AHI low, but sleep is not much better: CPAP to ASV
Hello all,
First, I'd like to apologize for the lengthy post, but I wanted to make sure to include as much as I can as I've been using my CPAP unit for about two months now to no avail.
My brother assisted me with my ResMed AirCurve 10 unit when I was too anxious to do so after my ACL reparation surgery.
Here is the original thread: http://www.apneaboard.com/forums/Thread-...pid=469354#
I have been diagnosed with severe obstructed sleep apnea and am mostly a mouth-breather due to having a heavily deviated septum. I'm also missing one sinus congenitally and have nasal polyps. I'm a side-sleeper and typically can only stay asleep for 5-6 hours at a time, never feeling rested when awoken. After waking up, I will go back to sleep 99% of the time. At this point, I will sleep for a maximum of two hours before waking up again and again; recycle and repeat.
Obviously, unrested and fragmented sleep is negatively affecting my life so I'd like to get to the bottom of this issue since my insurance won't cover my visit to the sleep doctor who signed off on the "study." Speaking of which, the AHI showed a whopping 69.6 events per hour. The good news? Since using the BiPAP unit the AHI has significantly dropped to single-digit numbers. However, sleep is still fragmented and I feel unrested.
I have been training myself to nose-breathe when trying to fall asleep. Falling asleep in itself takes around 40 minutes to 1 hour or longer.
Sometimes my nose will clog up. Cleaning with salt water/Ocean Nasal spray does not alleviate the congestion. I have high allergies which can potentially be the cause of congestion. There are at times a lot of mucus in my nose and throat that can be contributing to the congestion. Trying a 10" wedge pillow not only did not help, but felt very uncomfortable, especially after I woke up.
Unit: ResMed AirCurve 10
Mask: F&P Evora full large
Current settings:
Mode: VAuto
Min EPAP=10
Max IPAP=25 (Typically doesn't go above 18 in practice)
PS=6
Trigger Sensitivity: Very High
Humidity Level: 7 of 8
Humidity Temperature: 83°F (85 max)
Ramp Time: off
I've noticed instances of hypopneas and complete apneas even while using the unit each time I sleep. These breathing patterns resemble the Cheyne-Stokes and Biot's respiration and even Kussmaul breathing patterns from what I can see. A quick Google search can show you what I mean.
Much of these results has me thinking that central apnea could be the culprit and that I could potentially see more of a benefit with an ASV unit.
I've also noticed that the leak rate does increase significantly and have read that the acceptable threshold is 24 l/min and under. There are times that the leak rate is above that. However, I ensure that my mask on properly and sealed tight and the unit mentioned that there are no leaks. I have purchased a night camera that I will use to verify if I'm tampering with the mask while I'm asleep, otherwise the mask is securely on when falling asleep and waking up.
Tested PS levels have been 3.0, 4.0, 5.4, and 6. I have switched the PS from 5.4 to 6 the last few nights. At times, 5.4 feels like the air pressure is too low because I noticed I will stop breathing a couple times when attempting to fall asleep even with unit running and the mask secure. On the other hand, 6 can feel a tad bit overwhelming. I did used to have chest tightness when and my ear hurting on the side I'm sleeping on after waking up a while back but that hasn't been the case recently.
My brother noticed that I do roll over on my back when I sleep. Not sure if this is always the case but it can potentially be an issue.
The initial sleep study displayed an average Sp02 level of 88%. The sleep study was not completed correctly as I did not sleep enough so it seems. After purchasing my own Sp02 sensor and trying that for a couple nights, the average does show above 95%. I have another Sp02 sensor that I will try to double-check these results.
I have tried using the ResMed AirTouch F20 medium full face mask, but that mask was uncomfortable and really felt like it was bruising my nose.
Other issues I could potentially have is aerophagia or arrhythmia? A Google search says that there aren't necessarily symptoms and they can cause shortness of breath and fatigue, which I do feel during the day. I even have breathing problems during the day when I did not used to a few months prior.
Other things I've seen online are Armodafinil/Modafinil to help boost serotonin levels as well as supplemental oxygen with CPAP or even ASV units.
Easy to say that the prescribed settings or the unit purchased have not produced successful sleep results. Hopefully, my insurance clears up soon so that I may see a real sleep doctor to get proper results.
Attached images are information regarding my Polysomnography and Titration tests along with the last 3 nights of Oscar sleep data. Please let me know if you need other info from there, like tidal volume, mask pressure, respiratory rate, etc. or if you'd like me to zoom in a specific timeframe.
Some more attachments for more info.
SP02 levels appear well.
You can google Cheyne-Stokes and Biot's respiration and compare to my results as they do appear similar.
