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New and confused by all of it
#1
Hello Smile
I'm newly diagnosed with OSA, and I have 8 days of APAP in. I have struggled for as long as I can remember with daytime fatigue, brain fog and depression, but sleep apnea was never on my radar until my doctor pushed for a home sleep study to rule it out. An AHI of 11 scored me a new bedtime buddy. It's been a struggle to get used to it, but I'm committed to eventually feeling GOOD for the first time in forever. I'm confused about stuff though.
I'm not feeling better, in fact the last two days I've felt horrible. I downloaded Sleepyhead, but the only thing my brain fog can take away from it is that my AHI is higher while using my machine. I have my ramp set to start at 6, and it seems like I'm struggling to breathe until it hits around 9, that's when I start to relax. A bigger nose thing helped, but I had my Dr. approve an increase to start at 9 to see if that helps, and tonight will be my first night doing that.
Anyways, I took a screenshot from Sleepyhead if someone could give me some insight into it?
Also, what's up with clear airway apneas? How am I having OSA if my airway is clear? I don't snore, but I do wake up coughing and feeling like I'm drowning, and this has happened a few times while using the machine too. Does this all mean that it's just not going to work for me?
If you've followed my ramblings thus far, you're a trooper. Thanks!
   
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#2
obstructive (OSA)is a physical blockage of the airway
clear is also called central (CSA) and means that the airway is clear but that there is no effort to breathe, foe one of several reasons the brain stem does not think it needs to breathe right then.
sometimes CPAP can cause centrals to happen. sometimes they "happen" as we go to sleep or are starting to wake up -sleep/wake junk

all this means is that your machine is not adjusted perfectly for you and/or you are not used to it and are fighting it. Trusting that the machine will keep you breathing is sometimes hard to accept and get used to
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#3
Hi bgb699,
Welcome to the Apnea Board
Clear Airway Apneas are also referred to as Central Apneas. Your body forgets to breathe or in the case of Non-Obstructive Hypopneas breathing decreases significantly. You are still showing some Obstructive events so your Data is suggestive of mixed Apnea. Obstructive Apnea is caused by a collapsed airway. Central Apnea is the result of your body thinking it has done enough breathing and can stop for a while. The machine itself can cause Central Apnea and forms of Periodic Breathing and Hypopneas. For machine caused events, CO2 is washed out of your blood by the machine and your body is fooled into thinking you have been over breathing. Sometimes adjustments (reductions) to the level of Pressure Support can reduce or even eliminate the Centrals. It does seem that at higher pressures you had more CA events. Higher pressures can convert Periodic Breathing to Central Apnea. If traditional CPAP fails to reduce your Apneas (particularly Centrals) you might need an Auto Servo Ventilator ASV machine. This is a complicated subject. Some sleep Docs don't even know much about it. Stick with us. There are several people on this Board who can be very helpful with your situation. You already have the Sleepyhead software so you are off to a good start.

Rich

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#4
Hi and Welcome! I had quite a few CAs too to begin with, though not as many as you. Then, one day, they just stopped after a couple of months on CPAP. Now I might get one a week. They make up a large proportion of your events, but I would not worry just yet.

Were you awake during any part of that? Awake breathing can get reported as CA which is a false positive.

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#5
Been there, done that.

It's a process that for some only takes weeks and for some it takes months. For me, I am going on my 4 th month and still not sleeping as good as I expect. However it is a 100 times better than it was. My problem was getting comfortable with my new bed partner. I know we are not supposed to change the prescription settings but I will ask forgiveness later rather than permission.

Changed minimum pressure from 4 to 6 and EPR from off to 2. At least I can rest comfortable.

Now I need to give it some time. My doc does not want to talk to me until I have spent 3 months getting used to it. I bet he never had one of these contraptions strapped to his face.

Hang in there, it gets easier, however slowly.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#6
Hi bgb699,
WELCOME! to the forum.!
Hang in there for more responses to your post, much success to you with your CPAP therapy.
trish6hundred
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#7
A couple of other comments. Your AHI might be higher now as you did not sleep well during the test. It is just one night in a strange place, covered with wires and belts and tubes. Your AHI over time is a more accurate guideline. Your current AHI, show in your SH report is quite high. I would not feel good if mine was that high, so you still feeling poorly is not a surprise.

Your original starting pressure was on the low side. Like you, I feel that I breathe easier with a higher starting pressure. Waking up coughing and feeling like I'm drowning is a sign of OSA. I am very glad I don't experience that anymore. Stick with it, it will get better and you will feel better. Give it time. Your mind and body need to adjust to the therapy.
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#8
You're showing some indication of complex apnea, but most likely this will resolve shortly. Most people that have your pattern of both CA and OA end up doing better once they have adapted and dialed in the right pressures. Your minimum pressure of 6.0 is not cutting it, and as you said, you feel better once it reaches 9.0. I think i would start at 8.0 and if you can do without ramp, turn it off. The Dreamstation machines are kind of slow to respond to obstructive events (compared to Resmed), so when you see this many events, you need to give it a head-start.

Take the minimum to 8.0 and see if you don't do better. If the clear apnea persists or gets worse, well we can cross that bridge later. I think you will get a lot of relief by increasing the minimum.
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#9
(06-17-2016, 11:20 PM)Sleeprider Wrote: You're showing some indication of complex apnea, but most likely this will resolve shortly. Most people that have your pattern of both CA and OA end up doing better once they have adapted and dialed in the right pressures. Your minimum pressure of 6.0 is not cutting it, and as you said, you feel better once it reaches 9.0. I think i would start at 8.0 and if you can do without ramp, turn it off. The Dreamstation machines are kind of slow to respond to obstructive events (compared to Resmed), so when you see this many events, you need to give it a head-start.

Take the minimum to 8.0 and see if you don't do better. If the clear apnea persists or gets worse, well we can cross that bridge later. I think you will get a lot of relief by increasing the minimum.

I've only been on my CPAP a couple of weeks and my AHI during my sleep test was 36. The sleep study originally set me with a pressure of 8 and the DME wanted me to begin at 4 with a ramp up to 8. In just a few short weeks and two different masks, I now simply begin at 8 so it's constant from the beginning. I'm quite happy with that and adjusting pretty well as my AHI's have shown under 1!
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#10
Welcome bgb699 to ApneaBoard! Glad you're here where you'll get lots of helpful info from experienced users. Sounds like your settings need some adjustment but don't give up, it will get better in time. Keep us posted!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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