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Take a look at my SleepyHead data?
#1
Hi,

I've been struggling for a while now - AHI's normally in the 8-12 range every night. I've been meaning to get back on this forum and try to get some help from you guys and gals. Here is my data from last night; I'd appreciate any insight I can get.

[Image: fc1AF8x.png]

Thanks,
Randy
#2
Mostly central apnea. Are you seeing your doc about it?
Could be the Autoset is not the right machine for you.

If it were me, I'd lower the EPR down from 2 to 1 to see if the CAs lessen.
(The theory being that less EPR causes less CO2 washout.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
#3
First off. I am not a Doctor. Please do contact your doctor!

What I do see. You are doing well with your mask, no large leaks.
You have a couple of obstructive events but not bad. Your Clear Airwave or Central Apnea's AHI is almost 8. Doctor should want that below 5 at the most.
Do you have an oximeter that can record data while you sleep?
Mask pressure changes do not affect Central Apnea's which is why the machine left the pressure unchanged during the events. I would be contacting my doctor wanting them to look at that data.


#4
I would turn EPR off unless you think you need the exhale relief, then just set it to 1.

You could also try lowering the minimum pressure from 12 to 11.5, and if that doesn't cause you to have obstructive apneas, then work on lowering it to 11. You may not need that high of a minimum pressure which could be triggering the CA's.

Also, don't know if your on any type of medications, but that may cause you to have more Centrals.

Try one thing at a time, and give it a few days.

If you don't see a difference in CA's, you may want to talk to your doctor.

#5
Central apneas might be idiopathic (ie you have them regardless of anything else), drug induced (especially opiate painkillers) or pressure-induced.

If you are on medications, it might pay for your GP to do an audit and see which could possibly be contributing to the problem. Check your sleep study report and see if it was showing central apneas prior to starting with the machine. If so, you might need a different type of machine. Finally if you're not on medication and didn't have a prior history of CA, then they are likely pressure induced. Follow the advice above - reduce or turn off EPR, look at bringing your pressures down as far as possible without causing obstructive apneas and hypopneas.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
#6
Randman, you might reduce minimum pressure just a bit. I don't think your CAI is from the 2 cm EPR you're using. Your therapy is set to a range of 15/12 with EPR 2. I would drop that to 13/10 with EPR2. You might even be able to tolerate an auto CPAP minimum pressure of 8.0.

One question is, how do you feel currently with all this CA?
______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead


#7
I am not used to Sleepyhead (I have an S8 so I can't use it), but from what I can make out that is over 15 minutes of apnea in the night, which is a lot, but I can't see any information about apnea duration. 60 events total average about 15 seconds each, so it is possible that it is not so bad as it seems if they are all quite short. If a few of them are very long you must be feeling pretty auwful the next day, though - and very bloated, perhaps! I would seriously consider reducing the minimum APAP setting dramatically - to around 5 or 6 - for at least 1 or 2 nights and see how that affects you. My feeling is that such a high pressure is of very dubious value, unless there is good reason for believing you really need it. If the machine still insists on going to very high pressures you could consider modestly reducing the maximum pressure setting as well, keeping a close eye on the results.

There are only 3 events in the whole night marked as "obstructive", and I would want to zoom in on those waveforms but I would say all 3 are almost certainly during wakefulness (i.e. not real apneas), and might result from adjusting the mask before sleeping. When the waveform is very rough like that it usually means you are awake.

Some years ago I was using APAP and the machine was (wrongly) zapping up to about 10 to 13 cm by itself, and I found that itself was causing serious apneas. I forced it down to a MAXIMUM of 7 (which at that time was my prescribed setting), and the apneas immediately reduced massively. These days I set it on CPAP rather than APAP at a fixed pressure of 4.6, which works fairly well for me (less than 4.5 tends to result in inadequate flushing of expired air from the mask, I find). The Resmed S8 firmware is very primative in its heuristics and cannot keep track of my breath properly. I use an S8 with the Reslink data unit and Resscan. Hopefully the S9 has better heuristics than the S8.

A critically important question in my opinion is whether you have adequate ventilation? You may find that by making sure you have a really good supply of fresh air. Keep the window wide open and keep the S9 close to it, and make sure that there is an efficient through draft. I find that (plus avoiding excessive pressure) makes far more difference in reducing apneas than anything else.

