Finally had a PSG instead of a PG and the result shocked me

[mugen4u]

anyone? i'm getting desperate and losing faith in if they can help me

[Jay51]

I have 2 suggestions.  Your APAP machine, you said, failed to treat your OSA, and even caused a lot of centrals.  What pressures did you use?  There is a possibility that you could have had positional apnea (in which a soft cervical collar might help).  Also, sometimes people get  treatment emergent central apneas that go away in time.  Your CA may stay high since you had so many on the sleep study.  You can try your Lowenstein Prisma Smartmax again and repost some OSCAR charts to see if we can improve your sleep.  Give this option a try if you can.  

The other option is completely up to you.  You can purchase a different machine out of pocket.  There is a large supply of used machines here in the states, but not sure about the Netherlands where you live.  These machines may be out of your budget also.  My experience with ASV and advanced machines to treat central apnea is that they can be hard to get used to.  If you have had problems with your current machine, an advanced machine like ASV may be even more difficult for you (there is the possibility you may never get used to it). 

Your decision on how you want to proceed with your therapy.

[mugen4u]

I have 2 suggestions.  Your APAP machine, you said, failed to treat your OSA, and even caused a lot of centrals.  What pressures did you use?  There is a possibility that you could have had positional apnea (in which a soft cervical collar might help).  Also, sometimes people get  treatment emergent central apneas that go away in time.  Your CA may stay high since you had so many on the sleep study.  You can try your Lowenstein Prisma Smartmax again and repost some OSCAR charts to see if we can improve your sleep.  Give this option a try if you can.  

The other option is completely up to you.  You can purchase a different machine out of pocket.  There is a large supply of used machines here in the states, but not sure about the Netherlands where you live.  These machines may be out of your budget also.  My experience with ASV and advanced machines to treat central apnea is that they can be hard to get used to.  If you have had problems with your current machine, an advanced machine like ASV may be even more difficult for you (there is the possibility you may never get used to it). 

Your decision on how you want to proceed with your therapy.

the problem is that the recent sleep study said i barely had any OSA at all and it was mostly Central Apnea. UARS and OSA are ruled out.
i just dont understand why i had so many Central apnea. 

what other way is there to threat central apnea other than ASV machines?

[robbob2112]

The referral to the cardiologist might be a good thing to look into.

If you do choose to get an ASV machine one of the pre-checks required here in the states is a heart check to determine left ventricle ejection fraction. This is the percentage of blood sent back out to the body when the chamber contracts. It must not be below 45% or it can be life threatening according to the studies. You can read about it but an LvEF in the 60~70 range is what you should have.

In my case I started with obstructive apnea and the CPAP made things much worse and I have treatment emergent central apnea with a score of 56 per hour.

When they see 55/7hrs they do the math and get 7.85/hr which is just over the treatment range. Here in Colorado anything over 5 is looked at and depends on other issues if they treat it.

Robert

[gainerfull]

Part of the problem is these are all just educated guesses and you seem pretty resistant to feedback. You can have UARS and not have OSA. Please post a couple nights of your OSCAR data for more help. I know this is frustrating but we're literally pissing into the wind here.

[mugen4u]

Part of the problem is these are all just educated guesses and you seem pretty resistant to feedback. You can have UARS and not have OSA. Please post a couple nights of your OSCAR data for more help. I know this is frustrating but we're literally pissing into the wind here.

but like i said i had another sleep study and they ruled out UARS as i mostly had CSA events, shouldn't i trust the information they gave me? and like i said before i don't have a CPAP right now and the CPAP i used one year ago is already gone and i don't have any oscar information anymore either so i can't give you that information.

i would be happy to provide more information to you guys in case i actually have that.

The referral to the cardiologist might be a good thing to look into.

If you do choose to get an ASV machine one of the pre-checks required here in the states is a heart check to determine left ventricle ejection fraction.  This is the percentage of blood sent back out to the body when the chamber contracts.  It must not be below 45% or it can be life threatening according to the studies.  You can read about it but an LvEF in the 60~70 range is what you should have.

In my case I started with obstructive apnea and the CPAP made things much worse and I have treatment emergent central apnea with a score of 56 per hour.  

When they see 55/7hrs they do the math and get 7.85/hr which is just over the treatment range.  Here in Colorado anything over 5 is looked at and depends on other issues if they treat it.

Robert

oh ok that makes a lot of sense (pre-checks to check the heart), now i understand why they want to check my heart. thank you!

my guess is that in case my heart is fine (which i hope of course) i am going to get a ASV device as CPAP made things so much worse one year ago.

[robbob2112]

If you want more advice from the crew on here you will need to post some data. I understand the old cpap data is long gone, but you had the recent PSG. I suggest you redact the personal bits off that... i.e. screenshot then black out identifying stuff....

Then post that to get around guesses, an also the possibility what you think you are reading isn't what the dr is saying. I know I didn't understand all my results until I did a lot of research.

[mugen4u]

Hi,

It took a while but i got my PSG sleep study results, not sure what it all means but i hope you guys can give me more info:

https://ibb.co/7Kvy5S3
https://ibb.co/VpXBsn2
https://ibb.co/120n77X
https://ibb.co/KLJhZfq

it says i have an AHI of 8.1 which most of them are central sleep apnea however they tested my heart and it is working just fine.

i had 22 'awake' moments of a total of 42 minutes, are these awake moments actually waking up for a few miliseconds like arousel which means you had broken sleep or is this part of the sleep cycle when you go from rem/deep to light sleep that everyone has at night?

the quality of my REM and DEEP sleep seems to be great.

[Jay51]

Thank you very much for posting those results.  IMO, a machine with a back up rate would work best for you because you had so many central apneas.  The ASV and ST have back up rates.  The back up rate will "breath for you" by forcing you to breathe when you have a central apnea.  

You may be having an extreme reaction to air pressure.  I had severe OA with mild CA on a home sleep study on room air (no pap).  During the polysomnography though, I had twice as many CA's as OA's and H's.  

Getting a pap machine optimized for you should also decrease a lot of those arousals (22 awake periods you said for a total of 42 minutes).  Your sleep is very fragmented and stopping these arousals should give you more sleep continuity and help your energy levels IMO.

[mugen4u]

Thank you very much for posting those results.  IMO, a machine with a back up rate would work best for you because you had so many central apneas.  The ASV and ST have back up rates.  The back up rate will "breath for you" by forcing you to breathe when you have a central apnea.  

You may be having an extreme reaction to air pressure.  I had severe OA with mild CA on a home sleep study on room air (no pap).  During the polysomnography though, I had twice as many CA's as OA's and H's.  

Getting a pap machine optimized for you should also decrease a lot of those arousals (22 awake periods you said for a total of 42 minutes).  Your sleep is very fragmented and stopping these arousals should give you more sleep continuity and help your energy levels IMO.

Thank you for your fast reply.

Is that why i couldn't tolerate CPAP treatment last year? because it had no ASV or ST back up rates? it only made my AHI went up instead of down. 
i might as well just buy one because by the time the hospital is done with researching me and approving a CPAP with ASV and ST we are in Februari or even March. 

the problem is that here in the netherlands i dont think you can just buy one without the approval of the hospital, and they want to make an echo of my heart first which will take a while before i can have that.