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New to CPAP and have questions about my diagnosis
#11
RE: New to CPAP and have questions about my diagnosis
MikeBob, thanks for posting the sleep study. I'm quite struck by your O2 desaturations, which were below 90% for 22% of the study period. This is not good, and it tells me that you should trust the diagnosis of severe sleep apnea.

If you have the resources, you might want to invest in a recording O2 monitor compatible with Oscar, just to be sure your O2 sats have improved along with your AHI. On the welcome page of Oscar, click on Oximetry Wizard to see a list of monitors that would be compatible.

It might help you to know that the pressure range that successfully treats obstructive apnea is not correlated with the severity of the apnea. Someone can have severe apnea that is well treated at low pressures; someone else can have mild or moderate apnea that can't be budged except with high pressures.
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#12
RE: New to CPAP and have questions about my diagnosis
(02-12-2021, 04:37 PM)Dormeo Wrote: MikeBob, thanks for posting the sleep study.  I'm quite struck by your O2 desaturations, which were below 90% for 22% of the study period.  This is not good, and it tells me that you should trust the diagnosis of severe sleep apnea.  

If you have the resources, you might want to invest in a recording O2 monitor compatible with Oscar, just to be sure your O2 sats have improved along with your AHI.  On the welcome page of Oscar, click on Oximetry Wizard to see a list of monitors that would be compatible.

It might help you to know that the pressure range that successfully treats obstructive apnea is not correlated with the severity of the apnea.  Someone can have severe apnea that is well treated at low pressures; someone else can have mild or moderate apnea that can't be budged except with high pressures.

Thanks for the reply, and reminding me, The therapist had mentioned she wanted to hook me up to an oximeter again after her initial interpretation of the study. I just phoned the CPAP shop and they had no record of this request. And now will likely push this forward. Smile
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#13
RE: New to CPAP and have questions about my diagnosis
Good, I'm glad you'll be getting an oximeter -- ideally one whose data you can import into Oscar.
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#14
RE: New to CPAP and have questions about my diagnosis
This is a sample of what CSR looks like. zoom (click on the flow rate chart) until you have a 10-minute view that shows the flow rate in a similar manner to the above.  Scan the data using the arrow keys looking for a similar pattern then screenshot and post.  I am particularly interested in the areas of heavier flow limitations.

Because of your oxygen sats I do recommend that you get a recording pulse-oximeter to verify that you do not have an issue, this should be done periodically, but not every night unless you have an issue. 
 
.htm   File_CSR-example_zpsee76d5af[1].htm (Size: 18.97 KB / Downloads: 4)
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#15
RE: New to CPAP and have questions about my diagnosis
(02-12-2021, 05:48 PM)Gideon Wrote: This is a sample of what CSR looks like. zoom (click on the flow rate chart) until you have a 10-minute view that shows the flow rate in a similar manner to the above.  Scan the data using the arrow keys looking for a similar pattern then screenshot and post.  I am particularly interested in the areas of heavier flow limitations.

Because of your oxygen sats I do recommend that you get a recording pulse-oximeter to verify that you do not have an issue, this should be done periodically, but not every night unless you have an issue. 
 

Sorry I don't have permission to access the file you are wanting me to open
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#16
RE: New to CPAP and have questions about my diagnosis
try this
http://www.apneaboard.com/wiki/index.php..._Breathing
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#17
RE: New to CPAP and have questions about my diagnosis
Ok is this what you wanted?

   
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#18
RE: New to CPAP and have questions about my diagnosis
Yes, is this the worst of it?


Don't be alarmed, seriously don't.
This is the kind of stuff I was looking for because of the CSR reported in your diagnostic study.   Not enough here to worry about.
2:08:15 Reduced flow (Flow Limits? or CO2 induced breathing reduction?) prior to IMHO an incorrectly flagged RERA.  
2:09:00 Same as above
These 2 events indicate to me that you may be near your apneic threshold.  To be CSR there needs to be more of these in a row and they need a CA event in between in the reduced flow area before and after.  

02:14:15 arousal This is what your machine thought the heavier breathing was where the above RERAs are flagged.  I believe that this is CO2 affected breathing.  'high' CO2 levels in our blood provide the main drive to breathe and the impact of this what I interpret as happening for much of the period between 2:08:15 and the arousal at 02:14:15

02:10:30 see the smooth waxing and waning here,

High CO2 levels result in heavier breathing flushing more CO2 out of our system, As the levels reduce you breathe less and less deep until levels drop below your apneic threshold and you have a CA event (you are not here) then CO2 gradually builds up and you gradually increase the deepness of your breaths.  and the cycle repeats.

I would like you to scan the rest of the night for similar periods.
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#19
RE: New to CPAP and have questions about my diagnosis
   

K here is another
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#20
RE: New to CPAP and have questions about my diagnosis
Your first example looked like obstructive flow limitation that reduced flow rate resulting in a RERA where we saw recovery breathing. The most recent example is also obstructive. If this was a frequent feature of your sleep, I'd have you looking at positional therapy remedies like a soft cervical collar, but while this is chin-tucking obstruction, it's not worth chasing at this low AHI. Our sleep and sleep breathing is not perfect, and there is no reason to pursue that goal. Your results look very good. Don't over-analyze it, however your minimum pressure is set to 8.0 and your median is over 12.5. I would suggest that your minimum pressure is far too low.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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