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New Member - Just Started With APAP
#1
Question 
New Member here. I had a sleep study recently with the following issues recorded.

Apnea Index - 8.2
Hypop Index - 70.1
AHI 78
CA Index  - 1.6
O2 drops from 93% to 71%

I’ve completed 3 nights with the ResMed Airsense 10 APAP. Finally, think I got a good fit with the Swift FX Nasal Pillow mask on night 3 however I recall waking up a more frequently on the 3rd night and adjusting for slight leaks.

Looking at my sleepyhead data I’ve improved on the Hypopnea and OA significantly (AHI is way down from 78). However, I see a lot of Clear Airway Events. Comparing this to the data from my sleep study it seems like I’ve just inverted the numbers. 

Attempting to attach screenshots of first 3 nights data to see if anyone has any suggestions about the CA data.

Thanks


Day 1
h ttp://imgur.com/gsDv0Uw.png

Day 2
h ttp://imgur.com/nnwInjo.png

Day 3
h ttp://imgur.com/QDev5jZ.png
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#2
First, welcome to the board. Sorry you had to get this diagnosis but at least you came to the right place!!

I'm not very good at reading the graphs, but I can see your concerns. You do have way more clear away events than I ever had. I will let those who know more make suggestions.
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#3
I might think that your cpap machine responded to your OA events and raised the pressure. At that point the mask leaks took over until you calmed down.

If it were me I would raise my pressure to 8 and limit it to 12-14. I would look to be sure my mask was tight enough to seal but not so tight as to press the frame into my face.

Good luck Sleep-well

You are a work in progress and adjustments are part of that.

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#4
(04-15-2017, 03:37 PM)AndersonP Wrote: New Member here. I had a sleep study recently with the following issues recorded.

Apnea Index - 8.2
Hypop Index - 70.1
AHI 78
CA Index  - 1.6
O2 drops from 93% to 71%

I’ve completed 3 nights with the ResMed Airsense 10 APAP. Finally, think I got a good fit with the Swift FX Nasal Pillow mask on night 3 however I recall waking up a more frequently on the 3rd night and adjusting for slight leaks.

Looking at my sleepyhead data I’ve improved on the Hypopnea and OA significantly (AHI is way down from 78). However, I see a lot of Clear Airway Events. Comparing this to the data from my sleep study it seems like I’ve just inverted the numbers. 

Attempting to attach screenshots of first 3 nights data to see if anyone has any suggestions about the CA data.

Thanks


Day 1
h ttp://imgur.com/gsDv0Uw.png

Day 2
h ttp://imgur.com/nnwInjo.png

Day 3
h ttp://imgur.com/QDev5jZ.png
Because you had virtually no CA during your sleep study, and now you have virtually No obstructive events, I think you may have some pressure induced  CA events. I expect that this will; calm down a bit if we just let your body adapt to the therapy.  But I would like to help it along a bit.  

I would like to lower your max to 9cmH2O so you would be at 6-9 with an EPR of 1.  Lowering the pressure should lower your instance of CA.  It also has the possibility of raising your OA but don't worry for now, we want to find a good compromise of OA and CA for now.  Please try this and repost.

Thanks

Fred
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#5
(04-15-2017, 03:37 PM)AndersonP Wrote: New Member here. I had a sleep study recently with the following issues recorded.

Apnea Index - 8.2
Hypop Index - 70.1
AHI 78
CA Index  - 1.6
O2 drops from 93% to 71%

I’ve completed 3 nights with the ResMed Airsense 10 APAP. Finally, think I got a good fit with the Swift FX Nasal Pillow mask on night 3 however I recall waking up a more frequently on the 3rd night and adjusting for slight leaks.

Looking at my sleepyhead data I’ve improved on the Hypopnea and OA significantly (AHI is way down from 78). However, I see a lot of Clear Airway Events. Comparing this to the data from my sleep study it seems like I’ve just inverted the numbers. 

Attempting to attach screenshots of first 3 nights data to see if anyone has any suggestions about the CA data.

Thanks


Day 1[img] http://imgur.com/gsDv0Uw.png[/img]
Day 2
[Image: nnwInjo.png]
Day 3
[Image: QDev5jZ.png]

I think with all CA you should consider limiting maximum pressure.  Your pressure is rising due to flow limitations (great job on the charts).  So given what were seeing here, I'd recommend you to set the maximum pressure to 8.0 and turn off EPR.  So minimum 6.0, maximum 8.0 EPR off.  What we hope to see is the CA significantly reduced, and not too much OA taking its place.
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#6
Thanks!
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#7
Thanks everyone for the insights. I'll try lowering my max pressure tonight and see how things go for a few days. I've made the transition from thinking this would never work for me to thinking that the device isn't so bad and the benefits will be worth it.

Have a great weekend.
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#8
Hi AndersonP,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy and getting it dialed in to better meet your needs.
Hang in there for more responses to your post.
trish6hundred
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#9
Good morning,

I had a couple of different suggestions for new max pressure so I split the difference at 8.4. This has introduced some new indications on the charts (CSR and RERA). CA is slightly improved.

A couple of things - I had the flu recently and still have a substantial cough from that. It was bothering me last night and I took some prescription cough medicine with codeine.

Also, I believe I am mouth breathing as I woke up with a lot of dryness in the night and increased the humidity.

Thanks again to all of you for helping me out. I'm wondering how much trouble I'll be in with the Dr. when I go in after a month for my checkup and to let her review the data! Smile

h ttp://imgur.com/DuIoQ77.png
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#10
I don't see this as materially different from your previous results. CSR is just a (usually) erroneous label for periodic breathing. That is pretty meaningless as an isolated event like this. I suspect you may have what is known as complex apnea, and that is something to research and discuss with your doctor. Complex apnea is where a simple case of obstructive apnea, becomes predominately central apnea when treated with CPAP. It's not that uncommon, and sometimes it will respond to CPAP treatment; but the best solution in many cases is an adaptive servo ventilator (ASV). ASV is a bilevel positive pressure machine with sophisticated programming to adjust exhale pressure (EPAP) to treat OA, and a breath by breath pressure support to cause a breath during a central, hypopnea or periodic breathing, to stabilize respiration.
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