Intro, and so many questions

[Damiansd]

When I chatted with the doc about insomnia they reread my report and found that I had restless leg syndrome. We are addressing that.

I'd ask your doctor about it. It will show in your results.

Cheers,
D.

[jaswilliams]

Were you actually asleep in the period of high CA's as the machine does not know, if you were awake the CA's can be ignored even at that high number

[treehugger]

Thank you, Fred and Dave, Damian and Jas, for taking a look and giving feedback. Attached is a close up of the high-AHI night (I moved snore down because there weren't any, and moved mask pressure up). The sleep study report file is too large; I'll have to snip it. 

I think I was asleep during the high AHI. I don't keep my mask on when awake. I suspect that the ER zolpidem contributed to the crazy AHI. I also suspect that my AHI is pretty decent most nights because I keep arousing, and therefore get terrible sleep. There could be a little bit of restless leg going on; I feel some mild twitching when I lay down every night, but I didn't show any in the sleep study 3 months ago. I am absolutely sure that my airway wants to close no matter what position I lie in, unless I'm keeping it open. How can the CPAP tell I have an open airway? I still have a lot to learn about how that works. 

I've made an appt with the only sleep doc within 45 minutes, and he's booked 3 months out. That's not acceptable. Time to research doctors outside that radius and pick one on my insurance.

[SarcasticDave94]

Maybe this bit of info helps: any/most doctors you have a doc/patient relation can script a CPAP. This could be your primary care doc, or most others as well count I'm thinking. In other words, this doc that scripts CPAP use does not need to be a pulmonary or sleep health doc. This doc may want some documents to add to a patient chart; OSCAR and a copy of a sleep study could/should be presented as evidence. Primary care doc might be easiest as he/she would have the full story on your health. If your doc is like mine, it would be simple enough to ask if they'd help document necessity and consider scripting.

[treehugger]

Thanks, Dave, for the encouragement. My family doc has asked me to level up to a specialist. I always appreciate when he admits that something is outside his knowledge. I might ask him to help me fiddle with settings while I wait to get into someone else, tho. Worth a shot. The insurance is still paying for the machine, or I would adjust them myself.

[Gideon]

Honestly, all the insurance cares about is compliance, that you are using it. You can make changes yourself, but that is your choice.

The high AHI looks close to CSR (it isn't) This is the last half of the CSR pattern and I was wondering if it might be drug induced and you kind of said yes to that above. Thus I'll suggest ignoring this day and if others like it arise then evaluate what to do.

[treehugger]

Thanks, Fred. I do think it was connected to the zolpidem, which is an easy fix for the AHI, but leaves me without an insomnia treatment. (Going to look up CSR...)

[SarcasticDave94]

I agree with bonjour/Fred. Insurance compliance is focused on knowing if you used the CPAP for a certain time over so many days. They do not care who adjusted it. FWIW I even told my insurance I would do this and they really didn't care as long as I used it. At the Doc and DME level, they can only set the machine according to the script. You the patient can set it without script changes.

[treehugger]

Update:
sleep aids: I've been avoiding the zolpadem ER, and I've tried trazadone a few times.
clear airway apnea: Since I last posted, I had only had 1 night with an episode of CA events, UNTIL this weekend, where I've had CA events the past 2 nights, with no sleep aid. My previous working theory was that the zolpidem was contributing to the clustered CA events, because they had only happened on zolpidem. Not anymore.
compliance and settings: I verified with my insurance that they don't care if I change settings. So I changed my settings to "autoset for her"

Questions:
can someone point me to an explanation of how my machine can tell the difference between clear airway and obstructed apnea events?
and to how autoset on Resmed Airfit works, and how that differs from autoset for her?
I'm still 2 months out on the sleep dr appt, am I going to make it? haha joking/not joking

[SarcasticDave94]

When the machine senses resistance to higher pressures, it will flag Obstructive Apnea if it meets the time aspect. Central Apnea isn't caused by a resistance, so it goes through a test called Forced Oscillation Technique (FOT) where it sends air pulses to sense resistance. Finding no resistance as would be found in OA, it flags it CA.