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[JoeyWallaby]

Your obstructive apnea index is 8.3, mixed 0.8 and central 0.3 but hypopneas are 11.3. Those hypopneas could be obstructive or central, it doesn't look like they sub-classified them. They also listed a flow limitation index and RERA index on the report but didn't actually score flow limitations or RERAs.

[Tommysnoozer]

Thanks for your reply Joey,

This is all good info to take to my consultant next visit. I’ve been doing some swotting on the Wiki page to try and get myself up to speed, as I’m certain there’ll be some resistance from him. The amount knowledge I’ve gained here is overwhelming, but I feel much more positive about my treatment. 

I’ve attached some screens from an earlier sleep report from 2017 (found it whilst digging through my patient records) where FL was measured, but unfortunately not RERAs. I’m not sure if it’s any use as I’ve had a Septoplasty, Uvuloplasty and Turbinate reduction since then. 

Much appreciated,
TS

[Tommysnoozer]

Here’s the other 2 and I’ve flipped the graph page to make it easier to read
TS

[JoeyWallaby]

Don't know how long you've used for CPAP but it seems like a while, so I really doubt these CAs are going to resolve by themselves. Plain fixed CPAP appears to be doing an OKAY job treating most your OA but you still have residual hypopneas, it isn't doing anything for the CAs (might be making them worse) and you some level of flow limitation.

Post some close-ups of the flow-rate if you want to see how bad the flow limitation is.

See my thread here if you don't totally understand what I mean by sub-classifying hypopneas http://www.apneaboard.com/forums/Thread-...g-OPTIONAL

[Tommysnoozer]

I’ve been using my machine on and off (usually 4-6 week bursts on average, then the same time without) for nearly 3 years. My compliance has been fairly poor, so I wonder if I haven’t given it enough time for the CAs to subside (wishful thinking)? 

Am I correct in thinking that if the primary problem is OSA, then removing the Obstructive element should remove the need for CPAP, and thus remove the secondary (and more difficult to treat) problem of the TECSA? Or do my results show something otherwise? 

I’ve been seeing an ENT privately who has some specialty in Sleep Apnea who mentioned that some sort of procedure that hardens the soft palate might be beneficial.

I’ll have a proper read of that thread and also I’ll post some zoomed-in screens when I get a chance - I’ve been up the wall with work the past few days.

Thanks,
TS

[Tommysnoozer]

I’ve just glanced through your thread reub-classifying Hypopneas and looked at the results of my most recent Sleep Study. I understand it better now. So, because my hypopneas weren’t sub-classified I don’t know whether these Hypos were Obstructive or Central in nature and therefore just removing the Obstruction element might not eliminate Sleep Apnea?

[Tommysnoozer]

Hi all, apologies for the delayed reply. I've got some screens from the past few nights which are interesting. I switched from a Full Face mask to a Nasal (with chin strap) and the difference in my results is significant. My Obstructive events are completely gone, and my CAs and Hypos have improved also. This has greatly improved my EDS.

1st image is sleeping on my back with a FFM
2nd is sleeping on my side with Nasal (past 2 nights looks similar)
3rd is zoomed screen from same night (is there anything of note in there?)

Does this still look like EPR causing centrals? I tried EPR off with FFM but ended up with Aerophagia but I might give it another go with the Nasal.

Thanks for the help,
TS

[Tommysnoozer]

Post some close-ups of the flow-rate if you want to see how bad the flow limitation is.

See my thread here if you don't totally understand what I mean by sub-classifying hypopneas http://www.apneaboard.com/forums/Thread-...g-OPTIONAL

Hi Joey, is this image useful? As you can probably see by my replies to you I figured out that it's not so simple as removing the Obstruction to cure Sleep Apnea! It's good to know, since I was recommended Mandibular Advancement surgery, but refused after hearing about how awful recovery time can be (gf had Mandibular Reduction surgery as a teenager). 

It's an astonishing oversight not to sub-classify Hypos. I see it as a symptom of a wider diagnostics problem in the Medical Community - all too often they follow procedure without any disgression.

Cheers,
TS

[Geer1]

One night may just be an outlier.

My guess is the centrals are still present just weren't as bad that night. You should only be trying either EPR off or 1 as that is what is going to help centrals. Pick one and stick with it. Changing two things at once (EPR setting and mask type) makes it impossible to know what is causing the change in results if you make one change at a time and monitor the data for a few days after each change you will get a better idea of whether the change was good or not. Once you get what you think is likely ideal you need to just stick with it and not change things, let your body adapt fully to new settings and see what the longer term results look like.

[Sleeprider]

I'm seeing clustered obstructive events, and the zoomed image has flow limitation with pretty strong inspiratory snore. Have we talked about a soft cervical collar? See link in my signature links.