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+--- Thread: Not sure if I really need treatment (/Thread-Not-sure-if-I-really-need-treatment)
RE: Not sure if I really need treatment - Sleeprider - 12-16-2016
What an interesting report! The bottom line is a 12.8 AHI, but you actually scored far more central and mixed apnea events than obstructive. Also, the numerous hypopnea events were scored as obstructive, but are more likely central in nature. In addition to this unusual distribution pointing to central events, you actually have less apnea while lying on your back, than on your side. This is not characteristic of OSA. In addition to the evidence in your study, your physical build at 134 lbs, is not typical of someone who might be expected to present OSA.
The sleep study tells us that there is reasonable certainty that the events you are having on CPAP are unlikely to be obstructive. You only had two obstructive apnea, both while on your back. With the titration study you had, the clinic identified the pressure that produced the lowest number of obstructive events. It would still be interesting to see what kind of results they recorded, and whether the study actually mitigated your overall apnea.
I would conclude from what I am seeing in your sleep study, and the ambiguous results in the form of AHI events on your CPAP, that therapy has not been beneficial to this point. Treatment that actually produces worse results than baseline is not something I would continue. It will be important to observe whether a trend begins that points to improvement or not. From what has been discussed so far, your AHI has approximately doubled from baseline, and it is nearly certain that those events will be shown to be central or mixed in nature. CPAP can help in some cases of central apnea. but the data becomes more important to see at what point obstructive events give way to central. The difference of 0.5 cm pressure can make all the difference in the world. For most patients the use of ASV becomes more beneficial since CPAP cannot provide the stimulus to breath during central events.
RE: Not sure if I really need treatment - Sleeprider - 12-16-2016
I should add, it is not your doctor's fault you were dispensed a brick. That choice is made by the supplier who knows that the brick is cheaper and meets the needs of a single pressure prescription. I think you have a very persuasive argument in hand to ask your doctor to modify the script to Auto CPAP so you can both see what is going on. The Auto PAP can be set to single pressure, or to auto-titrate, but at least you can see the event type and correlation to pressure and other events.
RE: Not sure if I really need treatment - dbcyclist - 12-16-2016
Thanks for your insight! I'll certainly be discussing these things with my doctor in the hopes of getting to the bottom of it all. And I agree, the machine I was prescribed was likely more insurance driven than Doctor driven.