CSA Help

[Sustained]

Hi All,

New to the forum and have been trying to help improve my CSA issue. Have read a lot of posts but can seem to put it together so I am hopeful asking directly will help me.

Some background:

- Diagnosed with mild OSA 10 years ago, started CPAP and it made a huge difference. Always have used autoset with nasal pillow (P10) which has worked great until recently. I am in fairly good shape but have a thicker neck.

-Summer 2023 I noticed a few more CSA's then usual and flagged to my doctor. Basically CSA went from 1-2 to 3-5. Didn't have any difference on my day to day. Also didn't have any life changes or anything like that so we just agreed to monitor.

-Oct 2023: I ruptured my patellar tendon playing basketball and had surgery. That is when my AHI driven by CSAs has stayed above 5 and closer to 10. I chalked it up to a major event, stress, pain management and have to sleep on my back for the extended periods. (always was a side sleeper) Off any meds for weeks now.

-Nov 2023: So far November has been worse consistently worse. Up around 7-10 CSAs (no many OSAs at all) and i am noticing the difference day to day. I got the ok to sleep on my side the past two days and that has not helped.

Things I have done to improve:

1. Popped in SD card Nov 24th for Oscar tracking
   
2. Turned off EPR and set Pressure to 10 (no improvement)
   
3. Lowered pressure to 9 (no improvement)
   
4. Lowered pressure to 8 (CSA came down to 7 but OSA moved up to 1.7)
   
5. Ordered a cervical collar (its on its way)
   

The pressure changes were in consultation with the team that sold me the machine. Added some Oscar screenshots let me know if there is something more helpful.

What do you guys think?

[PeaceLoveAndPizza]

Please report the charts using our standard format. My signature has links to "Organise your OSCAR charts" which explains things.

[gainerfull]

I'm inclined to believe the soft cervical collar is going to help quite a bit. Although you are stopping breathing I believe the machine is actually not classifying the events correctly. Most of you events are clustered suggesting positional apnea and I actually think the "central apneas" are hypopneas or smaller obstructive events.

Keep in mind, not every soft cervical collar will automatically fix your issues so don't be discouraged if the first one you try doesn't bring you relief. Are you wearing an sp02 monitor? That could give you more information re: desaturations associated with these events.

Did you have central apnea in your sleep study pre CPAP?

[Sustained]

My Mistake I read the Chart organization as the advanced order was preferred. Will reattach.        

[Gideon]

Your centrals in the zoomed image are not centrals, they are preceded by an Arrousal and actually are you holding your breath when tossing because of the Arrousal.

[Sustained]

Thanks for the advice. So do you think this is likely a chin tucking thing?

Also do you notice any other patterns in the breathing. I tried to interpret the results using the forum's chart guides but not confident in my reading ability!!

[gainerfull]

Yes, likely chin tucking sleeping on your back. Once you solve the positional apnea we may find that you're also under-titrated but tough to tell until we get a clear signal.

You can buy a soft cervical collar from your local Walgreens / CVS (whatever they're called in Canada) and be sleeping better later tonight! Just wear it loose but not so loose you can tuck you chin inside of it.

[UnicornRider]

Keep posting OSCAR Reports after you get that soft cervical collar.

After an injury, it can take a while for your therapy to settle down as your body recovers.

I am interested to see your progress.

[Gideon]

I suspect that your centrals are somewhat elevated, but would need to see more and I'd like to see the arrousals reduced and see where you are at.
You may possibly need a different machine but I cannot tell at this time.

[Sustained]

Thanks everyone for the advice so far. It is very much appreciated!!

I am trying to track down my original sleep report but I do not recall having any CSAs at that time.


Still waiting on my collar as it should arrive today or tomorrow. 

Last night I had some Cheyene breathing which I am unsure what that means or if I ever had it before.

Have attached last nights charts. Let me know your thoughts.