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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Apologies for the one day gap. I wanted to hold off for a new mask delivery.
Attached is the result with Sleepriders settings
Clear airways as before. When I zoom in, there seems to be a cheyne stokes pattern.
Some notes from my side:
* I got the Philips Dreamwear nasal mask and found it far more comfortable.
* I woke up a lot, but felt ok'ish compared to normal. I often wake up with a cortisol stressed feeling, but felt quite chilled with the mask on.
Well that's disappointing, but not unexpected. Steady low pressure often improves CA, but in your case I don't see any difference. You will need the ASV. Your best strategy is to show your NHS counselor the results you have had to date, and specifically request ASV therapy as soon as possible. The more urgency you express, the more likely they will be to act accordingly. I think you know enough about the difference in therapy to discuss it. At this point, it is not settings, but comfort we need to pursue until you have the right device.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Just got an email from the original consultant who analysed my sleep test, they think it perhaps could be CPAP-emergent central sleep apnoea / complex sleep apnoea. OSA develops into central sleep apnoea when on CPAP.
I did not see your original sleep study as sufficient to reject central apnea. The way I see your report is 3 central apnea 58 obstructive apnea and 43 hypopnea which could be either central or obstructive. Your CAI was only 1/hour compared to an OAI of 19, and HAI (hypopnea) making up the remaining 23 events per hour. Even if we assume a split in the hypopnea events It's not unexpected that these results are interpreted as obstructive sleep apnea, but since hypopnea make up more than half of the events, there is some uncertainty. Most physicians will ask that a patient complete a trial period of about one-month to eliminate the possibility that central events are "real". Sometimes we see central events spontaneously resolve in a few weeks, but it is concerning that all events you have shown so far are central, and that they show up at all pressures.
I don't see much choice other than to "ride it out" and see if the results change. I would suggest you just use the most comfortable settings possible and see where it goes. I don't see any reason not to use settings of 7.0 minimum, 10 maximum and EPR at 2 or 3 as you find comfortable, and just play the long game. It's hard to read between the lines of your consultant's message, but even treatment emergent CA requires treatment with ASV if it does not resolve. Is that the direction they are taking?
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
I'm no expert but that but that is a very consistent CA pattern. I had a lot of CAs when I first started therapy and almost convinced myself that was my primary issue. It wasn't, and even with numerous CAs, my reports looked far different than yours.
First day, then about a week later, finally the night before last:
03-23-2023, 01:13 PM (This post was last modified: 03-23-2023, 01:14 PM by stanleyjack.)
RE: stanleyjack cpap progress thread
Thank you so much for you support Sleeprider. I will try those settings see how it plays out, while keeping things primed to acquire a ASV.
cdplatt, that is very similar to me. would you be able to zoom in on your flow rate around one of the clusters from your first week. Curious to see if you have the same pattern as me (see attached). how long did it take for the CAs to subside?
I've attached a zoomed in image. However, I wouldn't rely on my reports too much as a comparison to yours. The reason I posted the images in my earlier post was to show how different the pattern was. Yes I had CAs, but unlike your report, my reports were also littered with OAs, Hypopneas, Unclassified Apneas, and RERAs. Your report is showing almost exclusively CAs. I didn't place high reliance on my early reports as a diagnostic tool because I was struggling with the mask and forced air so much. Much of the time I was either not sleeping or barely sleeping. It wasn't a normal pattern of sleeping or breathing. It was garbage data.
I think it started to settle down around August when I started taping my mouth shut, but even then I was getting AHI scores running from 4 to 8 and sometimes much higher. The scores really started to drop in January last year when I finally switched to the N20 mask.
I think getting comfortable in the mask and being able to sleep is important to getting reliable data, but I wouldn't be surprised if your report doesn't change very much.
My mask appears more tolerable and sleep is on / off. Interestingly, last night I felt fairly well rested and thought maybe I might be making progress, but I woke up to check my data and I am still getting a lot of central events.
