[Diagnosis] Help guys!

[alexfryatt1993]

After getting zero help from doctors I am attempting to self diagnose and fix my sleep breathing problem. My AHI is basically zero, and my oxygen levels only move by a few %. However, I do suffer from a deviated septum which renders night time nasal breathing impossible.

What I see plenty of on my CPAP data is what I have shown below (also in an attachment). 
What do you guys think?

Any help or advice is sincerely appreciated! I am desperate to fix my issue, I'm not joking when I say it is killing me!
Thanks guys!

[Crimson Nape]

Hi alexfryatt1993! -
Unfortunately, the image is so small it is unreadable. Attempts to enlarge it, make it a blur. Please take a higher resolution screenshot and repost it here.

Thanks!

- Red

[Sleeprider]

The best I can tell is the image shows some severe flow limitation leading to arousal and more or less normal breathing. The flow limitation shows good flow increase into inspiration with a sharp pean and sudden reduction in flow as something causes obstruction through the end of the breath. In spite of the blur, I also see a secondary peak in some breaths as the obstruction is relieved and flow rate increases. This is a Class 2 flow limitation and is certainly disruptive https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688581/



You have self-identified the problem as a deviated septum. The resulting respiratory disturbance index (RDI) can be mitigated by use of positive pressure applied nasally, especially with nasal pillows to inflate the nasal tissues and mitigate nasal flow limitation. Another possibility aside from surgery is a nasal stent (Alaxo Nasal Stent) which mechanically opens and stents the nasal passages using a collapsible mesh. The nasal stents are sold for $395 on their website so I can't link to it here. Anyway, this is all food for thought. You could ask your physician for a referral to an ENT, sleep evaluation for RDI or prescription assistance with the Alaxo nasal stent. There are several good options to address this, and I think our role has to be to assist you in obtaining medical approval to acquire relief.

[alexfryatt1993]

Is this any better?

---

Thank you so much for your detailed reply! Glad I came here for help! Do you think a higher pressure setting on my CPAP machine would aid the high flow limitation?

[Crimson Nape]

Great! It would appear that it is a positional disruption, like turning to your side.

- Red

[Sleeprider]

What machine and what are your settings? Your profile does not show any useful information. How about an Oscar chart for the full night?

[alexfryatt1993]

Sorry, I'm new to all this. My machine is a Resmed airsense 10 Autoset. All settings are factory. 

Just downloaded Oscar, I previously used SleepHQ

[Sleeprider]

Alex, the feature on your Autoset that is going to make a big difference is to use the EPR feature that effectively gives you bilevel pressure with higher inhale and lower exhale (IPAP/EPAP) pressure. My recommendation for you is to set your machine to Autoset Mode with minimum pressure 8.0 and maximum pressure 12.0, EPR on full-time. Post a chart once you collect some data so we can where to go with this.

What is your mask? Sorry you had to deal with SleepHQ. Basically someone using a derivation of Oscar and charging for what we do for free.

[alexfryatt1993]

Thanks mate, I will do! How do I get a chart from Oscar? I've been on CPAP for 2 weeks now.

[Sleeprider]

Be sure your machine has a SD card (4 to 32 GB) behind the door on the left side. Data is recorded automatically during use when that SD card is in place. You will need to have a SD card reader to use that with Oscar. We have tutorials on how to organize Oscar Charts and how to attach charts to a post on the forum. That is all linked in my signature below.

Even without data, I'm looking forward to hearing your feedback once you try the settings I outlined above. I think you're going to notice a pleasant difference.