easy breath - Therapy Thread

[easy breath]

Hi. I am new CPAP user (3 days). I am asking for help understanding the significance of on screen readings.

Lab report, current (Home tests without reading of brain waves):
Breathing interruptions: 44/hr. 15 from Apnea. 29 from Hypopnea.
O2 basis 93%.
O2 below 90% for 11% of night.
Lowest O2: 67%
Snoring: Yes, Loud.
Paradoxical breathing: Yes.
No mention of central Apnea.

Sleep lab in 2003: Sleep with much dreaming (32%), disturbed, with eye movements and dense. (I could add more from that report if asked).

I have a heart problem that causes insufficiency. 

Machine readings (ResMed Airsense 10) for last 1 day:
Pressure: 9.5
AHI: 9.4
Total AI: 9.2
Central AI: 7.3

Does this mean that OSA using the machine is down to 2.1 (Subtract central from AHI)?

Why does current lab report not mention Central Apnea whereas the CPAP does?

Does this mean mixed Apnea? Is the Central Apnea likely to be “treatment induced” or is heart insufficiency likely? Or maybe it is because I move around a lot?

What do people think? And where to start?

[Dormeo]

Welcome!

Yes, your obstructive apnea index equals your total apnea index minus your central apnea index.

Your at-home test may have some information about central apnea. If you have a copy of the report, look for a number that is coupled with a lower-case "c."

The best way for us to help you would be for you to use the Oscar software. You need a laptop or desktop computer, an SD card in the card slot on your machine, and an SD card reader, either one that is built into your computer or one that you plug into a port on your computer.

It's pretty common for people to experience CAs when they're starting out on CPAP. These treatment-induced events often come after arousals (wake-ups or changes from deeper to more shallow sleep). They tend to subside with time, as the body adjusts to CPAP. But it'd be helpful to see an Oscar chart before we try to figure out more about what's going on with you.

I'd recommend that your talk with your cardiologist about your CA index to see whether he or she sees a problem, given your particular heart conditions.

[easy breath]

Thank you for replying!

My report is in Hebrew and does not have “C”.
However, I note that 15 Apneas plus 29 hypopneas adds up to the 44 breathing breaks, so all the breaks are accounted for, so it would seem (I hope) that the home test did not detect any Central Apnea at all. So I hope it will turn out that the CA is because of starting the therapy. In fact, the CA has gone down during the three nights that I have used the CPAP.

I will see if the CA goes down with time.

In any case, do I understand correctly that if the OAI index is just 2, then the CPAP is doing its job quite well, and there is no need to consider changing settings on the CPAP?

Thanks again.

---

Oh, another question, when I turn on the machine it starts at pressure of 4. It feels kind of hard to inhail, like I need to suck the air in through the machine.
Would it be good to raise the min. pressure? If yes, by how much?

[Deborah K.]

You really need to download and use Oscar, our free apnea reporting program.  It creates great charts that tell us lots of information about each night's sleep.  You can download and learn about it in the black ribbon at the top of every page.  It's the best way for us to be able to help you.  And, in fact, most people do need to make changes to their settings.  I don't know of anyone on this forum who has not needed to make changes, and we can help you do it yourself. It's the perfect way to provide great therapy and comfort for those of us with apnea.

Oscar is wonderful!  

I just noticed your question about raising your pressure. Yes, raise your starting pressure to 7. To do that, press the round button to wake your machine up, then Press and hold both buttons together for about 5 seconds. That will cause "settings" to show in the top window. Press the round button, then you will be in settings. Scroll down to pressure, and dial the pressure up from 4, then press the button so that the machine takes the new setting of 7.

[easy breath]

I have mail ordered a card reader and I plan to use Oscar when the card reader arrives, like both of you suggested.

I also will look in to how to get O2 and pulse readings. It is too bad the ResMed module and Nonin and senser are so expensive.

I am not sure why you sent me the link to bilevel. If you mean reduced pressure for exhaling, I have already turned that on and set it for 3. My machine is not formally a BPAP.

I will raise min. pressure for 7.

Thank you so much!

[SarcasticDave94]

The possibility of CA, which to the CPAP are Clear Airway but on the test means Central Apnea, might be better avoided and controlled with the ResMed AirCurve 10 or 11 VAuto, a Bilevel.

[jdougc]

Welcome to the forum.
Set your ramp pressure to 7cm, if ramp is turned on.

[easy breath]

OK, Here are the charts!

I put charts from two nights. 

   

   

   

Thank you

[Dormeo]

Easy Breath, Deborah K includes the link about VAuto in all her posts; it isn't directed at your situation.

I'm glad you're now using Oscar -- well done!

You're right that your sleep study showed no indication of CA events, given the arithmetic you point out. This means that your current CAs are probably what we call "treatment-emergent." This is not uncommon, and it usually resolves on its own over time as your body gets used to PAP therapy.

There's some more information here:

https://www.apneaboard.com/wiki/index.ph...tral_Apnea

For now, I would recommend that you keep your pressure settings right where they are and try lowering your EPR to 2. Give that a couple of days (unless the change is a disaster) and post again so we can see what your response to that change is.

Depending on your response, there are some additional changes we could suggest that you might want to consider.

[easy breath]

Last night I reduced EPR to 2, returned min to original setting of 4.

Started night in BED, the sleep was really bad, I felt the high pressure (8.5-9.5 for half an hour straight). After one hour I saw that AHI was at 27! (24 of which turned out to be from CA) 

I then moved to a RECLINER for the rest of night. My readings for second half of night (viewing using Oscar permissive mode) were AHI of 2.59 with CA at 1.95! Much lower than any period so far! 

There were not enough hours of good sleep to judge the results by how tired I feel today. I plan to sleep in the recliner tonight for the entire night, perhaps I will feel rested tomorrow!