I seem close but yet so far away

[super7pilot]

And what do I mean by that. Well as folks can see on my chart from last night (Oct 21-22 2024) I'm close with only one OSA. As soon as I get my sleep study from the VA sleep lab. I'll post it.  

I had returned to my P-10 nose pillows and put on my new chin strap and taped my mouth shut. Set pressure to min 8 with no ramp and EPR of 2 and max at 10.  Mask was on all night with no bathroom breaks.

AHI for the night was 4.6 with only one OSA and a bunch of clustered CSA's. I might try going up 1 on both min and max and going to 1 EPR.

Another thought I have had after reading a whole bunch of the threads is that it seems to be a trend that while our machines are helping with OSA's. They seem to be denying people a restful nights sleep while stopping OSA's. So, am I off base in thinking that I'm trading one poison for another?

I have never felt so unrested and I'm rather frustrated as well.

I do have a couple of new pillows and a soft cervical collar on the way. Wednesday/Thursday arrival.

Suggestions and thoughts are appreciated.

[Old Steve]

With out your sleep test it is hard to tell for sure if they are actually Central Apneas or just Clear Airway events being caused by treatment and EPR washing out too much CO2.  What I would try first would be to turn the EPR off and see if you have less CA events. 

[super7pilot]

Thanks old steve. If I had the CSA’s before. They and my OSA’s sure weren’t causing as much fatigue as I’m feeling after starting therapy to stop OSA’s. I was feeling much better and more alert before treatment. Even my BP was good at 130’s/80’s. Hence my trading poison analogy.

[dang71]

Although I can't help you, I can offer you solidarity. I feel like we're looking for the same solution to a problem that is very similar. The frustration is going up !

[Old Steve]

I see that this is your second thread on the same subject, from now on please keep your posts in this thread.  It is difficult to tell if you were actually asleep during your CA events.  As you have been told the CA's can be you having an arousal and then holding your breath.   If you are having several arousals because you are not accustomed to the CPAP treatment the CA's could possibly make you feel worse.   Increasing your minimum pressure can also make the CA's worse by causing more CO2 washout.  What minimum & maximum pressure did your sleep doc originally give you? 

[super7pilot]

Go easy on me oldsteve. I'm new, I'm tired, I'm frustrated, I'm grasping at straws and the VA is being slow in responding to my request for my report.
The Resmed was sent to me with 4-20cm. So it wasn't really set at up at all.

I just surfed the web on how to set the unit up. So outside of this forum I have been quite on my own. A week after getting the unit and prior to me joining this forum I had a zoom call with "first nation health" out of Arizona to do the initial setup. But even they didn't have my study to send MY setup info over the web to the machine.

The sleep study I had at the VA sleep lab in Walla Walla had me fully wired but no mask was used. All they said a month later via a letter was I had moderate Apnea and asked if I wanted a machine.

[SarcasticDave94]

The test you had without machine would be the diagnostic sleep study. Just like their answer to give default pressures as being right for you, the CPAP might be a default answer to machine type being right. Some require bilevel like a ResMed AirCurve VAuto. From there depending on your other health requirements, specialized bilevel may be needed, like ASV for Central Apnea or ST-A for those with lung disease.

The ASV will be indicated on that diagnostic when Centrals appear near equal to the Obstructive events. And ST-A with lung disease diagnosis from a pulmonary specialist doctor after a pulmonary function test.

[super7pilot]

Yep! Sarccastic dave. a lot of things depend on getting that study.

My sleep study was requested by my VA doc solely because she said that folks on more than two meds for BP tend to have OSA. I recall that when I was put on my three BP meds years ago. I was told that having a little bit of several meds would reduce negative side effects as compared to a bunch of one or two. And so have always been on three from the get go. Meds were Atenolol, HCTZ, Lisinopril. The Atenolol was changed to Coreg as Atenolol lowered my heart rate too much (low 50's) With Coreg I have a resting rate of 68ish. My ankles aren't swollen.

Never smoked and I rarely drink anymore.

[Deborah K.]

While you wait for your titration study, I suggest that you change your pressure settings to 9 to 13.  Your median pressure is 8.94 and you keep bumping up against your top pressure.  I think these changes should make you more comfortable and improve your therapy a bit.

Before your titration study call and ask that they have an ASV machine to use as part of the study.  Otherwise, they may not see that you need it, if you do.

[super7pilot]

Decided to make a major(ish) change.

Switched to CPAP mode
11.4CM
no ramp
EPR 2
P10 nasal pillows
chin strap and taped mouth
as per usual. zero to very few OA's and the CA's were fewer in number. So perhaps it is treatment emergent.
I was having some nasal stuffiness (Despite daily flonase and Nevage sinus flush) and switched to my F40 hybrid mask at 2am after a bathroom break. I noticed that when I do start to get stuffy. The P10 pillows get really noisy.

Over the short time I have had my resmed 11. My worst night of OA's was 1.64  And that night I had a 95% 9.68, epap 6.68/ 99% 10.66 epap 7.66

I might try EPR 1 tonight.

I do get the feeling that I'm concentrating too much on breathing and it's seems to take forever to get to sleep. That is IF I'm even getting much sleep. I do however think my nasal stuffiness issues (been an ongoing battle for many years) is one of my problems.

And still no response from the sleep lab about my initial results.