Intro, and so many questions

[treehugger]

Hello all, and thanks to everyone who contributes to and offers support and maintenance to this community.

I started using a CPAP 2 months ago; I'm on my way to acclimating to the mask. It has helped to a degree, but I am sure I need to look at other factors that affect my breathing and my sleep. By way of background, some of my risk factors for OSA are family history and being overweight and my age, 49. Last year I had a serious bout of pneumonia, I was flat sick for 2 months. And while my lungs feel fine, the atrophy and weakness that linger since that illness, I suspect, pushed me to need a CPAP much younger than I would have needed otherwise. I was so fatigued after being sick in bed for all those weeks that i needed 2 months of physical therapy in order to walk from my car to my work building, and to do stairs again. I feel like it aged me a decade. The weakness and abrupt decline of my physical activity level has caused me to gain 30 pounds in the last 8 months or so. I can feel my airway close when I lay down, no matter the position, unless I keep it open, even when I'm awake. I have some obstruction when I inhale, but exhalation is worse. 

I believe that my CPAP Rx needs adjusting, maybe even a switch to a BPAP. I have slept propped up since the pneumonia; if I sleep flat, even with the CPAP, my AHI is higher and my sleep more fragmented. I've had 2 doctors and the sleep study report recommend sleep aids, but I have mixed results with them. I still wake up a lot, but when I do sleep better, my AHI is higher. I don't want to pay for another sleep study just 3 months out, so I've scheduled a return to physical therapy, as well as an appt to a sleep doctor. (My PCP referred me to the sleep study.) I've downloaded OSCAR and look at my data every once in a while. 

I have many questions, but I'll start with 3.

1. Where can I study up on the terms used in the OSCAR reporting? I'd like to learn all the science and biology and nitty gritty. 
2. Has anyone else improved OSA symptoms with lifestyle changes that improve physical activity and overall strength?
3. The other night, I had taken a sleep aid, and for the final 1.5 hours of my sleep, my AHI was over 100. When I looked at my ResMed app that afternoon and saw my average AHI that night was 40 (my typical AHI on CPAP is 2.5-6, with an occasional outlier over 10), I thought it had to be an error, or my mask had slipped or something, but looking at the data, for 1.5 hours I stopped breathing every 3 breaths. I guess I'm curious as to whether episodes like that are to be expected, should I worry about taking sleep aids for now, and if I'm even reading the data correctly - maybe it is something else, and I'm misinterpreting?

I look forward to getting to know y'all, learn from  you, and hopefully offer something in return.

[Melman]

Welcome to the forum. I see you have OSCAR and assume you have and SD card in your machine. If not , any SD card will do up to a maximum of 32GB. It's important that we see data to be able to advise you. If you have a copy of your sleep study please post it with personal information redacted. We need to see the entire study report with tables, not just the summary. Also please post some OSCAR daily charts. Instructions are in the links below.  If you look att the top of the page you will see a link to the apnea board wiki. Search for the terms you want to learn about there. You're starting out with a first class machine. With data we can help you get the best results with it. Without data we can't be much help.

[DeepBreathing]

Hi Treehugger, welcome to Apnea Board.

In answer to your first question, there is a very complete glossary of terms in our wiki: http://www.apneaboard.com/wiki/index.php/Definitions

Lifestyle changes can certainly help, but are not a guaranteed cure. Generally only people with very mild apnea get much improvement, and for the rest of us we will rely on the hose. However there are all sorts of other health benefits from losing weight and increasing exercise. The Boss and I have recently done the Fast 800 diet (limited strictly to 800 calories a day) and both lost 4kg in two weeks. We've now gone on to the 5:2 diet, where we eat normally on 5 days a week and limit to 800 calories on the other two. The down side is that none of my clothes fit me any more!

[DeepBreathing]

Just following up my previous post...

That very high AHI is a worry, but if it's only occurring when you take that medication then you know what to do. Can you tell us what the medication was, and what dosage? Some drugs are known to cause impaired sleep breathing, including central apnea. It would very valuable to see your Oscar chart from that night and a typical night as well.

It would also help if you could post your sleep study report, so we can see what the underlying situation was. Please post the whole report including the charts and tables, not just the summary (which often glosses over things). Make sure you erase your name, address and other identifying information from all pages of the report.

Your description of the airway closing even when you're awake sounds strange. If this persists you should probably see an ear, nose & throat (ENT) specialist who can stick a camera up your nose and down the airway to get a good idea of what's happening. They can also do this while you're asleep, but that's a whole different level of complication.

[Gideon]

Please post results per the above. The thing that makes us different is thedata we look at. It is more detailed than most doctors look at we have the OSCAR development team available when we need them.

[treehugger]

Thanks, all! I've followed the directions for organizing a chart. What kind of time frame would be useful? The whole 1.5 hours of very high AHI? A shorter snippet? And a chart of an average night, I imagine.

[Gideon]

ALWAYS include a basic all night chart.  Include zoomed views when the clarify something. We will ask when we need more than the standard full night charts
Events
Flow Rate
Flow Limits
Pressure
Leaks
Snores

[treehugger]

ALWAYS include a basic all night chart.  Include zoomed views when the clarify something. We will ask when we need more than the standard full night charts
Events
Flow Rate
Flow Limits
Pressure
Leaks
Snores

Thank you Fred. Attached are a chart for the night of unusually high ahi, 2-21-20, and a chart of a more typical night, 2-17-20. F12 did not work on my laptop, so I took a screen shot. Let me know if I can improve the image quality (or set up OSCAR on my desktop). 

The CPAP has helped with the OSA to a degree, but not the insomnia. I wake up around 4am and get mediocre sleep after that. The insomnia is troubling because I can't seem to regain the strength I lost from pneumonia last year, and all doctors and friends keep reminding me that I might improve more with better sleep. I've tried diphenydramine, an herbal blend, melatonin, regular zolpidem, trazodone, and finally ER zolpidem. The ER zolpidem helps sometimes, the rest of them for a couple of hours, then I'm still up at 4 am. I don't want to take the ER zolpidem, however, if it's going to worsen my AHI.

I've got to get my sleep study report ready to upload still. I'm reading the wiki and googling acronyms. It's a lot to take in when one is sleep deprived.

[Gideon]

!7 Feb, Looks good your doc would be extremely happy with that.
Why fixed pressure?  I would run in auto min = 11, your current value, max = 14, because your pressure needs a small bump up to see if we can resolve a few of the remaining obstructive apneas.  And leave EPR = 3 though your 21 Feb chart contraindicates  the EPR

21 Feb That is all about the CA, central events.  Centrals can be very erratic and inconsistent, I call it consistently inconsistent.
Can you post a copy (redacted, we don't need personal details) a full copy including the charts and tables, not just the summaries.  Looking for hints about centrals in them mostly.

How often do you see a chart look like this, doesn't need to be this bad, but how often do you get a bunch of centrals?

Actions: Set EPR = 1  no other changes until after we see more data
A 2 minute and a 10 minute  zoom view of the cluster of centrals so we can see what is going on.

[SarcasticDave94]

Welcome to Apnea Board. That second chart looks great for an Etch A Sketch, not so great as OSCAR data. Hope you don't get that again. Best wishes your therapy will soon be doing well. Stick with the AB and we'll do our best to help make it happen.