[Treatment] Consistently getting <4 hours of sleep after several months

[snoor]

Hey Everyone,


I would like some guidance on dialing in my APAP therapy. My current settings are PS 4.0 over 4.0-25.0. I have yet to be able to see a provider for appx. A year ago, the last prescribed setting I had was for 10/6 APAP, but I wasn't able to get a good night's sleep consistently, so I went online looking for guidance. My current settings were recommended as a catch-all for my machine. I have been able to sleep with the current settings (PS 4.0 over 4.0-25.0) but am still experiencing issues sleeping through the night/feeling rested consistently (w/ other factors controlled: i.e., bedtime, last intake, caffeine, etc.). 

I cannot pull meaningful information from my OSCAR data as I need background knowledge to identify abnormalities/clues. I hope some of the members in this forum can help me analyze my OSCAR data and advise me on dialing in my therapy to get a good night's sleep.

OSCAR Data Below:

           




Thank you.

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Additionally:

       

[snoor]

Additional Information (Sleep Studies):
           

[Sleeprider]

Snoor, our preferred chart is a screen shot of the Daily Details with the summary details on the left. Read the Organize Your Oscar Charts article in my signature links below. The settings you need are EPAP min 5.0 IPAP max pressure 12.0, PS 3.6, Trigger Sensitivity on High.

[snoor]

Thank you for the guidance. I will be sure to follow the posting formatting guide in the future

[snoor]

Hi,

I've been using my current CPAP for going on 6 months now and can't manage to sleep through the night. I've done all I can to manage outside variables such as not eating/drinking 3+ hours before bed, finding a comfortable mask, sleep hygiene, and taking melatonin occasionally. But nothing seems to get me a consistent 6+ hours of sleep. I always wake up after 2-3 hours and feel energetic/rested; but if I take off my mask I fall right back to sleep (poor rest). I try to put my mask back on but just feel to anxious and end up staying awake or taking it off again.

I've included 3 of my daily report. Any feedback or suggestions to help tune in my therapy is much appreciated.

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Additional reports:
           

[snoor]

Additional reports:

           

[SarcasticDave94]

Please keep your posts together so we have your historical info. Thank you.

I am seeing a trigger of very high. Was it suggested to try this? Your other thread had Sleeprider mentioning trigger high and what seems to be your current pressures. The charts look good, but you indicate you can't sleep with it. I saw your sleep study report with Central Apnea and then zero anything else.

Possible reason...

Maybe just maybe they should be treating Central Apnea... With ASV. Oh no surprise either, you have Obstructive Apnea (G47.33) that needs treated, uh nope. You had ZERO Obstructive Apnea, ZERO Hypopnea.

Yes, your event numbers are great, but you're benefiting very little right now. If in fact ASV would be a better choice, you should probably set the VAuto back to doctor recommendations and fail it gloriously. Or take your copy of the sleep study, highlight the event count of 29 CA, 0 OA, 0 Hypopnea. Show this to the blind doctor. Ask him when your CA will get treated. Time to go livid. Addition to this, call and complain daily until they fix this.

[snoor]

Thank you for the guidance.

No. I struggled slightly adjusting to my newly adjusted settings and did some research (googling) on ways to ease my struggle. Ever since changing my settings my AHI has been consistently low (which I assume is good) and I rarely get any events registered when reviewing my data. But I still struggle sleeping through the night.

I've had several studies. I was initially on standard CPAP therapy but struggled breathing against the pressure. In regards to the obstructive apnea; the doctors attributed to my nasal congestion (I ended up having a turbinoplasty) and now use Azestaline and Saline regularly. This is the 1st time I'm hearing about a central apnea. I don't get to see my provider a lot due to moving around and availability conflicts.

I'll stick with my current settings; as returning to my doctor's settings was really rough for me. Although things aren't ideal right now, they are a lot better than before. In all truthfulness my doctors aren't the most 'engaged' w/ my care (whether that be a result of being overwhelmed or poor practice), so I don't get much out of them when I 'complain'. Also, it takes 3+ months to see them.

Are there any adjustments you'd recommend in the meantime? What does treating Central Apnea look like? Why wouldn't my current therapy be effective?

Thank you for taking the time to respond to me.

[OpalRose]

Snoor,

I've merged your threads. This way your history is in one thread.

[SarcasticDave94]

The main difference between Central and Obstructive Apnea is that Centrals for any cause will have an open, clear airway while Obstructive Apnea have a collapsed airway. Secondarily, the difference is in the treatment involves different machines tuned to the specific task. It appears to me that due to Central Apnea only, they're attempting to treat your condition with the wrong device, and as such seem to help explain why you're uncomfortable and not getting to the well rested state.

Central Apnea can be of an idiopathic cause, meaning medically unknown cause. This CA can be due to brain injuries, but there's many other causes, so don't be too alarmed that you're dealing with CA.

Even if they're intending to treat Obstructive Apnea due to turbinates and such, you still had zero Obstructive events. There's nothing there to treat, so this comes off as incompetent medical work. It could be as simple as they are clueless about Central Apnea and how to treat them, but they need to, because this is really your type of Apnea.

You might need to consider a consult with maybe your primary with this test result in hand. Hey doctor can you get me an ASV to treat CA? And fill in this doctor that the other can't see CA as an issue.

Maybe this is your answer to resolve the poor sleep with what you've got now, despite little to no events on OSCAR. And making some doctor recognize the CA only state of affairs on the test result should reasonably result in a script for ASV. But some doctors aren't reasonable, and are either too lazy to fight for the patient or plain ignorant and incompetent.