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Kessy’s Therapy Thread
#1
Kessy’s Therapy Thread
Hi


I'm grateful for this forum and all the help I got in the beginning. I had big problems with Flow Limitations; and you pointed that out and gave me good suggestions. I now sleep with a soft collar (it's actaully helped with my neck problems too), and have gotten the FL down and started to get some good nights with the CPAP (AirSense 11), despite some lingering issues to solve. I will get to change to AirFit F30i tomorrow to see if getting the air from the sides instead of blowing right at my nose will disturb me less (the air tickles me and wake me up sometimes).

My AHI are down significantly from 16-32 AHI to under 5; most nights even below 3. Tonight blew me away (no pun intended! Too-funny ) with a score below ONE!

But my OA is now almost always a lower number than the CA. I didn't show any CA during the sleep trial (but then again I didn't sleep well that night but very lightly). But I'm thinking it's not a problem when the numbers are so low? (I'll add the last nights screenshot with a very low number.)

But then, a few times, OSCAR has showned Cheney Stokes. It's happened possibly 4 or 5 times, but not in in several nights in a row. So I've thought it isn't anything to worry about? Since they are not MANY or long periods of Cheny Stokes; and I've read somewhere in here that the Resmed can sometimes say it's Cheney Stokes when it's not.

But I had one night last week where it looked a bit worse. I'll add it here too. Both a close up and of the whole night. (This was a BAD night, where I had a lot of FL= and that happens when I'm stressed and in a bad place emotionally, and that was bad night.) Does anyone know this something to worry about? 

(I have the pressure 8-17, and no RAMP, but EPR 3. )


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#2
RE: question about CA (cheney stokes)
CA on OSCAR is clear airway, which may also be another CA or Central Apnea. For us, the 2 CA items are similar enough to be considered the same. If you're certain you had no CA on your sleep study, these OSCAR charts with CA are treatment emergent CA. They'll diminish within a few months CPAP usage. The CA reported here are below 1 cAHI, and are minimal.

OSCAR charts showing CSR are probably falsely labeled as such, and will mean more like variable breathing. This is likely false flags unless you know you have a heart condition like congestive heart failure. CHF is one of the most likely reasons for true CSR to show. But if heart failure, or another heart condition, doesn't apply to you, then this CSR flag is false.
Mask Primer

Positional Apnea

Attach OSCAR, etc.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: question about CA (cheney stokes)
Thank you for your reply. I thought I had read something similiar to that, and it sounds like I don't need to worry. I have done a 24 ECG last summer and it didn't show anything, and my blod pressure is okay, but I've started taking Concerta a month ago, and it can effect the heart, so I've been a bit worried. I've felt a pressure in my chest on/off, but it's most likely side effects/muscular or/and anxiety. I feel more rested and have more energy, and can walk briskly without feeling bad, so I'm probably okay.

I will give the few CA's time to go away, and 95% of the nights they are very few. It was only that night I had that probably falsely registrered "cheney stokes event" that long.

Either way, thank you for your reply.
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#4
RE: question about CA (cheney stokes)
You're welcome. Note that on the CA flags, regardless of actual cause, they can be consistently inconsistent. They'll get a bit worse or better for no reason randomly. It should not get overwhelming though. If it does, post a chart and comment on them.
Mask Primer

Positional Apnea

Attach OSCAR, etc.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: question about CA (cheney stokes)
(06-09-2025, 09:07 AM)SarcasticDave94 Wrote: You're welcome. Note that on the CA flags, regardless of actual cause, they can be consistently inconsistent. They'll get a bit worse or better for no reason randomly. It should not get overwhelming though. If it does, post a chart and comment on them.

