[Diagnosis] Clear Airway, CSR events

[G. Szabo]

Every event that interferes with your normal sleeping pattern disturbs your sleep; it can move you from one sleep stage to another. You might not be fully awake, but you cannot have the needed length of sleeping stages either.

[frolic]

After 5 days at 10, my AHI is staying below 1. Thank you! Hoping the CA events / football waveforms settle down more as my body adjusts. Do you have any suggestions as to what is causing the higher pressures earlier in the night? I'm assuming sinus inflammation.

To the previous post, I've noticed CA occurring prior to night time awaking, where I tend to get out of bed (see gap in airflow waveform.) It appears to me that the CA precedes movement, & therefore may be triggering arousal.

I do sometimes see CA in the morning, when I am waking/awake but not out of bed but I am seeing that less in the more recent data after adj pressures so I'm not sure what to make of that yet.

[G. Szabo]

Your AHI is below 1, your flow limit and oxigen are excellent, and your insp/exp time ratio is in the expected range. Your CAs are expected to disappear with time.

Your initial pressure increase is associated with some flow limit spikes, probably because your minimum pressure is still a bit low. But I would not change it yet.

[frolic]

Last couple weeks have not been so good, lots of tossing & turning especially early on. Last night was bad. Oximeter started vibrating early morning. As I layed there, I felt like I was breathing OK but had to take several deep breaths to get the oximeter to calm down. That occurred at least twice. Today, I've been lightheaded all day so far today (1:30pm as I type); struggling to even think straight at times.

I feel like the CPAP is reducing my drive to breath normally. I'm thinking about getting a referral for another sleep study. What questions or comments should I be making to the doctor to make sure I'm getting the right testing?

In the meantime, can you recommend any further adjustments to the CPAP settings?

[SarcasticDave94]

More tests may not be helpful. Use the test results you have now to get whatever you need. If the doctor will script it.

[G. Szabo]

Your CAs increased for some unclear eason. You can try mitigating them by EPR=2. But, eventually you want to go back to 3.

[frolic]

Thank you for the advice. I won't bother posting a screenshot until the adjustment has had some time to settle in. But after dropping EPR to 2, AHI for the last 3 days: 1.7, 5.89, 1.44. Last night, I sleep pretty well.

Dropping the EPR seems counterintutive, but, after a little research, I get the general idea why it helps. Exhalation actually seems a bit easier/natural with EPR 2, which I wasn't expecting. However, I am curious as to why you are recommending an eventual return to EPR 3?

[G. Szabo]

Higher EPR lowers flow limits. It also makes breathing easier.

[HenryECole81]

Thank you. Catching up. Sorry for the delay.  Somehow my old Apnea Board email did not get changed.  Now corrected. 

My experience and what I thought was the Apnea Board guidance was to lower EPR if  many Clear Airways. That change had a marked effect in my sensed sleep and OSCAR reporting.

[G. Szabo]

When CAs are treatment-induced, their occurrence can decrease with time, which is often the case. When this decrease occurs, one can increase EPR.