Having a lot of difficulty

[GOTODPJ]

I went my medical records at the military hospital and asked for the detailed sleep study.  Filled out paperwork, they said they'd release it to me digitally.

Email comes in later - same summaries I already have.

Here's last night.  I reduced overall pressure and took EPR to 1.  Still a mountain of centrals.

I did find a chart in the second (titration study) that I posted.  Not nearly the details of OSCAR but maybe will provide insight to someone knowledgeable.

[SarcasticDave94]

I'll wait to hear about the event count and type fun the report. Your CA are still around in abundance.

[GOTODPJ]

Tried to pull my records from the military records office, but after several attempts, it keeps coming back to that all that's in my record is what I was able to post.  Either they don't know how to access the details, or the summary records that I have are all that remains.

I managed to get in touch with my Sleep Doc for some teleconsult.  According to my sleep studies (and the Doc appears to be looking at the same summary I have), there's no record of centrals.  Regardless, the data from the machine is pretty clear, so I'm being lined up for an ASV titration.

In general, is ASV the same, harder, or easier to tolerate than CPAP?

Just for fun, here's last night before I woke up and took off the mask.

[Dormeo]

Your original study said that most events were hypopneas. Hypopneas can be central or obstructive, so conceivably many of your were central. Was your elevation above sea level during the test and during treatment about the same? Have you recently started any new medications?

It's terrific your doctor has responded by offering titration for ASV. But in the meantime, there's an experiment you could try.

Your pressures are apparently being driven up by flow limitations, and higher pressures can trigger CAs. Try setting min = max = 7, with no EPR, and see how that goes. Next time you post a chart, do show the FL graph. (You can squeeze graphs into a single screen shot by grabbing the gray bars that separate them and pushing up.)

[SarcasticDave94]

The ASV is unique, so very different than CPAP, APAP. With the trainwreck shown above, it would be worth it to give it your best shot, IMO. It's gotta be better than this mess. You will want ResMed AirCurve 10 ASV, no other at all.

[GOTODPJ]

Got the results of my third sleep study.

Tech was very knowledgeable and talked more in detail than I had with my previous two sleep studies.

Results posted - to me, it looks like I had a much longer stretch of REM sleep when it was in ASV.  I definitely didn't walk out of there feeling like death like I had at the previous two.

Still seems like a lot of arousals?  Not sure what's normal.

[GOTODPJ]

Was your elevation above sea level during the test and during treatment about the same?  Have you recently started any new medications?

Your pressures are apparently being driven up by flow limitations, and higher pressures can trigger CAs.  Try setting min = max = 7, with no EPR, and see how that goes.  Next time you post a chart, do show the FL graph.  (You can squeeze graphs into a single screen shot by grabbing the gray bars that separate them and pushing up.)

Test was at sea level, along with all usage.  Started Sonata 5mg very recently but no other changes.

Some screenshots of last night.      

Had a nap earlier in the day, and then went to bed that night trying out a Resmed Quattro, pressure at 11.
   

Later than night, swapped back to a hybrid mask and changed pressure to 8.      

Haven't felt very rested today despite getting in bed pretty early.  Starting to think I need to just take a break.

Hopefully I've captured everything you're looking for in the screenshots.

[GOTODPJ]

Latest.

Do the tidal volume/minute vent graphs tell us anything? Not sure how to interpret them but they obviously correlate with flagged events.

Still waiting on an ASV.  Trying to see if there's anything to do in the meantime.

[GOTODPJ]

Almost time for my next appointment, but had an interesting development.

Diagnosed with a hiatal hernia. I think this is very likely related to the shortness of breath that I get laying down that's absolutely aggravated when wearing CPAP, and one of the big issues I've had with compliance (CAs notwithstanding).

Anyone dealt with CPAP while having a hiatal hernia? Any tips?

[SarcasticDave94]

Yes I've had a hiatal hernia, addressed with surgery when I had the bariatric sleeve surgery in 2016. The hernia has returned though.

Myself, I was able to use ASV while with the hernia. I don't recall making any special accommodations with the combo. Then again it could be that I was just happy to have controlled the very high centrals and was sleeping better.