My Journey Begins

[MediocreOpie]

First of all, I just want to say that I am glad I found this community! I've been poking around the last couple of days just looking at general information and also looking at information people have shared about my current setup. So, thank you!

I had a sleep study conducted on April 11, with an AHI of 23.4, and was prescribed a CPAP on May 3, which I was issued on Friday, May 10. I used it Friday night, but I did not know about using the SD card slot to capture my data, as one was not provided. However, after looking through this site and tinkering around with OSCAR yesterday, I put an SD card in to capture last night's data. I would say it was quite interesting. Here is a 3-minute snapshot from early this morning:

   

Interestingly enough, I was under the impression that my apnea was obstructive in nature based on the discussion with my provider, and it very well could have been, but this 3-minute peek into my night had me scratching my head. I had no obstructive apneas last night (don't know about Friday night). I have read that obstructive and central apnea can occur together and, through some of the discussion posts, I realize that the central apnea could/should subside as I adjust to sleeping with a CPAP.

Does anyone on here have a similar graph to this? It is concerning because it appears to me as Cheyne-Stokes, which could mean other medical issues going on...even though I feel generally great! Just curious if anyone else has seen similar data in their results and if there were any major concerns. 

Obviously, I know they will share this data with my doctor, so I will find something out at some point. Just wanted to reach out and start a conversation with others who may have similar scenarios. Needless to say, I have had a couple of great nights of sleep, relatively speaking, and am already feeling more energetic than I have in a few weeks!

Thanks again for this community. I'm glad I found it!

[Sleeprider]

Welcome to Apnea Board. Your chart shows that you are using a Resmed Airsense 10 Autoset in fixed CPAP mode with EPR at 2. Your AHI was mostly CA events and some hypopnea. This is not uncommon when adapting to CPAP and is nothing to worry about. CA event often occur when you change position in bed or arouse or transition to a lighter stage of sleep. Unlike central apnea, these are mostly just short breath holds or pauses. Your first CA event in the series you posted appears to be a movement or sigh followed by a short breath hold of about 15 seconds. All three apnea are followed by some flow-limited larger breaths. Your respiratory statistics show you have a good tidal volume, normal respiration rate and these results all point to good successful therapy. You used the machine for 6-hours so you had a total of about 12 CA events and only one or two hypopnea.

It appears your provider set you up at fixed pressure, and if you're comfortable,, that is fine. If you want to try automatic pressure, you will probably require a lower pressure than you currently have as fixed pressure. In autoset mode, you could set a minimum of 9 or 10 cm pressure and a maximum of 14, and the CPAP will only increase pressure when it detects obstruction, but will keep pressures lower other times.

[MediocreOpie]

Thanks for the reply! Good information to know. This is all pretty new to me, so I am still trying to learn the ins and outs of it all.

Yes, they set my pressure at a fixed 14 based on the results of my sleep study. I have a follow-up call with them next week, so we'll see if they make any changes. That 3 o'clock hour this morning was interesting. From sound asleep to wide awake and back to sleep in a short amount of time.

Honestly, just happy that I am getting the help I need! It's been a constant struggle for a few years now. Just had no idea what was going on until we started down this sleep path...

[Sleeprider]

The good news is the pressure is working to eliminate all obstructive apnea. The centrals usually disappear without any intervention as you become more comfortable with the therapy. These results are actually an excellent start.

[MediocreOpie]

Awesome! That's just what I want to hear! After only two days, I can certainly tell the difference; not huge, but a difference. I wish I had pushed the issue more sooner. Just had no idea what was going on.

[MediocreOpie]

So, I reached out to my doctor to obtain a copy of my sleep study and it shocked me.

Prior to putting the mask on me, I had 3 central apneas and 42 hypopneas. After they started titration, I had 40 central apneas. I had absolutely no obstructive apneas.

[Sleeprider]

Interesting information, and you are over-achieving based on those results. When CPAP contributes to central apnea, we normally reduce EPR and pressure. On the other hand, fixed pressure sometimes helps minimize central events. If at some point you want to try alternative settings, we need to keep your test results in mind. I'm actually surprised you tolerate the pressure of 14 with EPR 2 given that sleep study result.

[MediocreOpie]

I'll try to post my stuff later tonight. We have a choir concert to go to and I need to redact all of my info. I've been below 3 for the last three nights with my AHI. I can already tell I feel more energetic. It's not a huge increase, but much better than I had been doing.

[MediocreOpie]

Here is my study. Reading it sounds like I had a rough night. The only part I remember is waking up from a dead sleep and the technician coming in a few times to make adjustments to the mask after he put it on me. Again, I am certainly glad I made it to this point. My fatigue had just been getting worse and worse until I finally had enough. Glad I wasn't going crazy and the doctor actually listened to me.


  sleep_study_redacted.pdf (Size: 231.72 KB / Downloads: 24)

[Sleeprider]

Your diagnostic AHI showed OSA and hypopnea with a 23.3 AHI and RDI of 32.1. This shows a high degree of disrupted sleep, so therapy is appropriate. The titration did not find any pressure that was therapeutically recommended, and you had all central apnea. From a pressure of 6 to 11, your central apnea AHI went from 31 to nearly 80 events per hour, and at 14 AHI your had an AHI of 21. The study then recommends fixed pressure at 14 and not using auto mode.

Based on your current results with pressure at 14 and EPR 2, your AHI is really beating the odds. This is one for the books. I expect your results will be inconsistent and that central events will eventually return. Based on your sleep study, you should be failing at your use of CPAP, and yet, you're doing great so far. If CA events return, you will ultimately need a more sophisticated machine called an adaptive servo ventilator (ASV). On the other hand, you may be one of the rare cases that resolves sleep disordered breathing using CPAP. These are remarkable and unusual results. For the time being, there is nothing I would change about your therapy, but I will be surprised if it actually works in the long run in its current form.