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New diagnosis, 3 weeks with CPAP
#1
New diagnosis, 3 weeks with CPAP
I was recently diagnosed with sleep apnea, with AHI of 16. I've been using this machine for 3 weeks, on a trial basis. I understand that it takes some time to adjust and to find the correct settings. I've asked the DME for a copy of my home sleep study, but I haven't heard back from them yet. I've attached a copy of the OSCAR data from three weeks ago and from last night. I'm not seeing an improvement in how I feel over the past three weeks. I'm feeling somewhat discouraged at this point. I've been reading posts and wikis from this and another forum and slowly learning. I'll need to make a decision on whether to proceed with CPAP within the next three weeks. My DME would like me to return the doctor signed insurance papers for submission, but I think we need to first talk about what CPAP machine they'll be recommending as this all has to be included when the paperwork is submitted to the insurance company. 


       
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#2
RE: New diagnosis, 3 weeks with CPAP
Welcome to the Apnea Board,

In your first example you had a lot of clustering of obstructive events, this positional apnea is most frequently caused by your chin tucking to your chest.  While still there it is very much reduced in the more recent chart.  What did you change to fix that?  It wasn't pressure.  We typically recommend an anti-snoring sleep collar or a soft cervical collar for that.

I'm suggesting that you turn off your Flex and that should significantly reduce your Central Apneas.  If you had significant Centrals/Mixed/Complex apneas in your diagnostic study (without CPAP) you may have them for a while, so full copies, not just summaries of all your sleep studies are important.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#3
RE: New diagnosis, 3 weeks with CPAP
Quote:What did you change to fix that?  It wasn't pressure.

Thank you, bonjour.

It could be that I recently replaced a foam pillow with a fiber-filled pillow.

I'll ask my DME for the full report. I have the manual for the Dreamstation and can turn off the flex. Is it ok to do that during a trial period?

I've attached the sleep study report.


.pdf   report.pdf (Size: 366.78 KB / Downloads: 35)
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#4
RE: New diagnosis, 3 weeks with CPAP
Report says "probable CSR."
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#5
RE: New diagnosis, 3 weeks with CPAP
i would, That is considered a comfort feature, not a therapeutic one and most of the medical community has no idea of its therapeutic capacity.
Do you have any heart or breathing issues other than apnea? This is important. The report identified the hypopneas as looking like CSR. CSR is associated with some serious heart conditions, most notable CHF or Congestive Heart Failure. Either way please have your regular or cardiac doctor check for this.

Post a couple of 5 minute views of your clustered hypopneas for review please, just click on a cluster repeatedly until you have a 5 min shot please.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#6
RE: New diagnosis, 3 weeks with CPAP
(09-25-2019, 12:14 PM)bonjour Wrote: Do you have any heart or breathing issues other than apnea?  This is important.  The report identified the hypopneas as looking like CSR.  CSR is associated with some serious heart conditions, most notable CHF or Congestive Heart Failure.  Either way please have your regular or cardiac doctor check for this.

I've been diagnosed with COPD and asthma. I've never been a smoker. I developed a super-sensitivity to certain odors (particles?) such as diesel fumes, pine-sol, bleach, most cooking fumes after being exposed to unvented plasma cutter gases at my work place for about two years. The plasma gases were leaking into the office area and leaving a coating of powder on surfaces. My airway would close up and a feeling of doom and dread would come over me. Was on prednisone and then puffers for about 9 months. My employer properly vented the plasma cutter, my breathing has improved and I'm less sensitive to particles.

I've attached several 5 minute viewpoints.

           
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#7
RE: New diagnosis, 3 weeks with CPAP
In looking at the OSCAR plots, I see a correlation between the leak rate increasing and a series of events. I thought perhaps the increasing leak rate was causing the events, but it looks like the events start before the leak rate increases. Would the leak rate increase as a result of certain types of events which cause one to move their head position, perhaps in distress? Does such a leak then exasperate the situation, leading to additional events?

I told my sleep clinician that I waking up with an extremely dry mouth several times a week. He said the the data shows a proper mask fit. Will the leak rate increase if my mouth opens as well as if the mask position presents an opening? Does the clinician who is looking at the patient data downloaded from the CPAP MODEM have the same level of detail as the data available on the SD card?

I've attached a screenshot of an OSCAR screen which is zoomed to an area of increase in the leak rate.

[attachment=15737]
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#8
RE: New diagnosis, 3 weeks with CPAP
AHI readings have dropped significantly! Almost to 5, which is normal for a healthy person. It may take much of searching in the beginning before finding the right and proper settings. Hope they are found near future.
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#9
RE: New diagnosis, 3 weeks with CPAP
Thanks, unidee!
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#10
RE: New diagnosis, 3 weeks with CPAP
Lost my reply.  Your leak rate is well within limits, you are not mouth breathing which looks like the top of a table on the leak chart.
The data that your cilinican gets is low res data, yours is high res.That is close to CSR, but is not as regular as CSR, Keep an eye on it.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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