Frightening results

[PoolQ]

one "trick" I use to get faster action is ALWAYS tell them if you have already had any kind of heart event, they will not want the liability of causing another one for you. The delivery of my CPAP went from 7-10 days to same day, after hours Use your previous stroke to your best advantage.

[storywizard]

Hi Robotman..

I am in BC, what province are you in? They all deal with CPAP a little differently...

When I was on straight CPAP I had results similar to yours...it looked like lots of CA events...but when I had a sleep study and a titration it turned out I had few actual CA's...

Are you dealing at all with a doctor for this? Is there a sleep doctor in your area?

However, the only fix for what I did have was an ASV machine, maybe a BiLevel...
I have been on ASV for 3 months now it is incredible the level of comfort with the air...

I bought my machine thru Supplier #2, they are great.

The Canadian system is a little broken around sleep medicine, so I encourage you to get your GP on board with the sleep stuff if there is no actual physician around.

Sorry for the relatively confusing post, did not sleep well last night...mask issues...soon to be resolved...the ever hopeful Storywizard

all the best..

[robotman]

Thanks for the tips guys. I managed to see my doctor today, and was able to sound more knowledgeable thanks to your comments.

Hopefully he remembers this time to get me referrals for the sleep clinic and the sleep specialist.

[robotman]

So after talking to the respiratory therapist he made some adjustments to the machine (increasing the pressure to 11 and taking it off auto mode). Here's the new results from the next day:




Still pretty bad. The results from the day after that are even worse:




I had a theory that my AHI was skyrocketing at certain parts of the night because I was rolling over to sleep on my back. In fact, in the original pics I posted at the start of this thread, I had woken up on my back and noticed the time (before 1 on the graphs). And of course, my ex-wife always used to tell me to roll over, because I would stop breathing when I slept on my back. And when I had a stroke a couple months ago, I woke up on my back, half-paralyzed.

But it doesn't look like the cpap machine is doing anything to help when I am sleeping on my back. The respiratory therapist is confused as well, because the sections where the AHI skyrockets are central not obstructive according to the machine.

Tbh, the only reason I am using this machine is because I want to prevent another stroke. What should I do?

[Sleeprider]

Get an ASV machine! You have complex apnea. If your doctor can't recognize it, get a new doctor.

This is what I told you in post #4 of this thread on 7/28, and nothing has changed. My recommendation is actually to stop using this machine until you get a prescription revision. This machine and CPAP pressure is causing you to stop breathing with central apneas at least as much as your obstructive apnea experienced without CPAP. You are one of the lucky 15% that develop CPAP induced complex apnea. This is a serious situation and only a doctor that understands complex apnea can help get the right equipment. Alternatively, you can buy out of pocket, but even used ASV machines are expensive.

You need a Resmed Aircurve 10 ASV, or S9 VPAP Adapt, or PRS1 Auto SV Advanced model 960 or 950.

[robotman]

Thanks Sleeprider. The respiratory therapist says here in Canada you have to special order the bilevel machines, so we're waiting for the sleep study.

Should I really quit using it? I've always stopped breathing on my back, I'm not making this up. So I'm not sure that the machine is really giving me the sleep apnea. Also, there's been some nights (no back sleeping) where the results were very good.

[quiescence at last]

please consider (until you get the adaptive servo ventilator type, and if you do use the current machine, in the meantime)

I would do the following.
-Stay off my back (since my history was that I stopped breathing on my back), by strapping a backpack, tennis ball, or stuffed animal on your back so it wakes me.
-Reduce the pressure in 1 cm increments until CA subsides. I would then assess how much OA and H that is occurring. If OA is less than about 10 I would stick there. I would assess my sleepiness after a couple of days to see if there was a positive change. (a CPAP pressure under 7 cm will probably not feel comfortable so I would stop there).
-Change mask to a full face mask - some have found that more volume in the mask can make a difference in CA. If I had one at hand I would try it before reducing the pressure portion mentioned above, as pressures seem to need to be somewhat higher for same treatment than with pillows.

QAL

ps. can you post a chart of 5 minutes length from 2:00 to 2:05 on Aug 3 (your Aug 2 night)? Thanks.

.

[Sleeprider]

I agree with QAL. Completely quitting CPAP will allow OA to return in force. By reducing CPAP pressure incrementally, you should see a decrease in CA and increase in OA. There is no right answer here, you're looking for the best compromise. The goal is to get to the point that CA is less clustered and periodic breathing is less frequent, while keeping OA well below your sleep study background levels. Communicating the urgency of your situation to a doctor is going to take a strong push on your part to get past the people that screen communications and block you from health care.

[robotman]

I'm actually way ahead of you qal, last night I made a last minute trip to Canadian Tire and bought tennis balls. I cut a hole in the back of an old muscle shirt and made a pocket in the center of my back containing the ball and sewed it on. It's the ugliest thing you ever saw. I can't roll over with it on because it hurts my back; I'm afraid I'll throw my back out or something. So, success?

I didn't use the cpap machine at all last night, woke up feeling like I had a really lousy sleep. When I spoke to the rt a couple days ago, he actually turned the pressure up again, this time to 12. I still haven't gotten rid of my laryngitis; I wonder if having this thing blasting air down my throat all night is the equivalent to not "resting my voice" as the doctor said.

RT says all he can do is write a letter to the sleep clinic asking them to get me in for the testing sooner.

[robotman]

RT says normally the body adjusts in a couple weeks and the central apneas diminish. Now I'm confused.