Question about reliability of the CPAP data

[zynsa]

How reliable is the apnea events detected by CPAP and OSCAR software?

I have been using CPAP (Resmed airsense 11) for one month now. I am still getting about 10 AHI, 9 CA, 2 OA etc each night. I have tried adjusting various settings as per the guidance here (pressure range 9-16, EPR to 1, no ramp up). I use nasal pillow small. 

A few nights, I put it on for sometime before sleeping. I read books or browse web while wearing it. What I have noticed is that even during that time, CPAP machine detects similar metric i.e. 10 AHI, 9 CA, 2 OA etc. 

How is that possible? I am not asleep. I am breathing normally sitting upright in the bed. 

This makes me question everything. I always had sleeping troubles and when I was finally detected with sleep apnea (home sleep study, AHI 16, moderate to severe, not fat, not snorer), I was hopeful. I finally had something to work with however tedious it is.

But seeing that the CPAP keeps detecting the apnea events even when I am awake makes me worried. 

What if I got the diagnosis based on one night's faulty data that somehow induced apnea events? What if resmed just strengthens those faulty metrics by introducing its own faulty metrics?

What are your experiences? How reliable is the data in your opinion?

For the record, I initially indeed felt better using CPAP, and even now I feel better but I just cant get more than 3 hours of sleep on CPAP. Often, I wake up in the middle of night, spend a couple of hours doing something because I cant fall asleep. Then either force myself to sleep by swallowing another melatonin or just give up and start the day. Also, I do sometimes get up gasping for breath as I am trying to fall asleep. I used to think that that is hypnic jerk before I was officially diagnosed with sleep apnea. Sometimes it was so bad that I would try to fall asleep, then wake up gasping for breath and if that happened 6-7 times in a row, my brain would just give up and I wouldn't be able to fall asleep at all. I would be in the tired zombified state but not able to sleep or rest.

These metrics are making me lose hope. What if I dont have apnea and thus I don't even know what is wrong with me and how to fix it?

Does anyone else get detected with these apnea events if they wear it while they are awake?

[Sleeprider]

First of all, events recorded while you are awake do not count as sleep disordered breathing. Our "awake" breathing is surprisingly erratic and can include pauses and volume fluctuations that the CPAP counts as events. CPAP data is generally very accurate, but its main limitation is that id does not detect sleep, so you have to take that into consideration. Unless you are really exceptionally small, your small nasal pillow is unlikely the correct fit. Try the medium or large.

I have not been active in your therapy thread and I'll try to get more involved there https://www.apneaboard.com/forums/Thread...ata-please Your results have improved significantly there with help from Crimson Nape. Your settings have moved from a wide range of 9-16 EPR 2 with AHI over 14 to lower fixed pressure of 8.0 without EPR resulting in AHI 7. So a 50% improvement ahead of other comfort, pharmaceutical and mask issues is nothing to be frustrated over. It does take time and experimentation to optimize therapy. I'll throw in another thing that seems apparent in your most recent results, positional apnea. Your obstructive events are clearly occurring in clusters consistent with chin tucking. So read this and work on that aspect to cut your events even further. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[zynsa]

@Sleeprider, thanks for writing such a detailed and informative reply. I apologize that I noticed your response later and took some time to respond back.

I concur with your explanation about breathing patterns while awake vs sleeping are different. After reading your explanation, I remembered that as we transition from wakefulness to sleep, the breathing is handed over to an automated system. So your explanation is aligned with my prior knowledge about this.

While I am exceptionally small (134 lbs), I will give medium another try.

Without a doubt, "Crimson Nape" has been tremendously helpful and thanks to their responses I have rapidly iterated on the settings with some improved results. I apologize for sounding frustrated but that happened because of general feeling of tiredness and having reached plateau for improving metric.

Thank you for pointing me towards chin tucking and the wiki link. That makes perfect sense. I have ordered soft cervical collar and I will see if it helps.

Love this community and thank you.

As an aside, when I sleep with all the gear - mouth seal, surgical tape over mouth seal to stop drooling, chin strap, nasal strips, cpap mask, and finally eye mask -- I already look like a night monster (although I like to think of myself as a sleepnonaut), the addition of cervical collar is going to be interesting!

[Sleeprider]

The addition of a cervical collar often replaces the other aids. By supporting your jaw in a more closed position, tape often becomes unneeded. I hope you will be able to eventually get rid of the mouth seal as it seems like it might actually encourage saliva production. We're all different, so your solutions will be tailored to your particular needs, but the purpose of a soft cervical collar is actually both a light chin support, and more importantly, support of the back of the jaw. This can prevent retraction of the jaw which is a frequent contributor to obstruction, and this same pressure keeps your jaw in a more favorable position so that the back of your tongue can seal the pressurized air from entering your mouth. If you ever want an entertaining exercise to improve that seal, try sipping a glass of water through a straw. the act of accepting water into your mouth and swallowing, reinforces the mouth and tongue position needed to keep air out of your mouth and may be helpful once you master the exercise. This may also help you to overcome the problem with drooling.

This thread has moved back toward therapy. Would you support merging it with the other thread?

[zynsa]

Hi,

Thank you for your thoughtful answer and suggested remedies. I will check the exercise.

I am okay with merging this thread with the other thread. I have updated it with my latest results. For last two nights, I am getting similar results.

Sorry it took sometime to update this thread because getting used to cervical collar was hard. I used to get up due to choking sensation and remove it. Only in the last couple of nights I have been able to wear it for the entire duration.

But I am seeing some good results! Thank you for the suggestion. My mouth sealing technique was wrong. I fixed that. No drooling anymore and no leakages.