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Need Adjustments
#1
Need Adjustments
I was diagnosed with mild apnea and have been using a CPAP for 160 hours over more than 30 days, with an AHI of 8.9 and increasing. Lately I have switched to a full-face mask when the nasal mask had high leak rates. Currently things are not improving(nightly AHIs are 10 -15) I am waking 2-3 times a night sometimes with rapid pulse and very warm body. When the pressure goes high, I wake and have had air in my stomach and mouth. This wake pattern is almost the same before starting therapy. Any suggestions would be appreciated, I have attached the SleepyHead screen shots for several nights.
.docx   Apnea Charts.docx (Size: 594.03 KB / Downloads: 24)
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#2
RE: Need Adjustments
Welcome to the forum.

Your Apneas are 1/3 Obstructive Apnea and 2/3 Central Apnea.  Your Autoset machine is running basically wide open (4-19) with an EPR of 2.
Can you post the full results of your Sleep Studies, especially looking for your original study without CPAP, and the full study, not just the summary (you are entitled to have these)  I want to see what it says about Central Apnea.

This may be the wrong machine for you and the settings are not correct for the apneas that you have.

Without a more advanced machine, we need to narrow your range significantly, possibly to a single CPAP pressure to manage your currently predominant central apnea.  I'm looking to narrow the range initially to 8-13 with NO EPR.  Pressure changes and/or high pressures tend to trigger more central apnea events.  You are having a lot of flow limits so we might want to add EPR back in to manage those later.

In a very short statement, central apnea is where your brain does not send a signal to breathe frequently because of a CO2 blood gas level that is off.  

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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.
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#3
RE: Need Adjustments

.pdf   Sleep Lab Results.pdf (Size: 500 KB / Downloads: 38) Thank you for your response. Here is my original sleep study. I did not go back for the second study because I thought  an auto machine would take care of the problem. 
Earlier in this process with a nose mask and lots of leakage I was getting an AHI of 3 t0 6 but then things went into 10 - 14 and I got the full mask assuming the leakage was the problem.
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#4
RE: Need Adjustments
OK, your sleep study says that you had a small amount of central apnea prior to treatment.  It is not uncommon to see treatment onset central apnea which will typically go away after a few months.  I would suggest continuing with what I originally suggested for now.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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.
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#5
RE: Need Adjustments
Sleepless I agree with Bonjour, and you had a significant portion of mixed and central apnea. Standard procedure is to trial CPAP before moving to other options. We can help you optimize settings and understand what is going on if you post some detailed daily sleepyhead charts. Please use the methods for organizing and attaching charts in my signature.

Your pressure is all over the place and very mixed central and obstructive results. I completely agree with the suggestion to limit the pressure range and EPR and go from there.
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#6
RE: Need Adjustments
Thanks to both of you. Will make changes for tonight's sleep and hoping for the best. 
Ed
Shy
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#7
RE: Need Adjustments
Here is the chart for last night with the setting changes. For some reason I cannot get the top tabs on SleepyHead to work so I have screen printed to Word. 
Results appear to me to be no better with the new settings. Any advice would be most appreciated. 
Ed 

.docx   Apnea Chart 2.docx (Size: 163.52 KB / Downloads: 24)
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#8
RE: Need Adjustments
You may take a Screenshot of this by clicking the F12 button. (note F11 will remove your name and prepare the screenshot, but you must use F11 again to restore the mouse cursor and controls. The default storage location for screenshots is [ My Documents/Sleepyhead/Screenshots ]. Attach the file from that location.

CPAP will not work for you. Contact your doctor and explain you have complex apnea and need to be evaluated for ASV therapy.
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#9
RE: Need Adjustments
The nights are different you have 1/3 each of CA (down from 2/3) OA is still 1/3, and because we took out the EPR your Hypopnea went from 0 to 1/3.  Bottom line little to no progress.

With this machine it's a choice of which bad do you want to live with.  Sleeprider took you to where I thought we were heading, the need for an ASV machine
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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.
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#10
RE: Need Adjustments
Thank You for your quick response.  
Getting a new $3,000 machine is a bit of a shock. 
In the mean time should I go back to the original settings or just quit for a while.
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