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Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
#1
Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
My doctor was quick to prescribe a cpap, even before I had the study. I'm always tired, or rather, always have brain fog all day, and it takes me a good 4-8 hours to 'wake up'.

My AHI is 9, BUT I didnt fall asleep until 2am, and slept for only 3 hours or less. Now I was quitting coffee and that also messed me up. And to top it all off, the sleep study room had a dehumidifier running at max, so even while sitting there, my tongue would dry out and stick in my mouth, I consumed 2 liters of water and went to the bathroom twice during that entire wait from 9pm to 2am just to sleep.

Now I'm not unhealthy, could stand to lose 10 lbs of fat and am an early 30s male. 
I probably could use more exercise, especially in the colder months.
Oh, I also never sleep the same time 2 nights in a row, ever, like not in 20 years. 

I've attached my polysomnograph
(keep in mind I didnt sleep until 2-2:30am, and woken up at 5)

You can see every time I dozed off I supposedly had an osa/csa, but no osa during actual sleep,
I was also poking at the mask, as my face was so dry from the room.

I also attached another part of the report that was concerning to me, the technician reported that the equipment had some issues, and she even replaced the oxygen flow tube once on me.

Now I do have a cpap rental, but I have not been able to fall asleep with it on in weeks, only once where my belly filled up with air and I woke up in pain.


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#2
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
Welcome to Apnea Board,

At AHI 9, a CPAP treatment might help. It's might because you'd need to try it to see if it does help. We use OSCAR here to get data off the PAP and post it within this thread. I would recommend ResMed AirSense 10 or 11 AutoSet.

You can decide to get the CPAP and treat low level Apnea now while it is going to be easier. OR you can choose to not treat it while sailing on DeNile. But if you put it off, you will certainly be on PAP later and it may be more difficult to deal with.

It is your choice, but you asked.

Coffee
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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#3
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
sleep studies are notoriously inadequate even in the best of conditions. however, your symptoms suggest apnea so good to get on a machine.

in one way you're actually luckier than most: due to the influence of insurance companies, it's rare to be diagnosed with central apnea even when the study produces nearly all central apnea. in another way, you're not so lucky in that you weren't prescribed an asv machine which is designed to treat central apnea. cpap, apap and bilevel machines are not. you'll have to 'fail' with apap, then fail bipap and even then for reasons beyond comprehension it's still difficult to get the asv machine central apnea sufferers need. the moral of this story is if you don't feel better with your current machine after a reasonable trial period, go back and politely raise heck until you get what works.

no one thinks they sleep well at these things and we're really bad at knowing when we're asleep; you probably slept a bit longer than you think.

you had a lot of arousals which, fortunately, pretty much follow apnea events, so you should have fewer as you reduce your apnea.

watch for increasing centrals. pressure tends to increase them, especially with a cpap and apap. this usually abates after 30-90 days but in your case, because you are prone to centrals, I'm not so sure. it's possible to fine tune the settings to avoid them to a limited extent.

post some oscar charts of some nights with the machine. you'll get some good feedback here.

I'm curious about drinking 2 liters of water during your study. I understand it was dry in the room but that's a fair amount. do you drink much water at night at home?
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#4
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
>in one way you're actually luckier than most: due to the influence of insurance companies, it's rare to be diagnosed with central apnea even when the study produces nearly all central apnea. in another way, you're not so lucky in that you weren't prescribed an asv machine which is designed to treat central apnea. cpap, apap and bilevel machines are not. you'll have to 'fail' with apap, then fail bipap and even then for reasons beyond comprehension it's still difficult to get the asv machine central apnea sufferers need. the moral of this story is if you don't feel better with your current machine after a reasonable trial period, go back and politely raise heck until you get what works.

I have medicade or whatever right now, so they cover absolutely everything, and everyone knows this, they've been giving me so many useless tests and referrals all year. I was on a waiting list for 10 months for the cpap, so apparently they are not available now..

>no one thinks they sleep well at these things and we're really bad at knowing when we're asleep; you probably slept a bit longer than you think.
You can see on the first line of the graph when I was awake, which was documented in the report as 3 hours total sleep as well

>post some oscar charts of some nights with the machine. you'll get some good feedback here.
if I can ever fall asleep with it on

>I'm curious about drinking 2 liters of water during your study. I understand it was dry in the room but that's a fair amount. do you drink much water at night at home?
no, not a lot at home, but my skin would not stop itching and I was just so thirsty in the lab
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#5
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
what is DBE, noted in the study? I'm guessing disordered breathing episodes maybe meaning rera (respiratory effort related arousal)?
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#6
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
(12-16-2021, 03:21 PM)sheepless Wrote: what is DBE, noted in the study? I'm guessing disordered breathing episodes maybe meaning rera (respiratory effort related arousal)?

disordered breathing events?, which I assume was due to poking at the stuff on my face so much
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#7
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
in your opinion, why are you not falling asleep with it, and please be specific?
What are your settings?

One way to get used to it is to watch TV, play a game, read a book, any normal activity, while masked up and under pressure.
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#8
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
I didn't look will enough at the graph from the test. sheepless pointed out the Central events. This may change my machine recommendation if these CA become a real problem.

OK you have a PAP. What is the actual machine name? If it's ResMed, there's gold letters bottom right front. If it's 10 series that is.

We'll help you get into the clinical menu too get the settings. It's almost guaranteed to be default wide open and not optimized for you.

PS you should be able to order your copy of the machines Clinical Manual.
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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#9
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
(12-16-2021, 03:36 PM)Gideon Wrote: in your opinion, why are you not falling asleep with it, and please be specific?
What are your settings?

One way to get used to it is to watch TV, play a game, read a book, any normal activity, while masked up and under pressure.

I always have trouble falling asleep, having something on my face and in the way while I put my head to the side makes it worse. Part of me wonders if this is ptsd, or if it's just from using the phone till I sleep frequently

(12-16-2021, 03:54 PM)SarcasticDave94 Wrote: I didn't look will enough at the graph from the test. sheepless pointed out the Central events. This may change my machine recommendation if these CA become a real problem.

OK you have a PAP. What is the actual machine name? If it's ResMed, there's gold letters bottom right front. If it's 10 series that is.

We'll help you get into the clinical menu too get the settings. It's almost guaranteed to be default wide open and not optimized for you.

PS you should be able to order your copy of the machines Clinical Manual.

resmed airsense 10

clinicians menu:
max pressure :20
min pressure 5
mask: full face
response: standard
ramp time: tried it at auto and 20 min and I'd always feel it do this air pumping action when I was dozing off, which woke me up
start pressure: 4
epr: on
epr type: full time
epr level: 3
climate control: manual
tube temp: 80f
humidity: 5
ab filter: no
essentials: on
smartstart: off
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#10
RE: Was my sleep study designed to 'fail'? diagnosed with mild CSA, but skeptical
I got a hybrid mouth cover/nasal pillow mask, f30i but wonder if I should get a nasal pillow and use a chin strap. I have a deviated septum so I dont breath too well out my nose
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