE: First Post - would like your opinion
This is really all I have as far as a report goes:

TYPE OF STUDY: Home unattended clinical polysomnogram.

INDICATION FOR STUDY: Please see the notes from 8/19/2021.

PARAMETERS MONITORED: Include respiratory effort by chest movement,
respiratory effort by abdominal movement, nasal airflow/pressure, snoring,
body position, and oxygen saturation and pulse by pulse oximetry. All are
simultaneously recorded.

I have conducted an epoch-by-epoch review of the entire raw data recording
for interpretation of this study.

INTERPRETATION:
This patient had an unattended home study. The total recording time was
447 minute(s). The study was performed on a Class 3 device with a
excellent signal quality of 100%. The average heart rate was 56 with a
minimum of 42 and a maximum of 96.

During this study there were 54 apnea(s) and 39 hypopnea(s) to produce an
apnea/hypopnea index of 12.5. The patient had 4 minute(s) of oxygen
saturation less than 89%, with a lowest saturation of 86% on room air.
This is consistent with apnea of mild degree. There is desaturation
observed but it is not disproportionate to the apnea noted
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#4
RE: First Post - would like your opinion
Maybe this is all there is, but it gives me the impression it's a summary and not the full, detailed report. I'd consider asking that doctor if that's all there is, and if there's more details, to request them.

Note that respiratory effort belt is mentioned. This should be a wide Velcro belt worn I your chest during the diagnosic test. During an Apnea event, if there's no effort, it's a Central Apnea. If there's effort, it's Obstructive based.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: First Post - would like your opinion
I’m with Dave. I bet this is a summary based on a report with more detail. It’d be good to ask. In the US, you’re legally entitled to see a copy of the actual report.
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#6
RE: First Post - would like your opinion
If one were to do a statistical analysis, one would see grouping of the events with gaps between where there is less going on.  Your flow limits and events are commensurate.  I think you may be tucking your chin toward your chest, and if you awaken on your back more often than not, this is exactly what I see...chin tucking near the end of your sleep cycle where a lot of the events pile up.  You would be well advised to use a soft foam cervical collar, available at medical supplies outlets, probably WalMart, and of course widely on line.

However, before you whip out your plastic and place an order, please wait until other more knowledgeable responders offer their opinions.  They may differ, even substantially.
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#7
RE: First Post - would like your opinion
Your high is not above 11. Your pressure continues to raise and I would set the max at 10. 

The min is at 5 which is low for most adults. The absolute lowest the machine can go is 4. Those low numbers are for children and I wOuld raise my min to 7. 

Centrals seem to go up wIth a large range in your min and max. This would limit it to 3cm and I think you will be more comfortable and hopefully lessen your 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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