Another thing which can help for central apneas is taking Lobelia inflata D2 globules immediately before sleeping. It is a homeopathic remedy mostly used for reducing dependence on tobacco, but I find it makes a small but significantly helpful difference to reducing apneas. It is a plant traditionally used by native american indians for breathing disorders, and it apparently strengthens the signal in the nerve going from the brain to the thorax which triggers the breath. (The D2 refers to the concentration, the higher the concentration the more dilute it is; anything above D3 is utterly useless for our purposes, don't bother with it! You will almost certainly need a doctor's prescription for the D2 concentration.) Note that dose is important and you have to adjust it individually by trial and error! If the dose is too high it has the opposite effect!! Try 1 globule per night first (suck it in the mouth until completely dissolved). If it is the optimum dose it will help you drop off to sleep slightly faster than usual, it will slightly increase REM sleep, and slightly reduce apneas (not dramatically, in my experience, but the increase in REM sleep is a real gem). If the dose is too low, the effect will be reduced accordingly. If the dose is too high it will give you a restless/agitated feeling, it will take longer to get to sleep, and sleep will be more broken. In the morning if the dose is optimal or too low the Lobelia will probably have very limited or no drowsying effect, unless the optimal dose for you is relatively high (4-5 globules), in which case you might find yourself a bit sleepy for the first part of the day, and you probably want to sleep a bit longer. If the dose is too high you will probably feel more sleepy in the morning. Gradually increase the dose (maximum 5 globules, always in one go IMMEDIATELY before sleeping) until you find a very slight negative effect (slight restless feeling and broken sleep) then reduce the dose by one. If 1 globule is too strong, take 5 globules of D3 instead, which is the equivalent of 1/2 globule of D2. (Note: according to homeopathic doctrine the effectiveness for homeopathic purposes is supposed to INCREASE the MORE it is DILUTED!! Therefore a homeopathic doctor/pharmacist may try to persuade you that D3 is more "powerful" than D2!! It is NOT!! We are not using it as a homeopathic remedy here, therefore the homeopathic doctrines are entirely irrelevant to our particular purpose, which is as a traditional native american herbal medicine).
#8
Quote:My feeling is that such a high pressure is of very dubious value, unless there is good reason for believing you really need it.

While 15 is a reasonably high pressure, it's not unusual. What is you basis for saying it is of "dubious value"? Presumably it was prescribed following a sleep study. While these are not infallible, they are usually a good place to start, and much better than "a feeling".


Quote:Another thing which can help for central apneas is taking Lobelia inflata D2 globules immediately before sleeping.

I'd be very reluctant to take this substance in any dose at all. See here: http://www.webmd.com/vitamins-supplement...me=lobelia

Lobelia is considered LIKELY UNSAFE for most people when taken by mouth. Side effects include nausea, vomiting, diarrhea, cough, dizziness, tremors, and more serious effects.

Overdose may cause many serious toxic effects including sweating, convulsions, fast heartbeat, very low blood pressure, collapse, coma, and possibly death. Taking 0.6-1 gram of the leaf is said to be toxic, and 4 grams may be fatal.

Not enough is known about the safety of applying lobelia to the skin.

Special Precautions & Warnings:
Pregnancy and breast-feeding: It’s LIKELY UNSAFE for anyone to take lobelia by mouth. The particular concern during pregnancy is that it can cause serious vomiting. Don’t take lobelia if you are pregnant or breast-feeding.

Stomach or intestinal problems including ulcers, Crohn's disease, inflammatory bowel disease, infections, and others: Lobelia can irritate the GI tract.

Heart disease: Lobelia seems to affect the heart. Larger doses cause more of an effect.


Quote:It is a homeopathic remedy mostly used for reducing dependence on tobacco

Its use for reducing dependence on tobacco is banned by the FDA.

Quote:We are not using it as a homeopathic remedy here,

I'm glad you said this - homeopathy has absolutely no scientific basis at all and is nothing but a major fraud perpetrated by unscrupulous quacks.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
#9
(08-21-2016, 07:07 AM)DeepBreathing Wrote:
Quote:Another thing which can help for central apneas is taking Lobelia inflata D2 globules immediately before sleeping.

I'd be very reluctant to take this substance in any dose at all. See here: http://www.webmd.com/vitamins-supplement...me=lobelia

[i]Lobelia is considered LIKELY UNSAFE for most people when taken by mouth. Side effects include nausea, vomiting, diarrhea, cough, dizziness, tremors, and more serious effects.

I second, third, and fourth you DeepBreathing.
Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.


#10
I'm a bit confused. This thread was started by Randman who has NOT mentioned any homeopathic meds, yet the last couple responses are to Bhante, who on his third post, frankly came out of right field on this. I think it's fine to disagree with those suggestions, but we are still waiting to hear back from the O.P. to get back on topic.
______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead


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