LongDaysPleasantNights' Therapy Thread

[LongDaysPleasantNights]

Hi all,

Sleep-life story is this: In roughly my junior year of college, I noticed a marked drop in energy levels and my ability to think clearly and concentrate/stay on-task. I had not had these issues earlier in life, and I was getting a decent amount of sleep. No changes from the prior two years, at least. Probably averaging 6-7 hours of sleep on school nights, and 9-10 on weekends. No issues with my thyroid, and my blood work came back normal. I was sent an at-home sleep test, and that also came back clear.

I've since adjusted to my new "normal", which included a diagnosis of chronic fatigue that's currently treated with a prescribed non-amphetamine stimulant Provigil.

Fast forward to about a month ago, when I was asked to take another at-home sleep test that returned an AHI of ~14. I was diagnosed with mild sleep apnea and sent a Resmed Airsense 10. I feel fortunate in that I haven't had many issues adjusting to sleeping with the equipment. I started with and settled on the Resmed P30i nasal pillows.

I'm insured through Kaiser, and while my sleep therapist seems very pleasant, they haven't been all that hands-on. Essentially, they told me plug the unit  in and go to sleep, and that's all I've heard since.

What prompted me to join these forums was a recent trip to Florida. While away from home I noticed that my AHI seemed a fair bit better than usual. When I returned, the numbers ramped back up. I googled a bit and saw a correlation with unobstructive/central apnea and suspect that might be what's at hand, but thought I'd post here and see if I could get some input before approaching my Kaiser sleep therapist.

Would anyone have any suggestions as to setting I should try adjusting to see if I can get things under control with my current unit? Or if not, what things I should bring to my sleep therapist's attention? I've attached last night's Oscar data, as well as a zoomed portion of what I think is the relevant time period.

I'd appreciate any help you can offer.

Thanks!

[G. Szabo]

It would be best if you mitigated the leaks. Check your straps. If it does not help, you might need a different mask. Only you can figure this out by trial and error (and, of course, by reading the experiences posted on this forum).
Try to force yourself on your side during the night.
Use mouth taping and a soft cervical collar.
When you talk to your doctor, point out the high number of CAs. He/Se might suggest a different instrument. But before that, post a few CAs of yours in high resolution (i.e., in 2-3 minute windows) for the experts on this forum so they can verify their nature.

[LongDaysPleasantNights]

There was definitely a spike in my mask leakage last night, but on most other nights, it's been rare for it to spike above 23 - excluding when Ive woken up and taken it off to reposition.

I've zoomed in on a couple of the CA's from last night in the attached. It doesn't look like there's much of a correlation between my CA events and spikes in leak rate, which I think is interesting.

[joeblough]

i get CAs when falling asleep, either at the beginning of the night or when changing positions. if you have a spare iphone or ipod you could use SomnoPose to measure your body position and see if it correlates with the CAs.

i also found that lowering the EPR value made my CAs a little less intense.

[Deborah K.]

I see that you have a lot of CAs.  Was that the case in your sleep study?  Also, how long have you been using therapy?  Answering those will help us help you.  You need to change your starting pressure to at least 7 or 8.  At 6 you are not getting good enough therapy and your EPR cannot work properly.  Your flow limits are still high, so raising your therapy to a higher level will help.  If you are using ramp it would be good if you could turn it off, or at least drop it to five minutes.  You get negligible therapy while using ramp.

As to your leaks, you don't need to worry about them.  They are not high enough to interfere with your therapy.  If you look at the panel to the left of your chart you will see that your leaks are rated only 2.17.  That is because they are almost all under the 24 leaks threshold at which they can interfere.