ApophaticAxiom's Sleep Apnea Thread

[ApophaticAxiom]

Hello, all!

I am a 20 year old male who was diagnosed with a Chiari malformation in November of 2022, along with the condition's various sequelae (choice among them being sleep apnea). My sleep study was conducted in September 2023, and I obtained the results of the study in November 2023. I began using my prescribed APAP device on January 10th, 2024, but a month before that, I had resorted to borrowing a disused CPAP machine from somebody else. The CPAP machine that I was initially using, a ResMed Elite II, was set at a static 10 cm H2O. This machine was able to completely annihilate my apneas (regularly below zero / hr), but I regularly retained a number of hypopneas greater than 10 / hr. Without the advice of a physician, I elected to lower the pressure on this machine, and this resulted in a near complete cessation of the hypopneas. My current APAP machine, a ResMed Airsense 10 Autoset, was set to a minimum pressure of 5 and a maximum pressure of 15, but once I informed my physician of the discovery I had made while using my former CPAP machine, the maximum pressure was lowered to 10, and my first time using those settings occurred last night. I'm not sure if it made a difference. While my overall results have been positive (my AHI is regularly below 5), I have been experiencing a number of arousals each night (as few as one and as many as four per night. Unfortunately, I was only able to obtain an SD card yesterday, so I only have a single night of data to show you all), and my primary goal is to decrease the number of these arousals.

On the whole, my sleep apnea does not appear to be anywhere near as severe as it is for others (or, to put it another way, my sleep apnea does not appear to be as resistant to treatment as it is for other sufferers of the condition), so I'm not sure if any of you will have much advice for me, but if there's any way I can improve my treatment, I'd be glad to hear any thoughts that you have.

I believe I read that you would all find the results of my sleep study useful, so I've written the results below. In addition to that, I've attached some OSCAR data, though I'm not certain if I've included everything that you will need to assess my situation.

AHI: 11.5
RI: 14.1
Apnea Index: 9.0
UAI: 0.0
OAI: 8.0
CAI: 1.0
MAI: 0.0
Hypopnea Index: 2.4
% Flow lim. Br. without sn(FL): 12.0
Oxygen Desaturation Index: 6.0
Average Saturation: 96.0
Lowest Desaturation: 86.0
Lowest Saturation: 86.0
Baseline Saturation 99.0
Minimum pulse: 59.0
Maximum pulse: 117.0
Average pulse: 81.0
Avg. Breaths per Minute BPM: 11.5
Breaths: 4091
Obstructive apneas: 49
Central apneas: 5
Hypopneas: 14
Flow lim. Br. Without Sn (FL): 623.0
Flow lim. Br. With Sn (FL): 478
Snoring Events: 1001
No. of Desaturations: 41
Saturations
<= 90% : 0.6% 2.0 minutes
<= 89% : 0.3% 1.0 minutes
<= 88% 0.3% 1.0 minutes
<= 85% 0.0% 0.0 minutes
<= 80% 0.0% 0.0 minutes
       

Edit:
By the way, here's a question: I'm not sure what sort of mask I'm using. It's got nasal pillows, but it also has a section which covers my entire mouth. Would this count as a hybrid mask?

[Deborah K.]

You would probably be more comfortable and receive better therapy if you set your beginning pressure at 7 instead of 5.  4 and 5 are usually used for children, and a little higher is better for adults.  Also, the EPR settings do not work when you start a 5.  You can do this yourself with your ResMed machine.  If I were you I would also change the EPR setting to 3, as this will help more with your flow limits.  

As far as waking up, you are doing a great job by staying in bed and keeping your machine running.  The wake ups will likely go away as you adjust more and more to your machine.  Most of us do go through some adjustment challenges.  Our brains and bodies need to make these adjustments, and sometimes they do not happen as quickly as we might like.

[ApophaticAxiom]

I appreciate the input! I'll make these changes and see what tomorrow bring me. Thank you!

[ApophaticAxiom]

How'd I do last night?