Is this even working? (CPAP Data Frustrations)

[thekevster08]

Hi!

I'm coming up on 2 years of use and just not seeing the results I was hoping for.

Diagnosed with an AHI of 5.0.

Been on CPAP consistently for 2 years. Pressure ranges from 4-20, 7, 7-12, 8-15. I've tried all kinds of different variations.

Male, 35 years old, BMI of 29.7. I've gained about 20 lbs over the last 3 years, but have recently started running again (half marathon in may). I thought alcohol consumption may have had an impact, but I've been doing dry January and its just getting worse!

Its so frustrating because I have good nights (AHI < 2) and I can feel the HUGE difference between that and an AHI of 9.

I had a titration study done about a year ago, and the results came back that at a constant pressure of 7.0, i had an AHI of 0.0, so my pulmonologist had constant 7.0 pressure setting for months. Obviously that was not correct, but the speed at which I can address this through my doctor is just taking way too long. How do I go about troubleshooting this myself?


           

[Deborah K.]

I suggest you change your pressure settings to 10 to 18, as your median pressure is over 10 and you are bumping up against the 15 and need more headroom.

Also, it would help if you set your charts to be the same each time.  If you press the fn key to copy your Oscar cart it should format it correctly.  Make sure we see the following, and only the following, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

Also, make sure we can read to the very bottom of the Flow Limits.

Again, welcome, and good luck with improving your therapy and comfort!  

[jdougc]

Did you have any CAs, Central Apneas on you sleep study? Can you post a copy with your info redacted?
Do you sleep on you back or on your side?
Also do you have a soft cervical collar? You have some clusters of events and this might help as the increased pressure can't help if you are tucking your chin.
Hopefully experienced people can add better advice.

[Sleeprider]

Main problem is positional apnea https://www.apneaboard.com/wiki/index.ph...onal_Apnea

I agree with advice to set range to 10-15. Once you evaluate for positional obstructions we can look at the CA issue separately.

[Deborah K.]

Actually, I suggested 10 to 18 to give him a little headroom.

[thekevster08]

Thank you so much for the quick replies. Last night was exceptionally bad and I'm just so tired of being tired.

SCC is ordered and will be here Friday.

Pressure adjusted to 10-18. I'll try for a couple nights and update monday with data from the SCC and pressure changes.

Attaching sleep study results with info redacted.

1,2,3:

           

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4, 5:

       

[Sleeprider]

Your titration study was performed at very low pressure with no EPR. How did you arrive at current settings?

[thekevster08]

Yeah, I'm pretty upset about it. I have a high deductible health plan so paid $3k out of pocket for it, and they literally only tried 2 pressures and stopped at 7? That feels like a joke. I thought about calling insurance to see if they could pressure them to repeat the study at a reduced rate with someone who maybe knew what they were doing a bit more, but didn't know if something like that was possible.

After a year of the "prescribed" 7 not being high enough pressure, my doctor finally suggested we up it to the current range. I've been at that range since mid December and have a followup in march. These "lets try something random and check back in 3 months for $150 to meet for 6 minutes and just change the pressure to something else random" appointments are getting very annoying.

[Deborah K.]

Just a side note. Your sleep study indicates that you had an AHI of 10, not 5, and you had no CAs at all.

[jdougc]

Sleeprider is right about the positional apnea. Do you sleep on your back or are you are side sleeper?
Do you have a soft cervical collar to stop you from tucking your chin?
It helps so much that it is amazing!