[CPAP] Need help analyzing my data

[sammyua]

Hello everyone,


I started using OSCAR and recording my results onto SD card pretty much as soon as I started my therapy. Before using CPAP I had mixed Apnea (although obstructive was much more dominant). Since I started to sleep with CPAP I mainly have been having central one.

People are saying that it takes time to see the changes, but how long is that exactly? Before CPAP I had AHI of about 15-20, my results are much lower now, but they seem random.
I have attached screenshots from the past 3 nights- you can see that it kinda jumps all over the place- 3,6,5,9,7 etc. In other words, there is no steady number that is slowly going down, it feels very randomized what I get every night.

I would appreciate if someone could take a look at this and tell me what I am doing wrong/any feedback/ thoughts/ etc.. Also, please ask me any specific questions in case I forgot to include something. 

Thank you everyone!

[Expat31]

Hello,

Firstly your graphs are well presented, having all the key information easily visible. This helps a lot, thanks! 

On first look, it seems that the main issue to resolve is positional apnea as evidenced by the events clustering,  being the primary cause of your relatively high AHI. 
    
Please consider reading through the above link, as it explains just about all you need to know, especially on the potential solutions. 

Are you a back sleeper? Often this can be an issue... 

In your sleep study, what was the breakdown of your AHI between centrals and obstructive events? Did you have any CSRs in this study also? 

Apart from the positional apnea issue, your therapy seems to be quite effective. At the moment I would not propose any changes in your settings until this main issue is resolved.

[sammyua]

Hello,

Thank you for taking your time to reply. The link is very helpful- I indeed sleep elevated (on 2 pillows). Usually, I fall asleep on either side but, perhaps, I might switch to sleep on my back during the night, who knows.

I am not opposed to get soft foam collar and trying it out to see if it helps. Do you think I should try sleeping with 1 pillow or even without pillows first to see if decreased elevation will help?

Here are the results of my home sleep study:

Respiratory: There were 2 central apneas, 51 obstructive apneas, 7 mixed apneas, and 62 hypopneas resulting in an REI (Respiratory Event Index) of 13.9. The supine REI was 24.1 and the central apnea index was 0.23. The mean oxygen saturation was 96%. The lowest oxygen saturation was 90 %. Oxygen remained below 90% for 0.0 minutes, below 80% for 0.0, and below 70% for 0.0 minutes. Cardiac: Mean pulse was 64.4 BPM. Maximum pulse was 104 BPM. IMPRESSION: 1. Mild obstructive sleep apnea. 2. Quality of test was good. HSATs commonly lead to underestimation of the REI/AHI.

I did not find anything about CSRs- it probably was not done, although I am not sure.

Thank you again for your help, much appreciated!

[Expat31]

Yes, try with one pillow to see if this helps.  Some members have had success with a childs pillow also. 

With the effect of the head falling/ pushing down on the chest can effectively "clamp" the trachea closed. See demonstration of this with a video - positional apnea demo  

Also, another possibility is, do you sleep on your back? This can cause a blockage, this time in the upper airways, when the tongue falls back against the wall of the throat. 

Otherwise, just a few brief comments on your settings whilst you find the best solution for positional apnea. 

-  You have ramp on auto, best to switch off if you can, as you get no therapy benefit during ramp periods, or at least try limiting ramp time.

 - Usually an EPR setting of 3 gives a greater level of comfort. I don't this this will worsen your central apneas, which I think are likely positional obstructives. They were not really relevant in your sleep study.as just 2 central events.

You can repost a few nights after you have tried to lessen your clusters, either with a thinner pillow, side sleeping (if relevant), or a suitable soft cervical collar.

[ejbpesca]

You wrote:
"People are saying that it takes time to see the changes, but how long is that exactly?"

How long it takes to adapt to PAP therapy does not have an exact length of time.  How long have you been using your machine?  If just for a short period like a week or two you may be experiencing CAs that occur at the beginning of therapy as the body adapts to the therapy.