Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

My Experience So Far (and thoughts on changes to therapy)
#21
RE: My Experience So Far (and thoughts on changes to therapy)
Below are some views of the flow rate wave forms around a sampling of recent CA events.  Do these look like standard centrals or something else?

[Image: Dla9qcFl.png]

[Image: UhX2eaul.png]

[Image: 2DGD4qUl.png]
Post Reply Post Reply
#22
RE: My Experience So Far (and thoughts on changes to therapy)
Last night was much better than the night before as far as the numbers go. I felt I slept a little more peacefully too, though not great. Here is data from the night and a few CA events with the flow rate wave form.

[Image: 5L6tTgol.png]

[Image: ttjYIQal.png]

[Image: MXAAIOel.png]

[Image: ReCaa34l.png]
Post Reply Post Reply
#23
RE: My Experience So Far (and thoughts on changes to therapy)
All appears to be central or simple nocturnal movement (turning over), with no recovery breath at the end, just resumed breathing. No associated flow limitation or snores, so looks pretty normal. A couple of those events approach 20 seconds, which is long, but not overly alarming. Your event rate is down around 2 recently which is pretty good. I think you will see a natural reduction of events, and I'm not suggesting any changes. You appear to be getting more comfortable.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#24
RE: My Experience So Far (and thoughts on changes to therapy)
(09-27-2017, 09:30 AM)Sleeprider Wrote: All appears to be central or simple nocturnal movement (turning over), with no recovery breath at the end, just resumed breathing.  No associated flow limitation or snores, so looks pretty normal.  A couple of those events approach 20 seconds, which is long, but not overly alarming.  Your event rate is down around 2 recently which is pretty good.  I think you will see a natural reduction of events, and I'm not suggesting any changes.   You appear to be getting more comfortable.

Thanks Sleeprider. My PSG is overnight Friday, so for now I'll just leave things alone until that comes back and see if it shows anything more. As noted, I still feel pretty unrested and afternoons are a big struggle, but it may be something else entirely or I just need more time.
Post Reply Post Reply
#25
RE: My Experience So Far (and thoughts on changes to therapy)
The results of my sleep/titration study came back today. The report is linked below, but in short I've been told to go to a set pressure of 12 (instead of my current 8 to 12 range). I believe someone here (OpalRose IIRC) suggested going to a fixed pressure in another earlier thread I posted, though I think she suggested a lower pressure.

I'm fine giving it a shot, but just curious if that seems like a good approach based on my SleepyHead data and the sleep study.

FWIW, I still feel like crap, so I'm willing to try anything.


[Image: 4hJYrrxl.jpg]

[Image: 9VbywZpl.jpg]

[Image: wvFpMEGl.jpg]

[Image: mEh4ybol.jpg]
Post Reply Post Reply
#26
RE: My Experience So Far (and thoughts on changes to therapy)
Good luck with that because if anyone bothers to actually read your study, they will see your apnea is all CENTRAL apena and hypponea.

[Image: wvFpMEG.jpg]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#27
RE: My Experience So Far (and thoughts on changes to therapy)
(10-04-2017, 08:18 PM)Sleeprider Wrote: Good luck with that because if anyone bothers to actually read your study, they will see your apnea is all CENTRAL apena and hypponea.

[Image: wvFpMEG.jpg]
I notcied that too about all centrals and no obstructives. My home study showed the opposite - all obstructives and no centrals. SleepHead shows a mix, with centrals being dominant. Needless to say, I'm confused.

What do you take issue with the most? Moving to a fixed pressure or that the pressure is 12? FWIW, I tried it last night and only made it about 45 minutes before I had to lower the pressure. The fixed 12 felt awful, like I was being blown up like a balloon. I reduced it to 8.2, and fell asleep almost immediately.

SleepyHead showed an AHI of 2.5 and a mix of CA, OA, and hypopnea, with CA being dominant (about the usual for me).
Post Reply Post Reply
#28
RE: My Experience So Far (and thoughts on changes to therapy)
I don't think the titration study shows very much of value. The technician moved pressure in 2-cm increments and cherry-picked period of 60 minutes as the most effective. You had equally good results at a pressure of 7.0 with higher SpO2 and a longer trial. You had only 1 hypopnea at a pressure of 10, but due to the short trial time, AHI appears high. I actually see the onset of CA with pressures above 8.0 with a higher incidence of hypopnea. Personally, I think your best result is 7.0 and the test shows a potential for CPAP pressure induced centrals above that pressure. The objective of CPAP is to treat obstructive apnea and obstructive hypopnea. In this study the hypopnea are not classified, but my interpretation is that you are treated for obstructive events at all pressures, and you avoid central induced events at 7.0.

Bottom line is the conclusions of this study are not that clear, and it cold be interpreted several different ways. My recommendation would be fixed pressure at 7.0 with no EPR. The PSG results really confirm what we have seen in your Autoset results, that events really are central, and that higher pressure and pressure variation makes it worse. You are treated at low pressures, and do not have obstructive events. The big caveat to all of this is that I would want to have a discussion with the doctor and encourage him to acknowledge in his recommendation that the CPAP titration shows a tendency for you to replace OA with CA which may infer CPAP induced complex apnea syndrome. You may not need advanced treatment using ASV at this time, however your record should reflect some thoughtfulness about what these results REALLY show.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#29
RE: My Experience So Far (and thoughts on changes to therapy)
For the others reading this thread, This is why we like to see the Sleep Study report. The "Physicians Impression" Said "Obstructive Sleep Apnea Syndrome" and NO Obstructive Apneas were observed, none. Not arguing the "Impression" since Hypopnea is an obstructive event, but a large percentage (just under 50%) of the events are Central Apnea and no mention of this in the summary.

Fred
Post Reply Post Reply
#30
RE: My Experience So Far (and thoughts on changes to therapy)
Fred, the hypopnea may be central, but we would not know without reviewing the PSG trace to see respiratory effort. So far, we have seen similar "lack of effort" in the CPAP results, with an absence of snore and flow limitation. I think that at CPAP pressure, Esq has predominately central events, but don't doubt the diagnostic showed OSA.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Lanners - Therapy Help Lanners 25 982 1 hour ago
Last Post: TechieHippie
  Jakespeare65 - Therapy Help jakespeare65 28 842 11 hours ago
Last Post: jakespeare65
  WW4B Therapy thread WW4B 49 4,086 03-27-2024, 04:31 PM
Last Post: WW4B
  Therapy Help - Possible UARS - REM jkossis 8 178 03-27-2024, 02:09 PM
Last Post: Sleeprider
  [CPAP] Therapy help rekaviv 9 259 03-27-2024, 11:22 AM
Last Post: rekaviv
  IanD - Therapy Thread IanD 28 2,272 03-26-2024, 08:18 PM
Last Post: IanD
  MrIvanDrago - CPAP|Bi-PAP Therapy Journey MrIvanDrago 67 3,367 03-26-2024, 01:22 PM
Last Post: MrIvanDrago


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.