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[Treatment] Still Tired, Trying to treat Symptoms
#11
RE: Still Tired, Trying to treat Symptoms
Hello Everyone, 

I found my original sleep study report, and looking through it I realized that I actually only had 2 OA's during the study, 11 CA's and 70 H's. I attached the break down as well as last night's and the nights before OSCAR charts. Does anyone have any thoughts on my original sleep study and what I should change? I am gonna give it a few more days on 7.5 and if it doesn't seem to help try bumping pressures up by .5 as Dormeo suggested.


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#12
RE: Still Tired, Trying to treat Symptoms
I'm reading 11 Central, 1 mixed, 2 Obstructive on the event count. You need ASV. And I'll suggest ResMed AirCurve 10 ASV specifically.

Get an appointment with doc and ask if/when the CA are going to be addressed with ASV. Oh and don't buy it if the doc says the CA don't matter. I'm guessing you're still feeling fatigue and not well treated. That's why. Untreated CA.
Dave

OSCAR
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: Still Tired, Trying to treat Symptoms
PS you'll probably want to limit pressure swings for now. Don't use Ramp, probably limit flex. But it almost looks bad enough not to use it and get seen or a call conversation with doc on urgent need basis.
Dave

OSCAR
Standard OSCAR Chart Order
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Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#14
RE: Still Tired, Trying to treat Symptoms
Yeah, I was diagnosed at 19 when I was very oblivious and careless so I didn't really read into the report much and took their word for it. It makes sense now why despite being very compliant with treatment i still feel like crap almost every day no matter what I change. I'll be calling to schedule an appointment Monday morning to get this resolved ASAP. Any idea why I was told it was OA instead of CA? That's my biggest question why call it OA if I'm barely having any OAs. Thank you for the help! I'll post an update after I get an appointment.
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#15
RE: Still Tired, Trying to treat Symptoms
Yes, my guess is the familiar tune from doc McQuack is they either don't think CA is a problem or (2) they're blind to CA.

You have to make them see it as important. Quite seriously, make doc notice and hear your CA issue. Scribble some notes on the ongoing treatment failures, symptoms and complaints. Your fatigue, discomfort, things like that. Take that report with you with CA highlighted. And when the time comes, you'll request ResMed AirCurve 10 ASV. Change suppliers if you must, because the brand is important too. I've got this ResMed ASV and for you it'll fix that OSCAR mess and your PAP treatment issues ASAP.

Keep us updated and if any other questions come up, post here.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
RE: Still Tired, Trying to treat Symptoms
Your CAI in the sleep study was negligible -- 1.6. I don't think the CAs establish that you have central (or mixed) apnea. It was the hypopneas that stood out, as they do in your recent charts.

We don't always know whether Hs are central or obstructive. Could you zoom in to about a three-minute segment with an H in the middle?

I also see that you did much better on your left side than on either your back or your right side. Do you have any clues as to why that might be?

Although I don't yet see a reason to think you need an ASV machine, I agree with Dave that a good experiment would be to turn down flex. Try 1 and see how it goes.
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#17
RE: Still Tired, Trying to treat Symptoms
I will try that tonight. i honestly do not know why I had more on my right vs. any other position, I think it was mostly because the way the cables were set up I just favored sleeping on my right side that night, I am usually a very active sleeper so the cables were very restricting.  Here's a three minute chart with a H in the middle. Let me know if you would like any other's.


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#18
RE: Still Tired, Trying to treat Symptoms
Actually looking at the summary of all my treatment on OSCAR, the averages in the last year are as follows: 

AHI- 4.19
OA- 0.52
CA- 1.29
H- 2.38

So yes the H's have always been greater but the OA's seem to never have been the problem because consistently through my treatment OA's have been minimal while CA's and H's have been almost consistently higher than OA's. I attached the OSCAR Report below.


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#19
RE: Still Tired, Trying to treat Symptoms
Just a rule of thumb, if most of the apnea are central, the hypopnea usually also follow that trend, and that hypopnea is simply a diminishing respiratory effort without flow limitation or obstruction...central. You actually have better results with CPAP than with no treatment, but your AHI would be nearly zero with ASV. I don't see a clear path to acceptable sleep and low AHI with CPAP, however a Resmed Autoset machine would probably have a lower AHI because it seems to work quite a bit better to sync with this kind of issue. Technically, with CPAP you are treated and getting ASV is going to take a lot of determination and will be an uphill battle. Our wiki on Justifying Advanced PAP explains: http://www.apneaboard.com/wiki/index.php...P_Machines

So, we can try to optimize CPAP, or pursue ASV as an insured therapy or self-funded. In general, people with light central or complex apnea using CPAP do better with relatively steady pressure using low levels of Flex or EPR, or they move to ASV and solve the problem.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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.
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#20
RE: Still Tired, Trying to treat Symptoms
FWIW on the CA I was responding to the report from a sleep study just for reference. Now I will say CA hasn't been too much of an issue within OSCAR summary info. However Hypopnoea seemed to be there. Maybe these are Central based.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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