First, I'd like to apologize for the lengthy post, but I wanted to make sure to include as much as I can as I've been using my CPAP unit for about two months now to no avail.
My brother assisted me with my ResMed AirCurve 10 unit when I was too anxious to do so after my ACL reparation surgery.
Here is the original thread: http://www.apneaboard.com/forums/Thread-...pid=469354#
I have been diagnosed with severe obstructed sleep apnea and am mostly a mouth-breather due to having a heavily deviated septum. I'm also missing one sinus congenitally and have nasal polyps. I'm a side-sleeper and typically can only stay asleep for 5-6 hours at a time, never feeling rested when awoken. After waking up, I will go back to sleep 99% of the time. At this point, I will sleep for a maximum of two hours before waking up again and again; recycle and repeat.
Obviously, unrested and fragmented sleep is negatively affecting my life so I'd like to get to the bottom of this issue since my insurance won't cover my visit to the sleep doctor who signed off on the "study." Speaking of which, the AHI showed a whopping 69.6 events per hour. The good news? Since using the BiPAP unit the AHI has significantly dropped to single-digit numbers. However, sleep is still fragmented and I feel unrested.
I have been training myself to nose-breathe when trying to fall asleep. Falling asleep in itself takes around 40 minutes to 1 hour or longer.
Sometimes my nose will clog up. Cleaning with salt water/Ocean Nasal spray does not alleviate the congestion. I have high allergies which can potentially be the cause of congestion. There are at times a lot of mucus in my nose and throat that can be contributing to the congestion. Trying a 10" wedge pillow not only did not help, but felt very uncomfortable, especially after I woke up.
Unit: ResMed AirCurve 10
Mask: F&P Evora full large
Current settings:
Mode: VAuto
Min EPAP=10
Max IPAP=25 (Typically doesn't go above 18 in practice)
PS=6
Trigger Sensitivity: Very High
Humidity Level: 7 of 8
Humidity Temperature: 83°F (85 max)
Ramp Time: off
I've noticed instances of hypopneas and complete apneas even while using the unit each time I sleep. These breathing patterns resemble the Cheyne-Stokes and Biot's respiration and even Kussmaul breathing patterns from what I can see. A quick Google search can show you what I mean.
Much of these results has me thinking that central apnea could be the culprit and that I could potentially see more of a benefit with an ASV unit.
I've also noticed that the leak rate does increase significantly and have read that the acceptable threshold is 24 l/min and under. There are times that the leak rate is above that. However, I ensure that my mask on properly and sealed tight and the unit mentioned that there are no leaks. I have purchased a night camera that I will use to verify if I'm tampering with the mask while I'm asleep, otherwise the mask is securely on when falling asleep and waking up.
Tested PS levels have been 3.0, 4.0, 5.4, and 6. I have switched the PS from 5.4 to 6 the last few nights. At times, 5.4 feels like the air pressure is too low because I noticed I will stop breathing a couple times when attempting to fall asleep even with unit running and the mask secure. On the other hand, 6 can feel a tad bit overwhelming. I did used to have chest tightness when and my ear hurting on the side I'm sleeping on after waking up a while back but that hasn't been the case recently.
My brother noticed that I do roll over on my back when I sleep. Not sure if this is always the case but it can potentially be an issue.
The initial sleep study displayed an average Sp02 level of 88%. The sleep study was not completed correctly as I did not sleep enough so it seems. After purchasing my own Sp02 sensor and trying that for a couple nights, the average does show above 95%. I have another Sp02 sensor that I will try to double-check these results.
I have tried using the ResMed AirTouch F20 medium full face mask, but that mask was uncomfortable and really felt like it was bruising my nose.
Other issues I could potentially have is aerophagia or arrhythmia? A Google search says that there aren't necessarily symptoms and they can cause shortness of breath and fatigue, which I do feel during the day. I even have breathing problems during the day when I did not used to a few months prior.
Other things I've seen online are Armodafinil/Modafinil to help boost serotonin levels as well as supplemental oxygen with CPAP or even ASV units.
Easy to say that the prescribed settings or the unit purchased have not produced successful sleep results. Hopefully, my insurance clears up soon so that I may see a real sleep doctor to get proper results.
Attached images are information regarding my Polysomnography and Titration tests along with the last 3 nights of Oscar sleep data. Please let me know if you need other info from there, like tidal volume, mask pressure, respiratory rate, etc. or if you'd like me to zoom in a specific timeframe.
Some more attachments for more info.
SP02 levels appear well.
You can google Cheyne-Stokes and Biot's respiration and compare to my results as they do appear similar.
