AHI total average vs true AHI graphed hourly average

[Jessher]

           

Had a string of bad events over a month, morning headaches ect.
AHI night average 19.5,   True 1 hour average at worst, about 40 AHI 

Doc says looks great, I say not so fast buck wheat.  Who's right? Its my PCP and i think he's looking at Resmed report.

Here's a snapshot,  the rest of the month had about hour long 1 or 2 events a night. bad morning headaches heart arrythmeas. 
Jess

[enigmatic]

One thing I learned about the RESMED reports and dr. interpretations, they show one single constant value for many stats the entire session. Completely
ignoring the time series behavior in-between (at the sub second level). I was a bit frustrated about that.
Anyways, it looks like there's a lot you can do to improve. I'll let the experts chime in.

[staceyburke]

I know that these show centrals but I would look into if it could be positional apnea as well.  The problem is that the cpap  is not good at detecting Centrals because all it does is send a pulsating bursts of air and if they come back it is Obstructive and if it does not detect any air it is a central.  In a sleep lab they have wires to your head and a chest cord to see if you are trying to breath but can not (obstructive).  

The way you tell if it is positional apnea is clusters of OA and H events.  If you look at your events you can see small clusters of OA along with the centrals.  So my suggestion is to rule out Positional apnea... 

Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

Again, these may be all centrals but check out the possibility of Positional.  

[Deborah K.]

Can you post a copy of your sleep study?  That will help us a lot.  You show mostly central apneas.  If your sleep study shows the same, you may need a different type of pap machine.

If your doc did not give you a copy of your sleep study, ask for it.  Legally, he has to give it to you.

[Jessher]

   

Little more back story, i was well treated until foot surgery last August, majority  of AHI nightly average was  less than 1.5 a night. Now after surgery i get these clustered events mostly identified as CA's in Oscar, hourly AHI AVERAGE of about 40 one or two of these a night but have been tapering off.

 I just burns my butt  showing my PCP screen a shot of Oscar  ( event window, flow rate, hourly AHI, i forget the Last one), and get "Its well treated"   ( event window, flow rate, hourly AHI, i forget the Last one)

[Jay51]

Your sleep study showed 141 hypopneas, 60 obstructive apneas, and 40 central apneas.  I am not sure if the 3 charts you posted are true central apneas either, or if they are really obstructive events.  The results of your sleep study seem to back up the hypothesis that these are obstructive apnea and hypopnea clusters, and not true central apnea clusters.  

The main reason I wanted to post was that you spent 6 minutes under 88% spo2.  That means you qualify for supplemental oxygen if you want it.

[Jessher]

I'm not really worried about the central apnea thing.  Its more about convIncing the doctor that i'm having a problem getting back to before the surgery AHI events. he thinks its controlled.

[Jay51]

Showing your Dr. a copy of these latest OSCAR charts might help convince him or her that it is not well controlled right now, and not back to pre - surgery levels.

[Jessher]

Hi Jeff,
Yes I have, the problem is I don't think he. is a Oscar believer.
Just double checking myself before I confront him.  Strange setup, he's the gate keeper to my pulmonologist.  

Thank you

Jess

[Gideon]

Honestly I don't care about the AHI chart, but I do care about when these events occur and what occurs before and after them. Mostly I look at events, flow rate, pressure, and flow limits with a quick glance at leak.

But yes, we fairly often discover that clusters of CA events result from positional apnea