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Did your NP have anything to say about your AHI and your CAs?
As for treatment-induced CA, that's certainly a possibility. I'm sure that's why Gideon asked about your sleep study. When you get it, could you scan it, blanking out your personal information, and then post it here?
It's hard to draw conclusions from just one night, but it does look as though the CAs at the end of the previous night were just you breathing in a normal, irregular, awake pattern. I see you also have some little CA clusters before your breaks; could those also be awake breathing?
The next time you post a chart, could you include all and only these graphs:
Machine: REMstar System One with Autoflex Mask Type: Full face mask Mask Make & Model: Quattro AirFit F10 Humidifier: yes typical setting = 1 CPAP Pressure: 10.5-14.5 APAP with AFlex x1 CPAP Software: SleepyHead
EncoreBasic
yes. agree that the last night you posted did not show your pressures, and those mentioned by @Dormeo are best set.
If this were my readings, I would make the following adjustments which seem to be indicated by the first post a few days ago.
Adjust Ramp start pressure to 7.0 (from 4.0)
Adjust pressure min to 9.0 (from 6.0)
Adjust the pressure max to 12.0 (from 14.0)
I would re-institute the EPR to full time and make the EPR = 1. A little pressure relief on exhale likely will increase comfort.
02-07-2023, 05:16 PM (This post was last modified: 02-07-2023, 05:20 PM by SophiaJae.)
RE: Help adjusting pressure to lower AHI :)
I am attaching screen shots from a small faxed sleep report, hope they add historical value
Also, I had a deviated septum that was fixed after this sleep report, that is probably pertinent to know.
thank you
and one more screenshot that may not add value due to its size.
I adjusted my settings to the values like QAL suggested.
I am over the moon at the results: 3.02 AHI, 2 masks off, etc.
I am still concerned with the 22 CA, 2 H and 3 REI events, but could not be more thankful to all that have responded and this community space.
I'm delighted to hear things are better. QAL's advice seemed so counterintuitive to me: raise minimum and use EPR. But perhaps by making you more comfortable these settings helped your night to smooth out.
Thanks for posting the sleep study. No CAs detected that night, so I'm guessing you are indeed dealing with treatment-emergent central apnea. It's wonderful to see how well CPAP is controlling your obstructive apnea and hypopneas. An AHI in the 50-55 range indicates severe apnea, and you have that licked.
Stick with your current settings for a week or so to see how it goes. CAs are notoriously variable from one night to the next, so don't be surprised if you CA index bounces around.
(02-08-2023, 12:49 PM)SophiaJae Wrote: Thought I would check back in and provide another daily view.
Today's 7 day average of AHI is 6.24.
What other improvements can I do to get that number lower?
Also, any insight is appreciated.
Thank you in advance
You're continuing to have a cluster of CAs when you're (probably) falling asleep. I'm inclined to think those are sleep-transition CAs. Putting the cluster to one side, this was a pretty good night by the numbers. How would you evaluate the sleep subjectively? Are you feeling rested today?
You had some large leaks -- did they wake you up?
One additional experiment you might try, if you can hack it -- turning off the ramp. If the cluster really is from sleep transition, that probably won't make a difference, but if QAL's suggested settings are helping you, maybe having them in place from the start of the night would be a good thing. -- But if you rely on the ramp to fall asleep, don't turn it off!
The pattern of CA's on the front end of the night could be from falling asleep as I did develop a bit of restlessness when I got diagnosed with sleep apnea. If it is not sleep-transition CA's causing the cluster wonder what else could it be
I do feel rested, thank you for asking.
I am unsure if the leaks or maybe apneas, or bladder, wake me up; but, I do get up often in the middle of the night.
I will try to turn the ramp off, not sure if I will make it as increasing the ramp pressure has been a fun challenge
If you're feeling rested, then things are on a good path. Your subjective experiences are important data, along with the numerical ones.
If your bladder may be getting you up at night, try restricting fluids starting about four hours before you go to bed. Be especially careful drinking anything that has a diuretic effect, like coffee, tea, or alcohol.
Don't worry if turning off the ramp is not for you.
