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Still tired and having quite a bit of clearways
#1
Still tired and having quite a bit of clearways
Hello, I lowered my EPR per advice and sleep quite a bit more while using my Apap, But still not getting quite restful sleep yet

I go on Oscar to analyze and says I had around 20+ Clear way apneas?? Could this be keeping me from still not feeling rested?

Maybe my settings are not right..Just need a second opinion, Thanks! Smile

   
   
   
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#2
RE: Still tired and having quite a bit of clearways
Correct, this level of CA/Clear Airway, which in medical terms is Central Apnea, would likely be your sleep robbing thing. You have lower levels of anything else that could hinder sleep.

Let's go back to the beginning. How long have you been on the PAP? Longer than 3 months? What did your diagnosic and titration test reports state? Do you have these? If you don't yet have your copies, get the detailed versions, post redacted copies here. HIPAA law permits you to request and receive. I'm looking for how many CA were on these reports, signifying if they were pre-existing or treatment emergent.

Answering these questions tells us what type these CA are. Your answers inform us and shape our responses. Your EPR is only on 1, but you could try off to see if things change. Ramp can increase CA if it's on. Sometimes, the pressure range itself might affect the CA. Basically things that alter pressure might affect CA.

The problem can get complicated, because CA are consistently inconsistent and CA versus Obstructive Apnea are on opposite sides of the Apnea treatment teeter-totter. Treating one side will inevitably make the other go up.
Dave

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#3
RE: Still tired and having quite a bit of clearways
I was recently diagnosed with UARS from a PSG Sleep study and I started PAP therapy about a month ago

My sleep doctor didnt say I had a problem with central apneas 

I think they may be treatment emergent though but you can take a look 

Here the sleep study So you can see


https://www.dropbox.com/sh/lsw7p0yvuupf2...ZzjIa?dl=0
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#4
RE: Still tired and having quite a bit of clearways
From about a month ago**
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#5
RE: Still tired and having quite a bit of clearways
In your sleep study, I see low total sleep, arousals at a pace that surely disrupted sleep, more like fractured it. It was instructive to see that more arousals were not caused by effort to breathe than were. Also, it showed less than normal REM sleep, and plenty of NREM Stage N3, which is deep sleep. Aside from hypopnea, the remaining events are either central, or arousal related.

It appears to me that you are more helped by laying on your left side than by any airway pressure. APAP might be agitating you more than helping.

Maybe someone else will have a recommendation.

QAL
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#6
RE: Still tired and having quite a bit of clearways
How long has OP been on PAP therapy? Given that he/she joined AB in April 2021, that would perhaps indicate 7 months on PAP, so the centrals are probably not treatment emergent. In that case, OP needs to know that the current machine is NOT intended to deal with centrals. VAuto is the machine built to deal with centrals. Tell/show the provider the data and press for a better machine.
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#7
RE: Still tired and having quite a bit of clearways
>>>VAuto is the machine built to deal with centrals.<<<

Not true! It is the AC10 ASV which can treat central apneas.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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