TheAspiringSleeper [Therapy Thread]

[TheAspiringSleeper]

Here's a screenshot of OSCAR data from last night. Pressure is fixed at 9.0 cm H2O. I was awake for much of the recording time. The longest stretch of "sleep" is right at the end. The time appears to be shifted by 2 hours - local time during this recording was 12:00 am - 4:45 am.

I jerked awake with a kind of choking gasp at the end of this session. I also have a stomach cramp / nausea, possibly aerophagia?

I'm so tired. I know I can't keep this up.

[Sleeprider]

Well my guess was wrong, and your therapy actually looks very good. Near the time stamp 4:20 we see several large spikes in the flow rate indicating a gasp (higher flow rate). These are not associated with flow limitation, events or leaks, so we are left with a spontaneous arousal that is not apparently related to the therapy. The last part of the second session has a lot of leaks which would be disruptive to sleep.

You don't seem comfortable with current therapy, so let's try something else with your settings and we will see if it helps with comfort. Your machine is already in Autoset mode, so let's set a minimum pressure of 7.0, Maximum pressure of 9.0 and EPR On full-time at a setting of 3. This will significantly drop your apparent pressure. If you find the pressure changes from inhale to exhale to be disruptive, then just reduce the EPR setting to 1 or 2. I would suggest trying this while your are awake so you can evaluate the change to a bilevel pressure.

To correct the time, you must wait until after-noon machine time. I will suggest after 3:00 local time. Carefully reset the time back 2-hours to the correct time without changing the date. The clock time is not important, but it's nice if it can be reasonably close as you look at the data. Here is a link on how to access the settings, and you can request the clinical manual for the Airsense 11 if you don't already have it. https://www.apneaboard.com/resmed-airsen...setup-info

[TheAspiringSleeper]

Thank you for taking a look. I will try the settings you suggest. I suspect my therapy looks good here because I’m not asleep - the only part of that session where I’m certain I was “sleeping” was the last part of the second session.

When I was using the Dreamstation 2, the first couple of days I slept comparatively well and my AHI was consistently between 2-4. As I continued to use it, by week 3 my sleep was so fragmented I felt worse than if I didn’t use it at all.

I’m trying to get the raw data from my sleep study and the Dreamstation 2, but I don’t think the doctor understands what I’m asking for.

Is this really all in my head? It doesn’t make sense to me that I’d get less tolerant of CPAP with continued usage.

[SarcasticDave94]

Addressing the sleep study, just ask for the full detailed report, the multi paged one. Sleep diagnostic report, what parts do you want? All of it. If this doc can't figure out that simple request, I suppose you'll need lots more help.

[TheAspiringSleeper]

Thank you for replying. "Delaying while in denial" is exactly what I was afraid of  .

However... I really haven't been sleeping well since I started using CPAP (5 weeks or so, with a couple breaks of 5-7 days). I've had a couple nights where maybe? I slept OK and thought "oh, ok, this could work", but mostly it's been difficulty falling asleep, waking up frequently, & then not falling back asleep. Add to that the dry mouth, sore throat and stomach cramps / bloating.

I feel like a caged animal. For the last couple of weeks every day where I use CPAP is worse than the one before it. I'm so tired right now I can barely see. I'm not exercising or spending time with friends (too tired, everything hurts). My wife tells me I look like a different person. I'm tired all the time but I avoid going to bed because I know what's going to happen (again) - I'll watch the minutes turn into hours and every time I start to drift off something happens and I'm back awake again.

I'm stuck between desperately needing to get some sleep and trying to do what the doctors tell me. Right now the price is way too high.

I've attached a redacted copy of my home sleep study. I recently switched from a Dreamstation 2 to a ResMed AirSense 11... but I haven't been able to actually fall sleep with it yet.

I know there are a few nights with the Dreamstation 2 where I got halfway decent sleep. Does the Dreamstation 2 transmit detailed flow graphs to my doctor if I'm not using an SD card?

Thank you again for your replies.

   
   
   

[TheAspiringSleeper]

Thank you for your reply.

Here's the most recent OSCAR chart I have. I was awake for 90% of the recording time. The only part where I might have been kind of asleep was the last third or so of the second session (far right on the time series). I'll post more if I'm able to sleep with it again.

It’s difficult to get adequate deep and REM sleep with that kind of nightly disturbance

I understand... but whatever sleep I'm getting now is way, way worse that what I was getting before. I've never experienced excessive daytime tiredness without CPAP.

[attachment=37588]

[TheAspiringSleeper]

I posted my sleep study report to my other active thread (not re-posting to save on upload quota):

/forums/Thread-Health-Mild-Sleep-Apnea-How-Important-to-Treat?pid=424056#pid424056

Do you know if the Dreamstation 2 sends a detailed diagnostic report to the doctor if I'm not using an SD card? I understand that I can't use the Dreamstation 2 with OSCAR, but do you happen to know if this data is part of what's transmitted to the doc?

Thank you.

[SarcasticDave94]

OK, here's the events in actual count

Central 4
Mixed 0
Hypopnea 39
Obstructive 7

So in my opinion, here's what you have to deal with, you do have a low count of Central, meaning you stop breathing, without even the effort. These are due to lower than normal CO2 level, for unknown medical cause, or idiopathic.
You have no mixed here, but this is a one night snapshot.
You have a small level of full Obstructive Apnea. These are the throat has collapsed kind.
Now your worst. Hypopnea. These are partial Apnea, and really we've seen here in the forum that Hypopnea can be either Central or Obstructive events.

Common health knowledge is that most with Apnea diagnosis, the numbers will get worse as you age. I would encourage you to get used to PAP therapy early. Sit in the lazy boy and have PAP and mask on. Watch your TV, listen to radio, read you book. Something to occupy you a bit. Run the PAP as if you're trying to sleep. Try 30 minutes or so. Get used to it. My concern is the pattern from lots of others is untreated and it gets worse. When it does, it brings more serious health concerns.

[TheAspiringSleeper]

Thank you, Dave. Appreciate you taking the time to reply.

I'm really, really trying to get used to it. But lack of sleep is hurting me so severely in the short term that I'm not confident I'm making progress. I'm concerned I'm just reinforcing my negative impression of CPAP's effect on my life.

[SarcasticDave94]

Welcome.

Just confront that the PAP and mask wearing isn't normal. It is alien. The mask is a face hugging alien with an umbilical air cord, blowing nasty air from the mother CPAP ship. Ok well not really.

Each PAP user on this forum had to face this alien mask thing one day. It's not a failure that's on you. Apnea is a lot more common than you might think.

Try to get used to the PAP and mask. And try to relax as best as possible before you mask up. Breathe as normal as possible.

Examine your mask itself and ask yourself if it causes any discomfort. Lots make the mistake of making it too tight to control leaks. If you fell in that hole, OK, dust off and loosen the mask a small amount. If it leaks enough to be a disturbance, consider a different mask model. Yes we're trying to get therapy to be efficient but not at the cost of pain.

If you can't wear this all night, OK fine. Keep trying and extend it some each night.

It appears you OSCAR attachment didn't go right. Ask for assist if needed. Seeing OSCAR will help us in helping you a lot.

BTW you signed up on this forum. There's a rule that says you can't quit.

Time for coffee before bed