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JJohnson Therapy thread (new user)
#1
JJohnson Therapy thread (new user)
    Hello All,

I just started using my auto cpap about 2 weeks ago.  I have the Airsense 11 with the F20 mask.  The fit seems pretty good and I've been mostly successful with keeping it on all night and getting 6-8 hours each night.  

My AHI numbers every night have been mostly in the mid 20's, two nights around 15, and one night at 8.  I feel like my events are less severe than before (much less waking up gasping, but still some waking with trying to get a deep breath) but i also seem to still be having a lot of events.  I wouldn't say I'm waking up very refreshed!

Last night was the first night I saved data to an SD card and loaded into OSCAR.  I really don't know what I'm looking at yet, but it seems there are many Clear Airway events.  My summary info on the clinician menu on the machine  (AHI 22.1, Total AI 20.7, Obstructive AI 0.2, Central AI 20.1 - over 10 nights) seem similar to this one night of OSCAR data.  Looking for some feedback!!

I've tried attaching the chart from last night, please let me know if I need to reformat it somehow or more info is needed.

Thank you!  
Josh
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#2
RE: JJohnson Therapy thread (new user)
What did your sleep study look like? Did it show central sleep apnea? If you have a copy, post it here.

I suspect you have central sleep apnea and may need an ASV, which is the only type machine that can treat CA's.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: JJohnson Therapy thread (new user)
        Thanks for the reply.

I did a two night at home sleep test from Virtuox.  I wore a fingertip device.  Basically it looks like the opposite of the Obstructive and Central numbers from the Airsense data.  Not sure how to make sense of that other than I would guess the Airsense data is much more accurate?  There were some charts too but the printout is such super low quality that its almost unreadable.

Is two weeks of data enough to get an ENT to react?  I called after one week with my concerns and was told to wait at least a month for things to 'adjust'.  Would a sleep test be required for a ASV machine?  My experience so far has been that all these institutions are extremely overworked and getting anything done is very hard.  I'm going to call again.

Thanks for the input.

Josh
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#4
RE: JJohnson Therapy thread (new user)
Hello,

Have been trying to figure out the OSCAR data here and doing more reading in the forums.  I stumbled across something called "therapy onset central apnea".  I'm wondering if this might explain the difference between my sleep test and the OSCAR data?   

I've included my 2nd and 3rd nights OSCAR data as well as an Overview Chart which includes the basic data from before I had my SD card.  My AHI the previous 4 nights are the 4 highest nights overall since I started, so somehow I'm getting worse at least as far as AHI number goes. 

I do feel like I'm able to sleep a tiny bit better but still wake up frequently trying to take deep breaths.  I mostly breath thru my mouth as I've always had issues being able to breathe thru my nose much at all.  I have not touched the default settings.  

Are there setting changes that might help with the CA's if they are indeed caused by therapy onset?  Is there even a way to tell the difference between therapy onset CA's and actual central apnea?

Thanks for your time!


Attached Files Thumbnail(s)
           
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#5
RE: JJohnson Therapy thread (new user)
Welcome

Well, I've never seen such high CA numbers when there were so few on your sleep studies.  You have what is termed moderate sleep apnea. Even though there are so many I think your CAs must be treatment-emergent.  In that case, they will lessen, hopefully, a lot as time passes.

Though your AHI numbers are very high there are some things we can do to make your therapy better and more comfortable.

Raise your minimum pressure to 7.  Most adults feel air-starved at the low pressure you are using now.  Also, higher EPR, which you need, does not work at less than 7.

Turn off ramp unless you desperately need it.  If you keep it on, drop it to 5 or 10 minutes.

Turn EPR on full time, set at 3.  Some would differ on this, but I think it's more important to lower your flow limits than to worry about the high CAs for now.

Try that for tonight, then let us know how you are doing tomorrow or at least soon.  Best of luck!  Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#6
RE: JJohnson Therapy thread (new user)
Good Morning,  Thanks for the feedback Deborah.  Since your post I did have an appointment with a PA at the ENT on 6/12 to review my treatment so far.  Basically he said keep riding out the settings you have until you see the sleep Dr.  He did say my oxygen levels looked ok, FWIW, but he declined to change any settings because he didn't feel qualified to do so. 

I've been continuing to have very up and down results on the default settings.  I'll trend down for a week (mid-20's AHI to mid teens), then the next week I'll trend back up.  Last night I decided to make the suggestions above, 7min, EPR Full time level 3, and I kept Ramp on Auto.  

I feel my mask seal is pretty good most of the night.  I do still feel tired on waking and through the day though.  At night I'm not fully waking up nearly as much as before treatment, but still my numbers seem so high!  Last night my AHI was very high, but I also wasn't feeling great before bed (felt a little short of breath most of day yesterday, today feels better despite the higher numbers last night), I will try to stick with the new settings for a while to see what happens.

I attached the last two nights charts, 6/25 was default settings, 6/26 first night with new settings.

Thanks for any feedback, appreciate all your time and effort!

       
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#7
RE: JJohnson Therapy thread (new user)
Your CAs are higher yet, probably because of the increase in EPR. I suggest that you stay at the higher EPR for now anyway. If you can, turn the ramp off, or set it for only a few minutes. You get no real therapy during ramp, and if you wake up for a bathroom visit, when you get back in bed you go through ramp again.

I know it's been only one night with the new settings, but can you notice any difference in how you feel? Were you more or less comfortable? Probably you need more nights before you can notice anything. I'm going to ask a true expert if he will take a look at this thread, and hopefully, he will have more advice for you

.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#8
RE: JJohnson Therapy thread (new user)
(06-27-2024, 10:53 AM)Deborah K. Wrote: Your CAs are higher yet, probably because of the increase in EPR.  I suggest that you stay at the higher EPR for now anyway.  If you can, turn the ramp off, or set it for only a few minutes.  You get no real therapy during ramp, and if you wake up for a bathroom visit, when you get back in bed you go through ramp again.

I know it's been only one night with the new settings, but can you notice any difference in how you feel?  Were you more or less comfortable?  Probably you need more nights before you can notice anything.  I'm going to ask a true expert if he will take a look at this thread, and hopefully, he will have more advice for you

.

Thanks Deborah.  EPR off was tolerable for me, but now I would say breathing is definitely easier with the EPR on.  Breathing out feels very easy now.  It almost feels like the machine is sucking air out of me on exhale.  Last night i was feeling short of breath before bed and that continued all night, so hard to say what difference the changes made.  I did wake up very tired this morning, but so far today i do not feel short of breath at all.
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#9
RE: JJohnson Therapy thread (new user)
Jojo, I think you're heading towards ASV therapy, but your doctor is going to trial this CPAP for 30 days. Even though it is counter-intuitive to add EPR (exhale pressure relief) on someone with central apnea, I think you should try it and post the results so we can confirm the bilevel pressure is or is not effective. Go into settings and turn EPR on Full Time at setting 2.
Sleeprider
Apnea Board Moderator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: JJohnson Therapy thread (new user)
    Hi SleepRider, thanks for checking out my thread.  I did set the EPR to 2 last night and attached the results.  Slightly less AHI than EPR 3, but still high.  Where to go from here?  Is it safe to say the APAP isn't going to work for me? 

I've been reading Quitethe1's thread and am trying to digest all that great info.  I have an appt with the sleep Dr at my ENT on July 12 and am hoping to make a case for an ASV machine then if she does not propose it herself.  I have many questions on that whole process but I may be getting slightly ahead of myself Smile     

Thanks everyone!
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