New user, new diagnosis

[Hydrangea]

Your wife sounds like a good support person.

The sleep report said you left your 1st sleep study "in distress". I'm just being nosy, so ignore me if you prefer, but I'm curious why.

Kudos to you for giving the machine a try, rather than letting it sit in your closet. :-) I'm sure you'll get this figured out (this forum will surely help you!), and then you and your wife will be so happy for the machine!

[DeepBreathing]

http://imgur.com/a/sOhFs

Extracting the numbers from your sleep study, I'm seeing a central apnea index of 4.03 and a mixed apnea index of 0.92. This indicates you are prone to central apnea and your subsequent treatment seems to bear that out:

12/4/2017, AHI = 5.51, CAI = 3.53 - Ordinary sort of night
13/4/2017, AHI = 0.94, CAI = 0.47 - Good night!
14/4/2017, AHI = 9.29, CAI = 6.7 - Pretty horrible night

The majority of your centrals on the 14th seem to be clustered in the early morning and may well be "sleep-wake junk". To be sure, could you zoom in on the section from 05:45 top 07:00 so we can see it in more detail? On the 12th the bulk of the centrals came on at 3 am, associated with some obstructives and the consequent pressure increase. Again, could you give us a blowup of that time frame?

[derekf]

Last night's report: http://imgur.com/a/6JcWM

Looking at the CA events, I think I may have been awake/trying to get back to sleep for most of them. The CSR as well.

[derekf]

Hydrangea: I felt completely unrested and relatively annoyed - not only had I had a really uncomfortable night of "sleep" but the loading dock was right outside the window with deliveries all night (and people leaving their trucks in reverse so the beeping just never stopped), and also that dock is apparently where night-shift people go to have arguments. I had to drag myself out of there and into work.

DeepBreathing - located at http://imgur.com/a/HNu6W; also took close-up of the clusters from last night.

[Sleeprider]

I agree much more with Deepbreathing's analysis than what Bonjour concluded regarding central apnea. Your diagnostic study shows that centrals and mixed apnea may be a significant component of your sleep disorder. The continued centrals in your sleep suggest this may be a continuing challenge with therapy, however the problem is not severe, and may very likely be controlled as you adapt to the PAP therapy.

In the most recent graph we see your settings are presently 5-20 with EPR at full time on 3 on April 12 and 14. April 15, EPR was off and pressure limited to 5-9. CA and periodic breathing appear worse with the higher pressure and EPR. There is no flow limitation or snoring in any of the charts and OA appears well controlled at low pressure.

I think the next step in this process is to gradually reduce the pressure. I think using a fixed pressure, by using CPAP mode or APAP mode with the same minimum and maximum pressure will be helpful, and I would leave EPR off. I'd llke to see a night at a fixed pressure of 7.5 cm and see if the CA is further reduced and hopefully not replaced with OA.

[Beej]

Actually, alcohol is a central nervous system depressant, so depending on the amount, it definitely could affect your sleep and make the apnea worse. Be judicious in use and put several hours between alcohol consumption and bed time to give the alcohol time to be metabolized.

[derekf]

http://imgur.com/a/Rhm3Z

Slept poorly from 4ish-on. Was very shallow and seems like I spent a good chunk of it waiting to fall back asleep.

I also have a leak from the very front of the mask, where the elbow fits in. I'd seen somewhere on the interwebs that the fix was to disassemble and wrap the end of the elbow that fits into the mask with teflon tape; that does not seem to have helped any.

[Sleeprider]

If we discount for the disrupted sleep after 4:00 AM, you're AHI is less than 2. Let's repeat and hope for a more restful night.

If you are working with a DME, tell them you have a problem with the mask, otherwise I like to say "resistance is futile", go get a Resmed Airfit P10 pillows mask ($68 on Amazon) and leaks are a thing of the past.

[PaytonA]

Frankly, I think a lot of the CAs are sleep/wake junk which should be ignored.

[DeepBreathing]

All masks are vented to expel CO2. On some Resmed masks the vent is in the form of a collar around the elbow connection at the front of the mask. It appears to be a leak but is a required part of the system. This "leak" must not be plugged with teflon or otherwise.