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Treatment induced CA's?
Treatment induced CA's?
I'm a week into therapy, feeling exhausted, still trying to figure all this out and understand what I'm seeing. I'm so thankful for this forum and Oscar! I've spent some hours going through the forum yesterday and today...and I don't understand what I'm seeing in these graphs of mine. And thought maybe those who've been looking at these things for years might offer some clues.

I'm also using a fitness tracker, and during the highlighted episode, I was in 'deep sleep.' All the CA events occur when I'm not moving or repositioning -- according to the tracker.

This was a good night's sleep for me, the best so far since I started CPAP therapy, and fairly normal overall. (I'm struggling to see the benefit of this thing right now.) This was also the first night I had an SD card in my machine and using Oscar. The summary of the other week of sleeps gave me an AHI of 20+ (the average is probably around 14, but I'm not bothering with that until I have a month or more of data.) At the sleep lab my AHI was 7.2.

With my other health issues, central apnea wouldn't be a surprise. But that jump in score is slightly disconcerting to me.

Much thanks!

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RE: Treatment induced CA's?
You may see some benefit by increasing minimum to 8cm.

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RE: Treatment induced CA's?
I might not be thinking straight, but I can't seem to find how to do that! I'm using a ResMed Airsense 11 and can't see how to set the minimum or maximum pressures. They seem to be preset.
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RE: Treatment induced CA's?
(08-01-2023, 10:56 AM)Matwat Wrote: I might not be thinking straight, but I can't seem to find how to do that! I'm using a ResMed Airsense 11 and can't see how to set the minimum or maximum pressures. They seem to be preset.

You need to access the clinician's menu. Have you been into it? There are some guides on this site I believe.

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RE: Treatment induced CA's?

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RE: Treatment induced CA's?
Actually, I wouldn't recommend raising the minimum. That is unlikely to help you with the CAs, and it could even cause you to have more of them. Possible exception: if you feel a little air-starved at 5, bump it up to 6 and see whether that's better. But if 5 feels fine, leave your minimum there.

I would recommend reducing your EPR to 1 or 0. That might help with the CAs. Give it a try for a few nights and let's see how that goes.

The next time you post, be sure to include a screenshot of the whole night. This provides context that could be useful.

Also, please include all and only these graphs:

Flow rate
Pressure (not mask pressure)
Flow limitations

You can move graphs up and down by grabbing them in the title area to the left of the graphs, and you can squeeze all six graphs into your screenshot by grabbing the gray bars that separate them and pushing up a little.

You're just a week in, so it's really not surprising you don't yet see improvement in how rested you feel. It can take some patience, as your body gets used to the new sensations and routines. For some people, the process of adaptation can be sped up a bit by using the machine during the day or evening, outside the bedroom, while you watch TV or read or do something else low-key.
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RE: Treatment induced CA's?
If you have mostly CAs, ask your doctor about replacing your cpap with an ASV. That's what I did and I love my ASV!
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RE: Treatment induced CA's?
Thank you so much for the info!

I tried setting the pressure at 8, then at 6, then opted to leave it at 5.

Turning off the EPR did the trick! I know it's only one night, but compared to the last week, it's amazing! That's what was bugging me.

Some history, and why these CAs might be interesting -- there's a debate between VA neurologists, my GP, and Uncle Sam whether I have a motor neuron disease. The neurologists have run the gamut of tests. There's no clinical evidence of MND, MS, ALS, Parkinson's, and all the known stuff that might be causing my symptoms that the neurologists have suspected and ruled out. It feels like I've been poked by every VA neurologist in the region, like they have a betting pool in the breakroom, or maybe telling the residents, 'Hey, come check this out!' Or they're just playing 'pass the patient' because it's complicated or something. I've been poked and shocked in a lot of sensitive places.

I filed a disability claim for MND with encouragement from my GP, and Uncle Sam didn't deny it, and seemed to ignore their own neurologists. So, it's weird. My benefit rating is for 'undiagnosed degenerative motor neuron disease.' That's specifically not a diagnosis. I side with the neurologists on this one and just as confused as they are. Or maybe I'm in denial and just don't want to accept it.

Aside from sinus polyps and the sleep study, the other abnormal test I've had was an EMG, which indicated polyneuropathy with myotonia. I also have fasciculations from the top of my head to the souls of my feet, muscle cramps/spasms, myoclonus, loss of feeling in my arms and legs, dizziness, vertigo, loss of reflexes in my left leg and arm, and pain and weakness in my joints. The list goes on into crazy-land that's not clinically provable. (They might be hallucinations or auras for silent migraines. Beats me.) The EMG stated clearly "NO signs of motor neuron disease or radiculopathy" and the neurologist doing it said she's never seen something like me in her 10 years of practice and tried to prepare me for a future of tests and appointments...that all have ended up going nowhere and I feel like a crazy person.

When I went for the central nervous system disability exam, the examiner also filed 'Gulf War unexplained multi-symptom illnesses,' which opened up the sleep study and other 'fun' prizes. I was a medic in a tank battalion in the 90s. I wasn't a combat medic, but went to Kuwait for what they said was a 'training exercise.' We didn't use shelters. I become one with the dunes and ate and breathed a lot of sand. I've recently registered with the Gulf War toxic screening and burn pit registry, had that exam too, and I qualified. 

Seeing all those CAs in the first few days with 20-30 minutes in apnea, it felt like it was confirmation of MND. But now I'm not so sure again. 

Thanks to y'all, I felt good enough this morning to walk a mile before sunrise without the cane. It was awesome!

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