Frightening results

[3porpoise]

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

Hi robotman ,
Did you get a copy yet of the diagnostic sleep study to see if you had any central apneas that night? There's also lots of other info in the results....... # apneas on back/side , o2 desats, heart rate and how it reacts during apneas.....etc.....
3

[robotman]

No, we're trying to book another one. I don't understand all that fancy talk, but the rt said I can't just get the bilevel asv machine because they have to do tests to see if my heart can take it!

It's 2 in the afternoon where I live. I had to take a nap (with the cpap machine) because I slept so bad not using the machine last night, it was making me stupid or something.

[Sleeprider]

A lot of people have some CA events when adapting to CPAP. No one cures Complex apnea by adapting. This is really ridiculous.

Your health is more important. If I was in your position, I'd be getting a used ASV out of pocket, and let the "system" catch up when it can. The Canadian health care system is awesome when it works, but when it doesn't it's pretty awful! Where is your closest U.S. crossing?

[TyroneShoes]

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.

.

I pretty much agree with QAL and Sleeprider, but I would do one thing a little differently. Instead of decreasing by 1 cm increments, I would go to auto mode, and decrease just the bottom limit by 1 cm increments. IOW, a few nights at 11-12, a few more at 10-12, a few more at 9-12, and so on.

This will allow for the machine to raise pressure temporarily if it sees OA or FL events, which will minimize successive events. If you are still getting lots of CA events after doing this, then it makes sense to lower the top limit, assuming the machine does not raise back up to 12 regularly on its own, which is something you can keep tabs on in SleepyHead or equivalent software.

This approach essentially does the same thing (lowers nominal pressure to prevent CA-induced events) without the risk of it causing lots of new OA events or FL events that would not be problematic at a higher pressure, which would be the added risk of simply lowering the fixed pressure. IOW, there is a sweet spot that changes dynamically for most folks, which is what auto is all about addressing, and auto can find that sweet spot and minimize events much better than a fixed pressure can.

Remember that CA events may be somewhat benign if they are caused by the xPAP machine. Just the fact that it is blowing air can fool the respiratory feedback system because moving air gets more O2 into your bloodstream than still air (moving air has more opportunity to present available O2 molecules in physical contact with the cillia), so moving air when not taking a breath may not desat you as quickly as still air and you may not respond by breathing as quickly, which can be flagged as a false event, because rather than being based on how well your lungs are absorbing the O2 that is available it is based on a 10-second clock that makes a blind assumption about how long not breathing will take to cause a desat.

But get the correct machine ASAP. Be highly motivated to do that, but don't let the interim period get you down; I had a ~56 AHI probably for decades before I got therapy, so if that can kill you, it kills you slowly and incrementally. A few more weeks will likely not be all that traumatic to your health. The quicker the better, but don't fret, just get the new machine when you can.

[TyroneShoes]

Speaking of O2, since you are motivated to figure out what is up here, you are up against an obstacle, and since you may need more ammo to present your case to the docs, you might consider getting an oximeter.

The only real ultimate goal of xPAP is to prevent O2 desat, by either removing and preventing breathing obstructions, forcing a breath, or any of the other clever methods that these machines do. That they prevent micro-arousals and have enormous other benefits are really side issues and side benefits of preventing desat. So a $50 oximeter will at least tell you exactly where you stand, and this is also hard evidence that you can present to your sleep doc to help motivate him, should the numbers be not so great.

[quiescence at last]

hi. just a note that you gave 8 minute look around 2:00 on Aug 4th instead of 5 minute look at 2:00 on Aug 3rd. (picking aug 2nd night of sleep). the reason I wanted that short a time on that date was it was before onset of CAs, and 5 minutes or less we can see the contour of the breaths better. if you are game, please re-post.

love the ball in the back, wonder if you used that on your recent crummy non-CPAP night.

of course wondering if ball in the back affects your CA scores.



QAL

[robotman]

I used the tennis ball with the cpap machine for the first time last night.





There was one event early in the night. The tennis ball thing doesn't work quite as well as I hoped, with the whole shirt shifting around - I woke up with the ball close to under my shoulder, which still allowed me to sleep on my back comfortably if I allowed it. (Plus, the ball smells.)

[quiescence at last]

Quasimodo, is that you?

[Sleeprider]

I kind of prefer a softer approach to back sleeping like wedging a pillow behind me. I don't have problems with back sleeping when using the BPAP, but the point is to keep me from rolling, not to wake me up.

[robotman]

Quasimodo, is that you?

lol

I kind of prefer a softer approach to back sleeping like wedging a pillow behind me. I don't have problems with back sleeping when using the BPAP, but the point is to keep me from rolling, not to wake me up.

I like to have a pillow in front of me, seems to help with the cpap hose. Having another pillow behind me might be too many pillows.