[Diagnosis] Surprised newbie with CSA/OSA -- Any words of wisdom?

[CLCCW]

Hello and glad to have found you all!

I am a 64 year old healthy female living at 5,500 ft. elevation (40 years here). Reported daytime drowsiness at my annual physical and was referred for home sleep testing and to a pulmonologist. Test revealed "severe" apnea! I was shocked. I don't snore (per my spouse), and no abrupt awakenings or shortness of breath or anything. I am a deep dreamer and love to sleep, actually. I do wake up and have trouble falling back to sleep, but thought it was just my age.

Had a titration test next and an echocardiogram (mild regurgitation in 3 valves, no concern to doctors -- and heart is good, no a-fib or anything). Blood pressure normal, get regular exercise, etc.

I've been prescribed an AirSense 11 with AirFit 40 mask (I tolerated it ok in the lab overnight... started with nose-only mask which worked at first, but I ended up mouth breathing a lot and they switched to the 40 which was weird at first, but I ended up sleeping with it... it was weird, I could notice them changing stuff around (pressure, how the air came/went). The tech said I was quite perceptive.  

Quick observation: The morning after the all-night titration test, I felt WAY energetic, a bit like I had had a couple cups of coffee. I don't drink caffeine, but remember it well. Took a few hours to wear off. What is with that??

I am about to order my machine and mask (thinking of a local brick & mortar supplier for starters), but I can ask questions about all that later.

I thought I'd share my tests (de-identified) and see if you have anything worth noting. Doc has ordered pressures from 5-8 (still learning all this lingo and concepts!)

       

[SarcasticDave94]

First, welcome to Apnea Board,

The test data didn't get into details, however of note is Central Apnea and ASV Titration were mentioned. This clues us in that CA are an issue. Include the echocardiogram as another hint, possibly the medicals ordered that recently as well. A guess on my part, but the echo is still pushed on us to get a green light qualifyer to get ASV.

Ask the doctor's office for the detailed sleep study reports, include all taken. This isn't raw data, but the processed detailed versus summary info. There ought to be an event breakdown splitting Centrals and Obstructive into separate lines.

Your higher elevation might be partial cause of CA, assumed they're what you're dealing with.

From a former ASV user, mask will be very important. I've used Fisher and Paykel full face successfully with ASV. They're loose wearing but seal better in my use.

[CLCCW]

Thanks "SarcasticDave!" I have the full charted/graphed results, but wasn't sure if it made sense to post those. Also, I don't understand a lot of it. I will also keep note of your mask recommendation.

[SarcasticDave94]

For myself, the detailed table stating the diagnostic events from the sleep study will be helpful. This will show the events count and type. You're probably going to see about a 50/50 split between Central and Obstructive Apnea, if the doctor is contemplating ASV.

The detailed recommendation page might also be useful.

As you see fit, put those 2 items up redacted of your personal info. Members here will certainly help decipher the info.

[CLCCW]

Here are some more attachments/images of results from the Home Test. Will follow with a post from the Titration test. All Greek to me at this time, but slowly learning. I have an acronym glossary at the ready!

           

[CLCCW]

.....aaaannd here are the overnight Titration Study results. I see no mention of "snoring" on this one! I think the home test "heard" my spouse sawing wood! I have the graph one too, but could only do 3 images.

The results had this text, too:

"*SCORING NOTES** Delayed sleep and REM onsets. Extended periods of wake throughout the study. Occasional periods offragmented sleep. Occasional central hypopneas, spontaneous arousals. Occasional leg movements with arousals. Occasional mild to moderate leak causing a wandering flow signal, events NOT scored during these times."

           

[SarcasticDave94]

OK, attachment 1 here has 75 pAHIc 4%. The c stands for Centrals. It doesn't seem like it's 50% to me, but there's not just a few Central Apnea involved.

You're on the AutoSet 11 currently correct? If you want, add a recent OSCAR to see how the therapy is doing. There's a few ways to help diminish, or otherwise avoid but not treat, Central Apnea with setting edits. It doesn't always work for those with Central Apnea, but you can try it.

Central Apnea are stubborn, called consistently inconsistent, and only ASV can actually treat them.