RE: New User Help Please
Hi Immortal,
It would appear that you have Complex Sleep Apnea. I see Clear Airway events on the pie chart, but not showing up on your event graph.
Go to the bottom left side of the daily page (under the last graph). There is a drop down box. Click on CA to turn the bar from Red/Green to Black/Green. This way we can see on the graph where the CA’s show up.
If you have a copy of your sleep study, post it here. It would be interesting to see if you had Clear Airway events on that study.
RE: New User Help Please
First there is a problem with your CA events not showing, looking to find out why.
1. Your CA events are about equal to your obstructive apnea and at times is significant. You also appear to be using Flex. Turn it off because the pressure difference it creates may be causing Central APneas.
1a. How long have you been on CPAP?
1b. Can you post a copy of your Diagnostic Sleep Study?
1c. Did you have Central/Mixed/Complex apnea prior to CPAP treatment?
2. Your Obstructive apneas are clustered which indicates that you are likely tucking your chin. A loose-fitting soft cervical collar should prevent the chin tucking from obstructing your airway.
3. You have a LOT of RERAs, RERAs are a series of Flow Limitations followed by arousal, Arousals are bad.
4. You have too many Hypopneas
5. Your charts need to be improved, per the organize link in my signature, to show Events, Flow rate, Pressure, Leak Rate, and Snore. If and when any of the others are needed we will ask for them.
Actions:
1. work on getting and using a loose-fitting soft cervical collar to resolve the chin tucking.
2. turn off the Flex. It is likely increasing your Central Apneas.
3. answer the above questions.
Future:
The obstructive events you have indicated a need for more pressure. Your Central Apnea indicates that we do not want to increase pressure and that we may actually need to lower it. It is possible a new machine (ASV) may be in your future but it is way to early to make that call. So the future plan is to reevaluate and go from there.
RE: New User Help Please
Dear Bonjour,
Thank you for your kind response. I think I can best respond by copying some of your mail below.
First there is a problem with your CA events not showing, looking to find out why.
Thanks
1. Your CA events are about equal to your obstructive apnea and at times is significant. You also appear to be using Flex. Turn it off because the pressure difference it creates may be causing Central APneas.
I will do so immediately
1a. How long have you been on CPAP?
About 1 month
1b. Can you post a copy of your Diagnostic Sleep Study?
I have requested a copy of it from my doctor and I will post it as soon as I get it. I also have a copy of an at home study from 2016 which I will post after this response. Following this first at home study I had nasal surgery to address deviated septum issues and the Doctor said he had opened up my sinus as best he could, he also said that I have the smallest nasal passages he has ever seen. My girlfriend said she noticed my breathing stopping and heavy snoring so I had a sleep study done in May of this year (the one I spoke of earlier) and let me sleep part of the night hooked up to the electronics and then the put me on a cpap machine with a nose only mask for a couple of hours. The results of that study led me to CPAP.
1c. Did you have Central/Mixed/Complex apnea prior to CPAP treatment?
Nothing other than what I have been doing for the last month.
2. Your Obstructive apneas are clustered which indicates that you are likely tucking your chin. A loose-fitting soft cervical collar should prevent the chin tucking from obstructing your airway.
I will get one immediately and try it
3. You have a LOT of RERAs, RERAs are a series of Flow Limitations followed by arousal, Arousals are bad.
I understand thats why I am happy to have found this forum, I cannot believe that getting a machine with a fixed pressure (based on a couple of hours study) is what is needed for my condition.
4. You have too many Hypopneas
See my response above
5. Your charts need to be improved, per the organize link in my signature, to show Events, Flow rate, Pressure, Leak Rate, and Snore. If and when any of the others are needed we will ask for them.
I will read your link and make all the changes
Actions:
1. work on getting and using a loose-fitting soft cervical collar to resolve the chin tucking.
consider it done
2. turn off the Flex. It is likely increasing your Central Apneas.
Same as above
3. answer the above questions.
I hope I have done that as best as I can for now, please let me know what else I can do
Future:
The obstructive events you have indicated a need for more pressure. Your Central Apnea indicates that we do not want to increase pressure and that we may actually need to lower it.
That makes sense to me, although I am not experienced at all in this area the pressure of 11 has always seemed and felt high.
It is possible a new machine (ASV) may be in your future but it is way to early to make that call.
Since reading this I have been reading up on the ASV machines, based on my limited knowledge and experience and what my girlfriend says about my situation sounds good to me if and when you determine its the way to go
So the future plan is to reevaluate and go from there.
Ok and once again many thanks
RE: New User Help Please
Please find enclosed my study from 2016
[attachment=13818]
RE: New User Help Please
FYI that is the summary. It does not differentiate between Apnea and Hypopneas, and doesn't mention the presence or a absense of any form of Central apnea. To you have the full study? You are entitled to it.
RE: New User Help Please
Sorry ! Here it is, I thought I had this page included. I am on a moving train, so its a little challenging to do screen shots.
[attachment=13819]
RE: New User Help Please
G'day Immortal.
No doubt Fred will be back presently to talk to you in more detail, but I'm sorry to say you're going to have a fight on your hands. Looking at the table you posted above you can see that over 50% of your apneas were either central or mixed. You have in fact been mis-diagnosed.
Unfortunately doctors and sleep techs seem to have this tunnel vision which says "all apnea is obstructive apnea". In your case (and you're not Robinson Crusoe here) the tech has identified that you have apnea and just labelled it obstructive. And consequently recommended a course of treatment that will not give you consistent positive results.
I'll leave it to Fred to spell out the details further, but I believe you're definitely on your way to needing an ASV machine. The good news is that they are fantastic!
RE: New User Help Please
For you that page means that you do not have Treatment Emergent Central Apnea. And the summary is wrong which happens all to frequently.
It also means that turning off Flex will have very little impact and that you need to repeatedly complain to your doctor that this machine is not working for you..
You need to keep a daily log of your symptoms to show they are ongoing.
Also we need to reduce your obstructive events to treated levels and demonstrate that Central events still occur at unacceptable levels.
Search the wiki for "justifying advanced" and read the article. I'll post the link if SleepRider doesn't beat me to it.
Bottom line is you need to be on the ResMed ASV machine which is designed to treat Central and Complex Apnea.
Your doctor will not want to do anything for another 2 months because that will prove that your Centrals are not emergent.
