Feeling terrible

[ctenanthe]

Hi, I'm a new CPAP user (a few months now). Haven't been doing well, and can't get any support from doctor or CPAP provider. I've attached my OSCAR readings from last night. I woke up feeling terrible this morning (headache, exhausted, etc.). Does anyone know what my next steps should be?

I'm using P10 nasal pillow mask with humidity at 8 and tube temp at 81 (tried full face mask but it didn't work out). I can't tape my mouth because I will wake up in extreme panic due to suffocating. I do a saline nasal rinse and flonase every night.

[Deborah K.]

You are having almost entirely CAs.  Did your sleep study show a lot of CAs?  If you don't know, it would help if you would post a redacted copy of your sleep study.  If you don't have a copy, ask your doctor's office for it.  By law, they have to provide it if you ask for it.

[ctenanthe]

Thanks! I've attached my sleep study. I thought the 'CA' just meant clear airway apnea, like I am breathing through my mouth instead of my nose.

[OpalRose]

Clear airway (CA) means your airway is open, but you are not making any attempt to breathe.

This also shows on your sleep report.

[SarcasticDave94]

Unfortunately, no it's not mouth breathing vs nasal. You had some CA/Clear Airway/Central Apnea on the sleep study. The line on image 1, pAHIc 4% with 19 Central events. You had some CA, but not equal to half your events, from what I'm seeing.

The CPAP flags these as clear airway or CA because the airway is clear of obstruction, as in not a common Obstructive Apnea. Central Apnea is a long breath pause for several reasons. Most likely pertaining to Apnea is that while on a CPAP, the pressure upsets the level of CO2 remaining in the lungs, and in turn modified the next breath signal.

Now that's part of the issue, but again you had some on the test, so you're seemingly more sensitive to CA breath holds.

Action? With CPAP or AutoSet you might need to avoid some CA by lessening the pressure fluctuations in part by removing Ramp off it's on, EPR might need lowered, pressure range might need edited. All these YOU can do without Dr. Dolittle's input or bill.

Find your CPAP setup manual and request it free above.

PS, if the CA hinder, you can complain about it to doc. Maybe the ResMed AirCurve 10 VAuto will be somewhat better for you. Last answer is ASV, but like I mentioned above, the CA weren't 50% of the total. Alternate plan maybe you get them to give a Titration which includes bilevel and ASV, if it becomes necessary.

[ctenanthe]

Thanks for explaining this! I have changed a lot of settings myself. Pressure was set to 4 -10 originally but I was suffocating and have changed it to 8 - 15. I turned off the ramp and changed the EPR to 1 or 2.
 
I live in Colorado and the altitude (6,000 feet) and humidity (often less than 10% in the summer) might be aggravating. Overall experience with CPAP was much better when traveling to sea level.

[OpalRose]

The high altitude definitely could be a contributing factor and the use of EPR may also cause more CA's.

[SarcasticDave94]

Copy. High altitude like Opal Rose said will be a contributing factor.