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Not sure where to begin
#1
Not sure where to begin
I'm a long time CPAP user who has become complacent and I'm now running into some trouble as my AHI numbers have been way too high and I'm feeling the effects of it.  I use an autopap (Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-Flex (760P) with the settings set from 12 to 25. 

My numbers were reasonably good until Feb 20th when I had another surgery on my knee and that threw me out of whack.  I thought that I was leveling off post surgery, but lately the numbers have gone in the wrong direction and I realize that it's time for me to take charge of my situation and get things under control again.  With that in mind, I have an appt with my sleep doctor this week but I know from past experience that they don't always provide a whole lot of guidance so I'd like to be as prepared as possible in order to maximize my visit.
That's why I'm here.  I'm hoping that someone here can advise me on how to get back on track with my sleep and possibly give me some advice on what to ask my doctor or help me to get the most out of my appt with her.  I'm attaching my latest stats from OSCAR. 
Thanks in advance for any help!
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#2
RE: Not sure where to begin
Can you post a daily graph as well so we can see how your events are distributed over a typical night
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#3
RE: Not sure where to begin
Sure.  Please let me know if this isn't the right information.   Thanks!
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#4
RE: Not sure where to begin
Here's another screenshot.     I seem to be having an issue with leaks, also.
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#5
RE: Not sure where to begin
Make sure that all events are turned on (lower left corner of the charts, AHI of 23 and the 0.0 do not belong together.
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#6
RE: Not sure where to begin
I'm sorry, but I'm not sure what you mean? I see the AHI of 23 and the 0.0, but I don't see where to ensure that all events are turned on...?
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#7
RE: Not sure where to begin
Make sure your events are turned on,  In the drop down on the lower left of the charts.  
[attachment=11582]
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#8
RE: Not sure where to begin
Okay, thanks. I think that they're all on now. Green vs Red anyway.
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#9
RE: Not sure where to begin
I reorganized the charts according to the wiki.
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#10
RE: Not sure where to begin
Your Obstructive AHI = 15
Your Central AHI = 7
Total AHI = 22

I'm asking because of the Knee surgery, Opioids can increase central apnea,  are you taking them?  Any other meds of note?  
We need to increase your min pressure to reduce your Obstructive Apnea and your min PS to manage the Hypopnea.  This is likely to increase your Central Apnea.
To decrease your Central Apnea we need to reduce your Pressure and your Pressure support.

See a problem?  

The initial questions all revolve around your Central Apnea and its cause.
Do you have a history of Central Apnea prior to your surgery, I know that opioids are typically used for knee surgery and that opioids definitely can cause centrals.
I'm looking to understand if these centrals will go away in the future.  That will make a difference in the talking points with your doctor.
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