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Am I getting over sleep apnea ?? - BrassCat - 12-01-2020

Hello the forum. I have had sleep apnea for 20 years (or more). Thats when I did my first sleep lab. I've done 5 now. Went from cpap to auto bipap. Cardiologist had want me to do another, had triple bypass last year. Did an overnight sleep study about 10 days ago. They started with no mask for baseline. They never put a mask on me, next morning stated I do not meet criteria of sleep apnea now. 20 years ago weight 330, 10 years ago 295, now down to below 250 and dropping. I am tall, ideal maybe 210. I slept on my back most of the night.

So I have now slept without nask / machine, I snore and some gasping. I have decided to do several nights with a recording oximeter. CMS50D+. It seems ther oximetry report summary page gives a good overview. I will take several nights of these for the next dr visit. 

There are good periods and bad periods thru the night. I am wondering if it is body position.

Is there a reasonably priced body position recorder I can buy to correlate my oximetry report with??

Thanks for any help!!


RE: Am I getting over sleep apnea ?? - Sleeprider - 12-01-2020

Apnea or not, your SpO2 is below 90% a bunch, and I suspect that would not be the case on therapy. Given your past results posted on this forum, I would strongly suspect the sleep test was an anomaly. The image below was posted in May this year, and I seriously doubt you have miraculously eliminated the need for therapy, in fact, I'll just call B.S. on it right now.

Why not post a current daily details image of your therapy?  We can see what the settings are and maybe take a closer look at respiration. Hopefully your therapy is not so fractured into many sessions. A daily detail chart will show positional apnea that may have been missed by a sleep study, and we can quickly identify ways to help with your rather high AHI. 2SleepBeta has a thread where he monitored movement and body position http://www.apneaboard.com/forums/Thread-Re-words-positional-motion-accelerometer-Somnopose-Excel-spreadsheet-CSV-GMT-emulate?

[Image: attachment.php?aid=22851]


RE: Am I getting over sleep apnea ?? - mesenteria - 12-01-2020

I think it's probably a long shot that you don't need some form of therapy, even despite your excellent weight loss over the last few years.  But, let's say for giggles that you really don't need it, just some 'attitude' control for your resting body position.  We often find that one of the great contributors to apnea and hypopnea is the position of the head relative to the body.  While a few people CAN sleep on their backs with what amounts to impunity, and they don't suffer unduly, most of us slouch down and our heads tilt forward on our pillows, forcing our chins toward our chests.  This does a great job of pinching the otherwise open airway, and we get flow limitations, often severe ones.  This is a long way around me suggesting that, if you really don't need PAP therapy of any kind, you might still gain a LOT from using a soft foam cervical collar...IF you insist upon sleeping on your back.  They help to keep our chins up.

But I'm nodding after Sleeprider.


RE: Am I getting over sleep apnea ?? - BrassCat - 12-01-2020

Thanks for the replies. Yes, I am doubtful as well. That is why I am running a set of oximeter recordings.
The sleep study was performed in the central valley in California, most likely below 300 ft elevation. I live in the mountains, at 3000'.
How much does elevation affect sleep apnea??


RE: Am I getting over sleep apnea ?? - SarcasticDave94 - 12-01-2020

If the altitude were 6,000 ft or so, it tends to add Central Apnea labeled by xPAP machines as Clear Airway. Unless you had mild apnea upon diagnosis, I'd be skeptical that you don't have it now. Apnea and COPD like I've got are similar in some ways. When you're diagnosed with it, this is something you deal with for life. Various treatments, etc. help control these but they're still there. xPAP therapy makes symptoms go down, but the apnea still exist. Therapy, weight loss, sleep hygiene, etc. are means to control it, to treat it, but none are a cure for it.


RE: Am I getting over sleep apnea ?? - jaswilliams - 12-02-2020

Altitude causes central apnoea, you need to be tested at the same elevation as you sleep


RE: Am I getting over sleep apnea ?? - Illorum - 12-04-2020

The report says you had on average 24 4% desaturations an hour, which would put your AHI as at least 24. I don't see how they concluded you don't have sleep apnea - you at the very least have moderate, and I'd bet severe if this were a proper sleep study.


RE: Am I getting over sleep apnea ?? - BrassCat - 12-14-2020

[attachment=28680]Here are a new set of waveforms from last night. I have limited the range of pressure down a lot. Everything seems to look good until the bipap raises my exhalation pressure. This waveform set now includes oximeter and pulse info. Dream station auto bipap, is there a way I can set the exhalation pressure to stay fixed???

I see my sleep doctor this Wednesday, will have two more overnight data sets. When he looks at those where in the inhalation and exhalation pressures both climb high, he states those are instances where my machine is malfunctioning. 

Thanks for any feedback.
Stan


RE: Am I getting over sleep apnea ?? - Sleeprider - 12-14-2020

Increase pressure or get a soft cervical collar. The news is not good.with this lower pressure. The BiPAP algorithm is consistent with any titration protocol for obstructive sleep apnea. The EPAP must be raised for OSA events. You have a bunch and no place for the machine to go because of extremely limited pressure settings. Sometimes, some people should not be given access to settings. Sorry, this is self-inflicted damage. You still have moderate to severe obstructive sleep apnea...better to get comfortable with effective therapy settings and stop this nonsense.


RE: Am I getting over sleep apnea ?? - BrassCat - 12-21-2020

Perhaps I wrote too soon about any feedback. Seems the tech at my overnight sleep study, when he stated I did not meet the criteria for him to have me wear a mask, did not add that it was because of covid-19 and equipment contamination! At my visit with my sleep doctor, he explained it WAS A COVID ISSUE. Not sure how bad I would have had to require a mask being used during the study. Am I to assume it is a California issue, or is this taking place in other states? He acknowledges I certainly still have sleep apnea. Also, he showed me that when I get into serious apneas, in all instances during the study, it was because I was going into REM sleep, and had nothing to do with my neck out of position. A new machine is on the way.

Thanks again for all the positive assistance and helpful information. There is a lot of knowledge here.
Stan.