SuhDude7 - Therapy assistance needed.

[SuhDude7]

Hi all,

I was diagnosed with Sleep Apnea 1 year ago with an AHI of 18.5. I did a sleep study that confirmed that and with my Airsense 11, I am told to use a pressure of 4-6 (I prefer 7 for more airflow but I leak more).

I have been on an APAP/CPAP machine and my Doctor refuses to acknowledge that I've had Central Apneas the entirety of my Sleep Apnea experience; I am on Suboxone and have a history of Opiate use which are known to cause Central Apneas; my machine has always said that I have mostly Central Apneas but he does not believe it.

Upon seeing my OSCAR data, my AHI hasn't really lowered much since I started therapy; I'm wondering if I'm even on the right device - do I need an ASV machine? Any pressure suggestions? I am concerned about my cardiovascular health as a result of my CPAP situation.


Thanks all!

[Dormeo]

Oh good grief!

Do you know the breakdown of your AHI from your sleep study, especially your CA index? And what kind of study was it— at home or in a lab?

Have you printed out the summary you posted here to show the doctor? Would he be more likely to believe data from SleepHQ?

Your apnea is being poorly treated, and from what you’ve said, your doctor is pretty close to committing malpractice. Does he ever tell you why he doesn’t believe you’re having CAs?

If you can afford it, you might want to buy a recording oximeter compatible with Oscar. There’s a link on the home page that will take you to a list.

It might be helpful if you could post a typical daily chart.

[SuhDude7]

Thanks for the reply! I initially did a Watchpat One home study but then went in for a lab sleep study.

I've complained about likely having central apneas but he ignores my CPAP device and looks at the lab we did. For some reason, my apneas were very very low in the lab but that is not what happens at home. I'm not really sure how we got to this point. His damn office is sooo busy that in the year I've been a patient, I've met with him ONCE and did the sleep lab afterwards - we are now 6 months later finally meeting this Friday. It's been a joke of a process so far and he just thinks I'm a dumb kid/doesn't actually listen to my CA complaints.

I worry about my heart as I ocassionaly get little pains and I am concerned about my ongoing untreated apneas. The OSCAR data I showed above shows that I have high apneas still, right?

Please see the sleep lab attached. Thank you very much!

[SuhDude7]

All the doctor said was try increasing pressure to 8. If that changes nothing, I would need another sleep study to get an ASV machine.

I'm confused why my sleep study results don't show central apneas though

Any thoughts? Thank you

[Dormeo]

I'm confused about that sleep-test result too. Were you taking the same drugs back when you had the test?

It'd be good if you could post a typical recent Oscar chart so we could get a fuller picture of what's going on.

[Deborah K.]

Your study does show mostly central apneas, but the numbers are extremely low: 4 centrals and 1 hypopnea. The AHI would be less than 1. It makes no sense to me.

I agree. Post an Oscar chart, and let's see what's happening.

[SuhDude7]

Hey all,

I’ve been stuck using a CPAP for the last year and it’s basically never worked for me - kept getting tons of central apneas every night and my doctor didn’t do anything about it nor would he listen to me complain about Central Apneas; I even did a sleep study with him and while ignoring my Central Apneas, he kept me on CPAP   OSCAR always showed central apneas around 19 (see screenshot).

I independently purchased my own ASV machine (after wasting a year) on May 17th and immediately my central apneas went to zero. My AHI overall dropped to <5. But now, when I look at my Oscar graphs, the “central apnea” row is just blank. Like, it literally doesn’t show any central apneas at all like before - just nothing. Before, it would register CAs and show them in that row, now it’s just zeroes or not listed at all. I can’t turn them on or off, there’s no option; I have CA/Central Apneas check in all the view settings.

Anyone know why Oscar isn’t showing central apneas anymore with the ASV? Does that mean they're at 0? The rows on the graph are: first is overall AHI, second is central apnea, third is hypopnea. Just wondering why CAs disappeared completely—do they get labeled differently, or does ASV just not record them the same way?

Side note - my need for sleep remains at needing 10 hours to not be tired, is it my settings or something?

I'm open to any feedback or help, please! Thank you! <3

   

   

[SarcasticDave94]

CA on the ResMed ASV are under UA unidentified Apnea graph.

You really need to get that Ramp time off 45 minutes. Zero therapy during that time. It's locked at EPAP 4 for that 45 minutes. Best would be turn it off, but if you really need it, minimum timing and pressure 5 or 6.

You would likely do a bit better with a higher EPAP than 4. I would move this up to 5, then possibly 6. You might feel a bit air starved. PS Min 3 might be a bit better for you as well.

[Sleeprider]

I agree with Dave. Your events are nearly all happening while on Ramp. Simply turn it off, or set to Auto if necessary. Your chart starts at 2:50 AM (02:50) and the graph continues from noon (12:00) to about 2:40 pm (14:40). You may need to adjust the clock time if that is not your sleep time.

[SuhDude7]

Hi all,

I was diagnosed with sleep apnea about two years ago with an AHI of 20. I wasted almost 2 years on CPAP and I was noticing mostly centrals showing up for a while. I even did another sleep study but my sleep doctor never changed anything or moved me off CPAP - despite asking him every meeting. Eventually, I just bought an ASV machine myself (this was a great call and saved me a ton of money).

To no surprise, my AHI immediately dropped - now it’s pretty much always under 5. But here’s the frustrating part: I’m still just as tired as before. If anything, I only need about an hour less sleep (went from needing 10 hours to needing 9ish) but I still feel wiped out if I sleep less than that. Tried getting by on 8 hours the last two nights and I was just destroyed - eyes look rough, energy is trash.

You’ll see in my charts that there are some mask leaks but honestly, I greatly prefer the Dreamwear tube-on-top masks since I’m a side sleeper (stomach sleeper before starting CPAP  ). The Evora full face worked better for leaks but I just can’t get comfortable with the tube out front esp when sleeping on my side. 

You can see a night and day difference on my 2-month overview of when I switched from CPAP to an ASV.

I’m wondering is there anything obvious in my data that I’m missing or is there anything else I should be looking at?

Thanks for any input—really appreciate it!