New 2 CPAP - Wrong diagnosis?

[tiredPerson]

I first remember experiencing sleep breathing disorders after I started Zoloft 10 years ago. I did not stay on this medication long, but this is the first time I remember waking up with the room spinning. 
I ignore my problem for years despite a few exes telling me that it didn't seem I was breathing and that I look dead when I sleep. But I went on for years waking up dizzy and with headaches, and feeling afraid to sleep for fear I'd stop breathing and wouldn't wake. 
I have always known my brain just wasn't telling me to breathe, I've witnessed in between states of being awake and asleep, on many occasion. 
I have felt so awful, you guys know how it feels after you wake up. 
I finally spoke up and followed through with getting help, but I am getting to a point where I can no longer function like this and my memory is getting bad. I'm only 33. 

I told the technician that I believe I have CSA, and he said that the machine will say. They did an at home sleep study, which is not really what I wanted, but I think it's an insurance issue.
I was 100% awake but trying to fall asleep the entire study, the machine turned off before I ever fell asleep. I told this to several people after I saw what time they said the study ended. I also saw that they noted that I said I snore, which I do not. I can't count on one hand the amount of times I remember snoring or anyone saying I snore. I am silent when I sleep, and I breathe fairly shallow. I also told them that. I also told them that I have a huge amount REM and dreaming, and I dream within 10 mins of falling asleep and my dreams last until I wake... like I have EPIC adventure dreams every night of my life and I remember them in detail. They said that's because of sleep deprivation.

They said I had an AHI of 6.8 with hypopneas and they diagnosed me with OSA. I told the doctor all of the above and he just said "Well your apnea is probably worse if you were awake and your AHI was 6.8" and he asked if I want to do the titration in the lab or with an APAP. I said I wanted to do it in the lab because I want more information, and then he said there is 90% chance insurance will deny the lab titration. I don't think he ever specified I wanted to do in lab because I got a call for a mask fitting the same day. Maybe he did. 

So, now I have the ResMed AirSense 10 AutoSet for Her, and sleepyhead, I can see what is going on, and it is exactly what I thought. I have about 70% centrals, about 20% hypopneas, and the rest are RERA and obstructive. My AHI was at first as high as 22 and 16, and then went down to 3 and then last night it was 6. My pressure is 5 - 15.  My machine also backs up that most of my AHI is central when i look in clinical setting.

I have an appointment with my doctor on the 6th... what do I say? I feel I was misdiagnosed. I am not good at speaking to doctors. Will he see that I am about 70% centrals? They said my info is sent to a cloud. I just have had a hard time with people believing I have CSA but I truly feel I do. I don't snore. I don't ever feel any obstruction.

[tiredPerson]

* I meant I CAN count on one hand. Seems the edit button disappeared.

[PollCat]

Someone will respond to your questions soon. I was tempted, but am too tired to think and type clearly.

[tiredPerson]

Someone will respond to your questions soon.  I was tempted, but am too tired to think and type clearly.

Ha, thank you. I understand.

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Also adding, I looked in resscan and it looks like they are showing almost only centrals, and some hypopneas. But obstructives are next to none.

[jaswilliams]

Follow the instructions in my signature to download sleepyhead an then post a daily graph. Your machine will treat any OSA it finds so will not report them, it is unable to fix CA’s so they get reported, if your remaining AHI is under 5 then you are considered treated, however most of us find we feel better with an AHI of lest than 2.


It is not clear from you post your actual AHI only that the remaining score is mostly CA’s with a few hypopnea’s

[tiredPerson]

Here are some screenshots. When I mentioned 22 and 16, those were some AHIs I got for segments of sleep where I woke up and went back to sleep. Those weren't total night. Here are daily AHIs. I haven't been on this a week yet. 
But you know, seeing as I was awake through my sleep study, I don't know how he could understand what is going on with me.

[Walla Walla]

If you can follow the instructions on arranging your charts in the link below it would help. If I were you I'd turn off EPR and set your minimum and maximum pressures both to 6cm. Try that for a couple of nights and see if the CA events reduce or go away.

[jaswilliams]

Can you provide a full screen shot as the flow graphs also provide valuable information on event distribution, You may find your CA’s are reduced if you drop the EPR to a value of 1. Or running fixed pressure may also reduce the CA’s - there are various causes of Central Aponea


You may find the CA’s reduce over time. If they don’t then a different machine such as an ASV will be required. But insurance  has a set protocol to follow.

- Get issued and fail CPAP - this is where you are
- Get issued and fail BIPAP trial
- Get ASV


The above process can and does take a number of months  to years to happen and at various stages along the way treatment will become successful for some users, so not all will be issued with an ASV.


Do you have any other medical conditions or take any medication that can suppress your breathing ?

[tiredPerson]

I sometimes take a melatonin. Occasionally a benadryl but I don't like how it makes me feel. I have found benzos and antidepressants make me feel much much worse, I'll wake up totally disoriented. So I do not take those. 
I actually felt better the week before the CPAP, but my sleep issues have always been unpredictable usually. One day I will feel great, the next I will have a migraine for 8 hours and feel off balance. 
Health issues are still something I'm trying to figure out. I have high ANA and waiting to see rheumatologist, high blood pressure, and hormonal imbalance. 
I'll figure out the rest of this here in a min. 
I'm worried if I change my pressures and stuff my doctor will get upset or it might affect my insurance or something? I haven't met my compliance yet or anything and I'm not sure if this is my titration period? I really don't understand how this system works. I don't know what info he sees from the cloud.

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Yes, some nights, like the night before last, my breathing is mostly normal, and then other times I have a cluster of CAs. I'll post that shortly.

[tiredPerson]

Here they are. Some of the leaking is my fault. I figet with my mask alot because I'm not entirely settled on it. I might switch to the dreamware, but I was worried about it slipping off my head. And sometimes I may yawn or release some pressure through my mouth because it feels really good to me, like a big nice exhale. Also I didn't include most times where I am awake, although Im awake for about an hour or so in the beginning of a few of these.