[Diagnosis] Still need a APAP Machine?

[BazM]

My wife as been using a F&P Sleepstyle Auto APAP for about six years now. She was originally diagnosed with severe sleep apnea.
She has not had any further sleep studies done since starting with her machine.

I showed little interest in her sleep data until now. Last month I was diagnosed with severe sleep apna as well and have been having a sleep trial for two weeks now.
SAfter researching and reading many posts from this forum, I started looking at all her sleep data on her SD card from over the years.  

From what I see, I cannot understand why she has a need to still use a machine.

I have added charts from three days last week. What are people thoughts?

[Sleeprider]

I don't think you can accurately judge whether she needs CPAP based on charts recorded under pressure. She is apparently well treated with minimal pressure, but would have set her minimum pressure to 6.0 so the EPR could work on those RERA and flow limits. I bet she would feel better with the higher pressure and EPR. Anyway, she was probably put on CPAP for a high-enough event rate that was more hypopnea than anything else. The real tell is whether she is more comfortable without the CPAP than with it.

[OpalRose]

From what I see, I cannot understand why she has a need to still use a machine.

To respond to your statement.....  what you are seeing on her graphs are "treated" numbers.  You are never really cured from Sleep Apnea.  If she went off her machine, she would more than likely suffer through the night.  In other words, she would be right back where she started from 6 years ago.  

You stated she was diagnosed with SEVERE sleep apnea.  That means that her breathing was disrupted or stopped more than 30 times an hour.  Her AHI readings are very good now.  The only real way to know is for her to have another overnight sleep study done.

https://www.apneaboard.com/wiki/index.ph...ndex_(AHI)

<5 Normal (no Sleep Apnea)
5-15 Mild Sleep Apnea
15-30 Moderate Sleep Apnea
>30 Severe Sleep Apnea

Now, even though her AHI readings are good doesn't mean she sleeps well.
Her chart shows a high Flow Limitation rate which could be disruptive to sleep.
I also see some Rera's.  Does she sleep well?  Is she tired during the day?  
Although, amazingly her pressure doesn't go much above 5cm, so it's possible FL doesn't bother her, or the F&P algorithm doesn't react to flow limitation the way ResMed machines do.

Although she's using an EPR setting of 2, she won't receive much benefit from it while using a low start pressure of 4cm.  Ask her if she would like to try EPR 3 to tame the Flow Limitations.  She would then have to move her minimum pressure to 7cm to receive the benefit of EPR.  (7 min minus 3 EPR = 4 exhale pressure.)  

Or.... she could just move the minimum to 6cm and leave EPR set at 2.

Does the SleepStyle show a Flow Limitation graph? If yes include it next time.

[BazM]

... The real tell is whether she is more comfortable without the CPAP than with it.

she said that she canot sleep without the APAP. She does wake up often during the night and is tired during the day.
As you suggested, I will ask her if she wants me to adjust her min pressure. Thanks, Skyrider!

[BazM]

Hi OpalRose,

I have attached charts again showing other data on their respective days.

Wife does wake up often during the night and is tired during the day. As advised by Sleeprider, and now yourself, I will make those adjustments and see how it goes.

Thank you...

[OpalRose]

I think she will start to sleep better once the FL comes down.

Set minimum to 6 cm and EPR to 2. See how that feels. After a couple days, please repost. She may need a bump up to 7cm min, EPR 3. But give it a few days.

[BazM]

Will try that .

[ewriter]

Hi,

I'm not an expert by any means and have used several machines and masks over the past 12 or so years; but it seems your wife has few apneas and a very low AHI when on the machine. What is her breathing like when sleeping without the machine? (you would need to watch her while she sleeps or try a PAT).

[BazM]

... it seems your wife has few apneas and a very low AHI when on the machine. What is her breathing like when sleeping without the machine?

Hi ewriter,

She doesn't sleep well because of pain issues but appears to breath okay. I have a technical issue with her machine now as it will only sit on min pressure and wont adjust up at all during her night of sleep. Tried resetting the machine and will check data tomorrow. Maybe machine after 6 years exactly has finally died.

[BazM]

I think she will start to sleep better once the FL comes down.

Set minimum to 6 cm and EPR to 2.  See how that feels.  After a couple days, please repost.  She may need a bump up to 7cm min, EPR 3.  But give it a few days.

Machine was playing up after power off and reset all good again.

Setting to 6 cm seems to have fixed her issue. Graphs attached!