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Sleephead readings on 5-20cmh therapy
#1
Sleephead readings on 5-20cmh therapy
Hello all. So I've been on CPAP now for just over a month and am about to have my first followup with my doctor tomorrow. I'm still trying to figure out how to read sleephead data. Right now i'm on 5-20 therapy level using Dreamwear Nasal Mask (non-pillow). According to ResMed app, I am averaging 4-5 times mask coming off. And getting good amount of leakage. I've attached my most recent sleephead data along with what ResMed app caught. I would appreciate any kind of interpretation so that I know what to expect from my doctor tomorrow. THank you to all who can help with this!


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#2
RE: Sleephead readings on 5-20cmh therapy
hello figgy15.

your ahi is (barely) below the treatment threshold of under 5, which is good. the question now is how do you feel? if good, congratulations. if not, be prepared to be a strong self-advocate.

you have a high proportion of central apnea (or more precisely, clear airway) events. these may be treatment emergent, in which case the centrals often subside in time. treatment emergent centrals with obstructive apnea is callled complex apnea. natively having both obstructive and central apnea is called mixed apnea.

has your daily ahi been consistent or jump around a lot? did you have any central apnea during your sleep study or references in the report to complex or mixed apnea?

there have been a fair number of us here that have mixed apnea ahi's around 5 on apap but still feel pretty bad. our insurance based system often will not pay for a therapy modality that can address this problem because of their rules about ahi 5> and central's having to be more than 50% of your apnea and a couple others. that's why you have may have to be a squeaky wheel.

either way, make sure your doc acknowledges the central apnea and explains to you how they expect to address them. you might be asked to keep trying the apap to be sure the centrals won't resolve with time. or if you had centrals during your sleep study and/or you have a knowledgable and cooperative sleep doc, they may suggest another sleep study to trial and titrate a couple different machine types (modalities).

again, at this point it boils down to how you feel.
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#3
RE: Sleephead readings on 5-20cmh therapy
You might want to increase your minimum to 7cm and decrease your EPR to 2cm.
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#4
RE: Sleephead readings on 5-20cmh therapy
(07-23-2018, 06:32 PM)I have to say that I have noticed a difference during the day since starting my cpap treatment.  4 hrs of CPAP sleeping (which I\ve done) does feel better then my old 8hrs without it.  I Wrote: hello figgy15.  

your ahi is (barely) below the treatment threshold of under 5, which is good. the question now is how do you feel?  if good, congratulations.  if not, be prepared  to be a strong self-advocate.

you have a high proportion of central apnea (or more precisely, clear airway) events.  these may be treatment emergent, in which case the centrals often subside in time.  treatment emergent centrals with obstructive apnea is callled complex apnea.  natively having both obstructive and central apnea is called mixed apnea.  

has your daily ahi been consistent or jump around a lot?  did you have any central apnea during your sleep study or references in the report to complex or mixed apnea?  

there have been a fair number of us here that have mixed apnea ahi's around 5 on apap but still feel pretty bad.  our insurance based system often will not pay for a therapy modality that can address this problem because of their rules about ahi 5> and central's having to be more than 50% of your apnea and a couple others.  that's why you have may have to be a squeaky wheel.

either way, make sure your doc acknowledges the central apnea and explains to you how they expect to address them.  you might be asked to keep trying the apap to be sure the centrals won't resolve with time.  or if you had centrals during your sleep study and/or you have a knowledgable and cooperative sleep doc, they may suggest another sleep study to trial and titrate a couple different machine types (modalities).

again, at this point it boils down to how you feel.


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#5
RE: Sleephead readings on 5-20cmh therapy
Your settings are fairly wide-open, but your needs are consistently from 7.0 to 11.0. Keep in mind you are using EPR setting of 3, so when your pressure is less than 7, the exhale pressure is stuck at 4.0. Walla Walla suggested increasing minimum pressure to 7.0, and I agree. Your maximum pressure could be set at 11.4 and I think this range pretty well satisfies your needs. Your most recent results include a CAI (clear airway apnea index) of 2.4. If you continue to see the CA events, then reducing the EPR to 2 will help.
Sleeprider
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#6
RE: Sleephead readings on 5-20cmh therapy
Thank you Sleeprider and thank you Walla Walla.  I will try those settings tonight.
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