Normal or NOT my report numbers I am at a lost

[Lise C Gervais]

Lise C Gervais Wrote: 
Yes tell me about Dream Station Pro Bpap using a lot of water. I have notice sometime I am empty in the morning. Just got this machine but I don’t understand the report
I am set 17 preassure right off the bat to start exhaling, then inhaling is 25.  So I am 25/17
Every morning when I look it is never the same number

AHI.         Usage.       Mask fit.      Clear Airway.      Obstruction apnea.       Total Hypopnea
10.2.         12.44.        66.                62.                         18.                           50
22.1.           9.01.        87.               138.                        39.                           23
40.4.           9.13.       100.              300.                        65.                            8
13.8.           6.14.        93.                43.                         21.                           22
19.1.           7.50.        89.                67.                         35.                           48
31.8.         10.55.       100.              211.                       119.                          17
17.9.          8.51.        100.              126.                         26.                           7
14.2.         12.11.         60.                94.                         21.                          58
30.9.           9.27.       100.              253.                         34.                            5

Is this mild , moderate, or severe to your opinion ?
This is my report since I had the Dream Station. But I have no idea what it means if good or bad ?
I am at a lost can someone help me to describe each department of titles and what they mean
I would appreciate some kind of difenition of this report.. Greatly appreciated and Thank you. 

[Sleeprider]

You have complex sleep apnea with a mixture of both central and obstructive apnea. You need to take your results to your doctor and get a test for ASV (adaptive servo ventilator), which can resolve complex apena. Your apnea ranges from moderate to severe even with treatment. Do not delay, you are using the wrong therapy for your condition.

[Sleeprider]

Lise, in addition to my above recommendation, your current therapy pressures are very high with a lot of pressure support (inhale pressure minus exhale pressure 25-17= 8) PS=8 cm). You probably need much much lower pressures and less pressure support to give you immediate relief, however the solution is to get a bilevel machine with what is called a backup rate, which gives you the pressure needed to take a breath when you don't take one yourself.

I strongly recommend you immediately pursue proper diagnosis and treatment. Get copies of your sleep studies. Ask your doctor what his plans are, and if they are not to immediately remedy this, you need to get a second opinion and proper care. Your doctor is aware of your problem because he prescribed a bilevel machine, and used the pressure support of 8-cm which may have temporarily cleared your central apnea during titration testing. THIS IS THE WRONG MACHINE! You must obtain titration for ASV as soon as possible. In the meanwhile you would be more comfortable with lower fixed pressure and nearly no pressure support, and possibly using no machine at all.

The best machine for your condition is probably the Resmed Aircurve 10 ASV https://www.resmed.com/us/en/commercial-...0-asv.html https://www.resmed.com/us/dam/documents/...er_eng.pdf

The Philips Respironics Dreamstation BiPAP Auto SV Advanced is also an ASV machine, but in general I have seen better, more comfortable results with the Resmed. You may wish to express a preference for the Resmed when the time comes.

[Lise C Gervais]

What is a ASV adaptive servo Ventillator.

[kiwii]

This is the product page for the ResMed machine:

https://www.resmed.com/us/en/consumer/pr...0-asv.html

[Sleeprider]

Lise, I see you are in Ontario. Your provincial health system is not well suited to treating complex apnea, but ASV is a bilevel machine that looks like your CPAP, but it automatically adjusts pressure to prevent obstructive apnea, and provides pressure support (more inhale pressure) when you have central apnea or hypopnea, to cause a full breath. The biggest difference from your current machine is that it actively provides inhalation pressure when you have central apnea. Your current machine just stays at exhale (lower) pressure.

Call the doctor or whoever is managing your CPAP care, and ask them about what the health care system does for central and complex apnea. You need a different treatment.

[Mogy]

Hi Lise,
It can be difficult to start CPAP therapy for some people. Your body/mind is not used to the extra pressure from the machine.
What was the result from your sleep study? Did it mention CAI, Central apnea or complex apnea?
Who set you up with your machine at those pressures?
When I started on CPAP I had a similar reaction. My treated AHI was higher than my untreated AHI. It appeared that my apnea was worse than it was before I started therapy. Complex apnea. After a month with my machine, things settled down, I got used to the machine and most of the clear airways(Centrals) went away.
It is still too early to tell whether this will happen to you. The CPAP induced complex apnea may go away with time, or it may not. If it doesn't, there is another machine that will treat the complex apnea. The ASV.
Don't worry and don't do anything too quickly. Give your body a chance to adapt to the change you have just given it.

[pholynyk]

Lisa, I asked my DME about whether or not the Ontario ADP covers ASV machines, and she said it does not. If you have good coverage with an extended health plan, it may be covered, otherwise you will have to pay it yourself. There may be on-line options, such as Supplier #2, that can reduce your cost. Do talk to your doctor first.

[kiwii]

Lise, I'm so glad that you found this forum! You're being hit with a lot of information, and it can be hard to process everything all at once. Hang in there! I've only been here a few months, but have seen people's lives be transformed once their sleep apnea is successfully treated.

I am writing to let you know this:

I have never seen Sleeprider speak so emphatically. He is one of the experienced and knowledgeable people here. I've seen the success people have had when he helped them get the right treatment when they needed more than the basic cpap or bilevel machine could provide.

Because of this, I would urge you to contact your doctor as Sleeprider has suggested.

I apologize if my wording is alarming. I have no knowledge of what you need. It is just that I have learned to trust Sleeprider's opinion, and I've never seen him speak so strongly.

[Mogy]

Hi Kiwi, Sleeprider,
Normal I would defer to Sleeprider's knowledge and good judgement but on this occasion I feel very strongly as well. I have followed Sleeprider's suggestion for pressure adjustments with good results. On this occasion I don't feel his recommendation is correct at this time. It is too early.
From studies published by NCBI, greater than 90 percent of complex apnea resolve by themselves.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700705/

"While obstructive sleep apnea is effectively treated with continuous positive airway pressure (CPAP), roughly 10% of initial CPAP titrations result in emergence of central apneas or hypopneas, a phenomenon referred to as treatment-emergent central sleep apnea (CSA). Although the majority of treatment-emergent CSA resolves with ongoing CPAP therapy , some patients exhibit persistent CSA, creating a therapeutic challenge."