I will. Thank you.
"consistently inconsistent" was a funny, but I gather pretty accurate expression. Smile  I've understood that as long as they're not that many it's nothing to worry about. It was mainly the "cheney stokes", that is'nt a "real" one, that made me wonder if I needed to worry. (and starting a medication that can effect the heart too; and being 50)

My main issue is that I really need to be in a good place mentally to get good results. When I go to bed with to much worry/anger/anxiety the results go down the drain. Partly because the collar doesn't seem to stop me those nights from pressing down my chin, but somehow I seem to get more OA's and CA's as well then. It surprised me a bit, but made me realize I really need to take good care of me and try to deal with emotions better, BEFORE going to bed.

Just one question (sorry if it's written somewhere; I have severe ADHD so I have some trouble reading long texts): isn't a high pressure something that can cause more CA's? I think my pressure is pretty high, for being a female who isn't that big and doesn't have severe sleep apnea (at least my doctor said I had to have a much higher AHI to be in the "severe case group"). :-/ But I can't seem to lower it, because then the OA's increase too much.
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#6
RE: question about CA (cheney stokes)
High pressure and CA:

sometimes yes, it does add to more CA. But more important to avoid your type of CA, and then only if they become bad, is pressure swings or fluctuations.

Examples for some EPR or wide pressures between min and max can make CA worse, but it'll very likely make Obstructive Apnea, Hypopnea, and Flow Limits worse. CA are in the opposite end of a teeter-totter than all the other events. Push down CA side, all the others probably go up. Solution is to find a balance that makes therapy the most helpful.

As for your Max pressure itself, 17 wasn't reached. OSCAR says Max pressure was just short of 12.
Mask Primer

Positional Apnea

Attach OSCAR, etc.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: question about CA (cheney stokes)
Totally agree with Dave. 

Your CSA on the charts appears when you are having a massive cluster of OA's as well; so that pretty much negates the CSA as being real.  You had a massive case of positional apnea here.  (Line up the CSA vertically with the light blue OA's in your chart). 

5.3Positional Apne
Download OSCAR
OSCAR Chart Organization
Attaching Files


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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#8
RE: question about CA (cheney stokes)
(06-09-2025, 11:21 AM)SarcasticDave94 Wrote: High pressure and CA:

sometimes yes, it does add to more CA. But more important to avoid your type of CA, and then only if they become bad, is pressure swings or fluctuations.


As for your Max pressure itself, 17 wasn't reached. OSCAR says Max pressure was just short of 12.

Okay. Thank you again for the explanation. That was interesting. And yeah, that night I had lowered the pressure to 15: to try and see if that worked= obviously it didn't: it caused the worst night in a long time. Many nights the pressure does go up to max or almost max more times during the night, but it had stayed below or at 15 for some nights, so I thought I could try lowering it. That wasn't a good call. I'm eager to try my new mask tomorrow, and I hope it will solve some of the last problems. Either way it's a LOT better now than it was before at least.
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#9
RE: question about CA (cheney stokes)
(06-09-2025, 01:53 PM)Jay51 Wrote: Totally agree with Dave. 

Your CSA on the charts appears when you are having a massive cluster of OA's as well; so that pretty much negates the CSA as being real.  You had a massive case of positional apnea here.  (Line up the CSA vertically with the light blue OA's in your chart). 

Thanks for the reply. Interesting, I didn't know that that was a clue that the CSA isn't "real". Yes, those bad nights the positional apneas is a problem, still, despite the collar and ergonomical pillow. But the nights the FL is low is increasing in numbers. I can't really see any other common cause except when I'm too stressed when I go to bed; then I seem to press my chin down no matter what. (So I'm really forced to try to deal with my emotions and the stress better right now; and I notice that more excercise helps to relax my mind and make the FL less frequent.)
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#10
RE: question about CA (cheney stokes)
Kessy, please don't start new threads as we need to see your history.

Were you able to raise your bed a little bit more and did it help with your flow limitations?
Are you still using the basal spray for your allergies?
Are you doing any calming breathing exercises before sleep?

We need to see the device settings.

I hope you get some good rest.
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