[Diagnosis] Diagnosed with mild OSA - Could this be UARS?

[roroboon]

Hi All! I'm still new to the sleep apnea world and trying to learn as much as I can! 

Many of my family members have been diagnosed. I thought that as a younger, healthy adult there was no way I could have sleep apnea. I have many events during the night waking up feeling like I can't breathe, and I am constantly waking up feeling like I didn't sleep at all. The constant waking and daytime fatigue is really wearing me down.

I decided to go ahead and do a Lofta sleep study and I was hoping someone would give me some insight on my sleep study results. My diagnosis is technically mild OSA, but my AHI is really low.

I ordered a ResMed AirSense 11 which should be here in a few days. I am hoping I made the right call because I'm reading that I might have UARS. Any insight is appreciated!

Thank you!

[OpalRose]

Hi roroboon,

Welcome to Apnea Board!

Good move to order the A11.  When you receive your machine, be sure you have an SD card installed while you sleep.  That is the only way to gather data for OSCAR reports.  

Order a Clinicians Manual HERE.  You'll need this to help you set your machine up.

To start, set your pressures to:

Minimum at 7 cm.
Maximum at 15 cm.
EPR set at 2.

Use these settings for few days and post a Screenshot of the daily page in OSCAR.  From there, we can advise on any changes that may be needed.

[roroboon]

Thank you, OpalRose! I will return to this thread once I have some OSCAR data and post my results. I appreciate you giving me a few recommendations for initial setup.

[roroboon]

Good Morning!

I received my Airsense 11 last night and trialed it with the settings you proposed. It appears I had a lot of CAs during the night. Are there any settings I can tweak to help with that?

Here are my current settings:
Mode
Auto for Her
Pressure Min
7.00 cmH2O
Pressure Max
15.00 cmH2O
Antibacterial Filter
No
Climate Control
Auto
EPR
Full Time
EPR Level
2 cmH2O
Humidifier Status
Off
Mask
Pillows
Ramp
Off
Response
Standard
Smart Start
On
Temperature
26 ºC
Temperature Enable
Auto

[OpalRose]

The CA's may be just be treatment emergent, as I didn't notice any on your sleep report.  It could be they don't test for it, I'm not sure.  In answer to your question, the only machine geared toward treating CA's is an ASV.  If the CA's are treatment emergent, they will lessen in time on their own.  

I do see some aspect of Positional Apnea, where you might be sleeping in a way where your head tilts forward into your chest, thus cutting off your air.  Can you tell us if you sleep on your back, or are you using a too tall bed pillow that could force your head into a "chin tuck" position?  

Read through this link and see if this applies to your situation at all?  

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

I notice you're using the "For Her" mode.  I haven't het seen this mode to be helpful.  I believe the pressure will only rise to 12cm for apnea and 17 to help with flow limitation when using the For Her mode.  If you are willing, change that to the AutoSet mode.  

Let's try to bring your minimum pressure up a bit to 8cm, leave the max pressure where it is.  I would like to see the EPR set at 3 to help with the high flow limitation. also to see if this aggravates the CA situation.  But it bothers you, then keep EPR set at 2.

[roroboon]

Hi OpalRose,

I appreciate all the help you're giving me with my therapy! 

I have adjusted my settings to what you listed and I'm going to try some humidity tonight as well. I am really hoping that I didn't have central apnea all along as I'm not sure that my sleep study reported those.

It is definitely possible that my pillow is holding my head up too high causing me to chin tuck as I sleep. I'll swap it out for one that allows me to lay flatter tonight to see if the CAs drop. I tend to change positions as I sleep, but I primarily sleep on my back. It is more comfortable to fall sleep on my side but I'm still dialing in the mask. It leaks a bit laying on my side or my stomach.

I'll give these settings a go for a day or so and check back in with some more data!

[roroboon]

Just checking in to share that I slept much better last night with way fewer CAs. I will be keeping the EPR at 3!

[stevesleep]

The CA's may be just be treatment emergent, as I didn't notice any on your sleep report.  It could be they don't test for it, I'm not sure.  In answer to your question, the only machine geared toward treating CA's is an ASV.  If the CA's are treatment emergent, they will lessen in time on their own. 

Hey Opal quick question on the CA's. You said ASV can treat it. Is the Aircurve 10 VAuto an ASV? Or what machine would be one?

Secondly, why is it a case that only those machines can treat it? What about the machine functions allows for this?

[OpalRose]

Hey Opal quick question on the CA's. You said ASV can treat it. *Is the Aircurve 10 VAuto an ASV? Or what machine would be one?
Secondly, why is it a case that only those machines can treat it? What about the machine functions allows for this?

* No, the AirCurve 10 VAuto is not an ASV.  The AirCurve 10 VAuto does not provide a backup rate and is not normally recommended for Central Sleep Apnea.

I'm not an expert on the differences on how these machines work, but an ASV-Adaptive Servo-Ventilation machine and the AirCurve 10 ST both provide a backup respiratory rate that helps maintain breathing if Central Apnea occurs.


Brief descriptions:

* AirCurve 10 ST: A bilevel device with backup rate that provides exceptional patient-ventilator synchrony, reducing the work of breathing so patients remain comfortable and well ventilated.

* AirCurve 10 ASV: A bilevel device for central breathing disorders such as Cheyne-Stokes respiration, central sleep apnea, or obstructive events. The AirCurve 10 ASV targets the patient’s own recent minute ventilation. By treating central breathing disorders with auto-adjusting pressure support, and upper airway obstruction with auto-adjusting expiratory positive airway pressure, the device works to rapidly stabilize breathing.

* AirCurve 10 VAuto: An auto-adjusting bilevel device for patients who need greater pressure support to treat their obstructive sleep apnea. It uses the comfort of both the proven AutoSet algorithm and Easy-Breathe waveform in its VAuto algorithm.[/b][/b]

[OpalRose]

Just checking in to share that I slept much better last night with way fewer CAs. I will be keeping the EPR at 3!

Hopefully, the CA's will continue use to diminish. However, keep working on the leaks. They often contribute to more FLow limitation and apnea.

When you repost a chart, please leave the calendar off. This will free up all the statistics on that left sidebar, which is helpful to see.