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[Treatment] Starting to lose it.
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JamesW Offline

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Posts: 57
Joined: Nov 2015

Machine: Resmed Airsense 10
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: In built
CPAP Pressure: 6-10
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Sydney, Australia

Post: #1
Gross Starting to lose it.
have been on CPAP since last November and it has been a roller coaster ride. My prescription settings are a straight pressure of 7 and an apap setting of 5-10. I had these after the usual two sleep studies. I have had some nights of low AHI under .75 on average, however on a few nights my AHI is up quite a bit, for me anyway, and I am starting to get very concerned. I have a follow up appointment with my sleep doctor this coming Monday and I will be putting my concerns to him. Mainly I am worried about the nights of high CA's. I have always had some CA's, however my testing didn't reveal any. I picked up a replacement Airsense 10 Auto yesterday, the first one was quite noisy and the new one is just as bad after one night, and trialed a Mirage FX mask last night. My Eson is not my best friend, with some leak issues. I seem to have a lot going on Unsure I have attached some overview graphs. I would be keen for a few thoughts about where I am and how to proceed.

James
01-29-2016 03:41 PM
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Rick_V Offline

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Posts: 51
Joined: Jan 2016

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: Unsure
CPAP Pressure: 5-9
CPAP Software: ResScan SleepyHead

Other Comments: CPAPing since 2006

Sex: Male
Location: Fort White, Fl.

Post: #2
RE: Starting to lose it.
Do you follow a routine? My AHI"s are always <0.3 unless I stay up late or eat late or drink alcohol or drink caffeine after lunchtime etc. Sometimes these factors play a big part in quality of sleep.
01-29-2016 03:54 PM
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Sleeprider Online
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Posts: 3,335
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #3
RE: Starting to lose it.
Hi James. Your data show a small increase in CA events, but really it's very very low both in the aggregate AHI and CA. This is not a concern for your health. Clear apnea can be central events as in complex apnea, but I'd guess the few events you're having may be clustered around periods when you are awake or semi-awake. Some of us refer to this as sleep-wake-junk, and it's more common than you think. It is simply holding your breath as you turn in your sleep, or while you're semi-awake before the autonomic breathing reflex kicks in. The modern CPAPs with data do a pretty good job of interpreting events, but they can't tell when you're asleep, and the only tool they have for determining a CA is a pressure pulse or the Resmed Forced Oscillation Technique (FOT) with pressure sensor to determine if the airway is clear or obstructed. This is NOT a diagnostic of central apnea.

It would be more revealing if you could post a Daily graph of the events, rather than a long-term trend. I just want to emphasize this is common, and not at a level of concern.

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01-29-2016 04:38 PM
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Sleepster Offline
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Posts: 4,991
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #4
RE: Starting to lose it.
I very much doubt that your doctor will share your concerns. In fact, quite the opposite. The data shows that the machine is doing a stellar job of treating your condition.

Many people confuse the diagnosis of "sleep apnea" with the occurrence of apneas. Apneas will occur in almost every person. They are defined as a certain percentage drop in the flow of air for a time of 10 seconds. You could have a higher percentage drop for only 9 seconds and it wouldn't count as an apnea. The diagnosis of sleep apnea is based on statistical criteria. Therefore so is the treatment. The purpose of CPAP therapy is not to eliminate all apneas (although in some cases it does appear to do that for some people) but to lower their occurrence from an unhealthy level to a healthy one.

The same medical criteria used to diagnose your condition will now declare it treated.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
01-29-2016 04:50 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

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Sex: Male
Location: Sillicon Valley

Post: #5
RE: Starting to lose it.
So my question is are you concerned about the centrals just because they are there or are you not sleeping as well as you would like and are looking for the cause?
Personally I have up to 40 or 50 centrals a night and am sleeping just fine. I kept questioning the Doctor about the number because I was not sleeping as well as I wanted, even with a low AHI, and my Doctor kept telling me that the centrals I was having was nothing to worry about. I went to a pulmonologist and discovered the reason I was not sleeping well, fixed that and the centrals remain while I am speeling quite well.
01-29-2016 05:30 PM
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JamesW Offline

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Posts: 57
Joined: Nov 2015

Machine: Resmed Airsense 10
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: In built
CPAP Pressure: 6-10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Sydney, Australia

Post: #6
RE: Starting to lose it.
        I sound a little paranoid, my wife seems to think so Dielaughing but I do over think my health issues. Apart from sleep apnea I have a chronic lung infection that is very difficult to cure, the simple way to describe it is non tuberculosis bacteria (NTM) and I am mildly bi polar. I have attached a couple of screen shots from a good night and a not so good night. I am very grateful for the support that this forum gives me like

James
01-29-2016 05:47 PM
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JamesW Offline

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Posts: 57
Joined: Nov 2015

Machine: Resmed Airsense 10
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: In built
CPAP Pressure: 6-10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Sydney, Australia

Post: #7
RE: Starting to lose it.
(01-29-2016 05:30 PM)PoolQ Wrote:  So my question is are you concerned about the centrals just because they are there or are you not sleeping as well as you would like and are looking for the cause?
Personally I have up to 40 or 50 centrals a night and am sleeping just fine. I kept questioning the Doctor about the number because I was not sleeping as well as I wanted, even with a low AHI, and my Doctor kept telling me that the centrals I was having was nothing to worry about. I went to a pulmonologist and discovered the reason I was not sleeping well, fixed that and the centrals remain while I am speeling quite well.

I guess that the CA events worry me a fair bit, insert paranoia figure Smile I am sleeping OK and waking up pretty well rested. Far more now then before I started on CPAP.

James
01-29-2016 06:04 PM
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OpalRose Offline

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Posts: 3,167
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #8
RE: Starting to lose it.
JamesW,
I don't see anything in your numbers to worry about. You don't have that many CA's, and normally they will settle down after awhile.

What I do see is that your start pressure of 5 is too low, and your max pressure should be raised.
If you look at your pressure graph, you zoom right up to 9 pretty fast and stay there.

A good start pressure for you would be 7, which is what you were titrated at.
Also, since your bumping against your max pressure of 9, you could raise it to 10.

APAP setting 7-10, and watch for a couple weeks to see how you feel.

OpalRose
01-29-2016 06:09 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #9
RE: Starting to lose it.
I have been on since July of last year. I found that it took quite some time for me to "trust" the machine and process. I do not give control of my breathing over to a machine easily. I also had to recover from waking every 30-60 minutes all night, every night before CPAP. I was always scared that this would come back. Each month I trusted the machine a little more and got the machine a little more dialed in.
01-29-2016 06:18 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #10
RE: Starting to lose it.
(01-29-2016 05:47 PM)JamesW Wrote:  I sound a little paranoid, my wife seems to think so Dielaughing but I do over think my health issues. Apart from sleep apnea I have a chronic lung infection that is very difficult to cure, the simple way to describe it is non tuberculosis bacteria (NTM) and I am mildly bi polar. I have attached a couple of screen shots from a good night and a not so good night. I am very grateful for the support that this forum gives me like

James

Both nights look Ace to me.
Many people would love to have graphs that good.

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.
01-29-2016 07:24 PM
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