CA (cluster?) events not reducing

[Dormeo]

I have zero knowledge of cardiology and would not want to venture an opinion. Sorry!

[Jay51]

Thank you for your honest answers T818.  Sorry to hear about your current situation.  I would recommend trying to become your own best expert, then.  Do as much research as you can to try to figure out a successful solution to your problem.  A lot of people come to ApneaBoard because the advice that they were given did not work.  They are advocating for themselves.  

I wish you well in your endeavors.  Feel free to post more OSCAR charts or anything else here so we can give suggestions, too.  By experimenting, you may find a workable, long term solution, too.  Don't give up.

[T818]

Thanks Dormeo & Jay51 for the support & encouragement. Had a follow-up with cardiologist. according to him, my condition is very mild and nothing to worry about & hopefully, it will go away soon. he thinks pulmonary hypertension is caused by sleep related problems.
so all I can do now is to focus on maximizing my Bilevel therapy. I will keep posting my data here to fine tune my therapy.

[Dormeo]

I'm glad you got some reassurance from the doctor. Onward!

[T818]

Settings sound okay with PS 4 and the help of very-high trigger.  Without seeing charts from those trials it is difficult to comment as we do want to see the results.  Vauto mode with a limited range might be revealing. Your range of trials range from 9/5 to 14/10. With lower settings being more comfortable, I'll suggest EPAP min 5.0, IPAP max 12.0, PS 4.

I tried this settings for the last couple of weeks. not seeing much improvement. would you please take a look at the recent data and evaluate? what changes can I make? is there anything else that I can try such as... a different mask or some sleeping aids etc

[Jay51]

Your charts continue to look pretty good IMO.  0.00 95%tile flow limitations.  Fairly quick inhalation (no problems it seems).  Ok tidal volume, but on the low-normal side.  Clean chart.  A very few, negligible CA's.  

 I know you stated you suffered from sleep apnea for 12+ years, and have been in pap therapy for 7+ years or so.  Maybe some of your health problems are unrelated to sleep apnea?  If you get your therapy as good as it can be, and your don't feel better, then that seems to point to another health problem(s) being the cause and not sleep apnea.

[T818]

I had all sorts of blood tests done like cbc, electrolytes, thyroid, testosterone, magnesium. all are normal.

it seems I have reached a dead end with no way out

[Dormeo]

Some other things to have checked, if you haven't already: iron panel, vitamin D and B vitamins, and markers for autoimmune disease, especially in the connective-tissue-disease family.

Way back when, I was finally diagnosed with a connective-tissue disease that, like most CT diseases, causes fatigue and brain fog. (It was successfully treated, in the end.) Before that, my work-up included a CT scan of my brain. That's something else you might ask about.

I know it's hard to find the diagnostic work you may need in Bangladesh, so I will really be hoping you have some luck.

[T818]

Hi Dormeo,
Vitamin D & Feritinnin test was done & results were ok. I didn't do whole Iron panel. will give it a try & B vitamins as well.

markers for autoimmune disease, especially in the connective-tissue-disease family: these are not done. can you please tell me which department handles this kind of health issue? also what are the relevant tests?

[Dormeo]

My primary care physician ordered the tests for me, but your medical system may work differently. The medical specialty for this family of diseases is rheumatology. The connective-tissue diseases are all associated with fatigue; they include scleroderma, Hashimoto's thyroiditis, rheumatoid arthritis, primary Sjogren's Syndrome, mixed connective-tissue disease, undifferentiated CTD, CREST syndrome, and lupus. There are others, though they aren't coming to mind at the moment.

There are some general screening tests for this family of conditions. There some good information here:

https://emedicine.medscape.com/article/334482-workup