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Very new (6 weeks) to CPAP so quite low on the learning curve. 31 on home sleep test, with 29 obstructive and 2 central. I just switched from Resmed P10 to P30i because the hose at the chin kept getting knocked around and I got tired of (and from) being blasted with air in the face when the pillows moved. P30i is - maybe - slightly better. The jury is still out on whether I feel better since CPAP since my sleep is no better than it was before.
I usually have 0 obstructive and up to 5 centrals, with few occasional hypopneas. Are the centrals "real" or just a result of my moving around, sighing or yawning (all of which I do when feeling stressed, which I've been since being on CPAP)? Attached are data from 2 recent nights, one is 5.05 and the other is 0.37, which are pretty much my high and low. What did I do to get the 0.37 that I didn't do when I got the 5.05?
I'm new to my diagnosis and to CPAP, with 7 weeks on a Resmed Airsense 11. I have a lot to learn and am awed by the level of knowledge I see on the forum. My sleep study (at home - Kaiser) showed 31 AHI with 29 obstructive and 2 central. I'm not overweight, never smoked, rarely drink, don't have related comorbidities, and have come to (almost) accept a genetic component though I don't think my parents were ever diagnosed. For 5 weeks I used a P10 but got tired of fighting with the (medium) pillows to stay in place every time I moved. I switched to a P30i, hoping things would get better with a sturdier frame but I'm experiencing the same. Kaiser ordered a cushion to replace the pillows hoping for better luck, but it hasn't arrived yet. I'm trying hard to avoid using a mask that covers my nose. If I'm lucky I get 7 hours of sleep per night, always interrupted by the noise, air blowing on my face when the pillows move, and the pillows hurting my nostrils.
I started treatment on APAP (4-12) and did okay, but the respiratory therapist changed me to CPAP level 6. A few weeks ago I experimented with increasing the pressure to 6.6 and had a headache, nausea and was belching. I went back to and stayed at 6. AHIs have averaged in the 2s for the past 4 weeks - almost all centrals. AHIs once got as low as 0.37 a few weeks ago. I was surprised and dismayed to see last night's 6.94. The obstructives were because I set my pillows high since reflux was bothersome (Is there a correlation between CPAP and aggravated reflux?). I realized I was holding chin to sternum, and they stopped when I rearranged the pillows. Note to self - don't do that again.
Can you identify a possible cause for the CSRs? I rarely have them, and rarely have RERA. What else could have caused my numbers to jump? Should I be concerned, or just attribute it to expected fluctuations? Should I be doing something different? The irony is I had a half-way decent night's sleep, albeit shorter than I would have liked.
I'm attaching last night's report (6.94) as well as the one where I only had 0.37 AHI to see if you can spot what's different. I know it takes time and 7 weeks isn't a lot, but I'm feeling frustrated, disheartened, and disappointed with not sleeping well. But I'm also determined to stick with it.
Could you please post your sleep studies, and a 10 minute view of a couple of the CA groups so we can see the character of the CA events to see what we can see that is actually happening..
Your EPR is incorrectly set because you did not give it enough room to work. Effectively you have EPR=2
Because you currently have high CA events I'd like you to set EPR=1. This is to reduce the CA events assuming that they are real.
It is possible that the central apneas are misclassified based on the report of positional apnea and chin tucking, one of the reasons I want to see the 10 minute view of the CA events.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
(08-07-2022, 01:54 PM)Gideon Wrote: Could you please post your sleep studies, and a 10 minute view of a couple of the CA groups so we can see the character of the CA events to see what we can see that is actually happening..
Your EPR is incorrectly set because you did not give it enough room to work. Effectively you have EPR=2
Because you currently have high CA events I'd like you to set EPR=1. This is to reduce the CA events assuming that they are real.
It is possible that the central apneas are misclassified based on the report of positional apnea and chin tucking, one of the reasons I want to see the 10 minute view of the CA events.
This is what I have of the sleep study (no graphics were included in the patient portion of the EHR) though I've seen the full one and will asks Kaiser to send it via email. Oops, it looks like I left off the score = 31.4 with no breakdown given. I also attached some of the CA events and hope I did it right. I will change the EPR this evening. Fingers crossed.
Thank you again for your guidance. I sure need it!
I'm almost 2 months into CPAP with a sleep test score of 31 AHI. I don't have but have seen the test (Watchpat through Kaiser) and CAs were between 2-3. I've had CRs every night and CSRs maybe once a week. I rarely have OAs.
My questions:
-Are the CRs real?
-Can you see if there's a connection between CRs and something else that may be happening? (I'm still low on the reading OSCAR learning curve)
-What's causing the CSRs and should I be concerned?
I use:
Resmed Airsense 11
N30i cushion
CPAP 6
EPR 1 (down from 3 at Apnea Board suggestion)
Average CA (30 days) 2.4
% CSR (30 days) 0.3
Average H (30 days) 0.08
Attached are a couple of recent nights' data.
Sleep has finally (!) improved once EPR was reduced and I switched to cushions from pillows.
Is there something I can do to improve? I see some mouth breathing. Chin strap was unceremoniously thrown across the room the first night I used it.
I'm just a novice myself, the experts must be exceptionally busy these days, they usually monitor and answer questions quite timely.
I believe what I have read about CSR's on cpap is that arousal states can appear on the read-out as CS respirations. Do you think you could have been awake or at least partially awake at the time the cpap read CSRs?
As a nurse, I've only witnessed true CSRs with traumatic brain injuries, severe heart failure, and end of life patients.
I'm only 3 months in on my CPAP and have been told I need to give myself more time to get used to it. The experts here have helped me adjust my settings. I see the goals as low AHI and limited discomfort (ie: most tolerable mask, low leaks, no rain-out, limited/no aerophagia). Hit those goals, use it, and be patient. <3
KP I toss and turn all night, and when I do that I tend to hold my breath. I *suspect* that may have been what was happening and was hoping to confirm that - with pointers on how to spot it when it happens again (so far it hasn’t).
KP I toss and turn all night, and when I do that I tend to hold my breath. I *suspect* that may have been what was happening and was hoping to confirm that - with pointers on how to spot it when it happens again (so far it hasn’t).
08-17-2022, 01:12 PM (This post was last modified: 08-17-2022, 01:13 PM by WakeUpTime.)
RE: Please help me understand the CAs and CSRs
Is it possible that tossing and turning might be moving your mask a bit, causing some leaks? I noticed on several of your CA alerts that your leak rate spikes in the few minutes prior to many of those multiple CA alerts. Just a thought.
The mask (n30i) moves constantly. I’m a side sleeper and the hiss and gust almost always wakes me. I’m trying my best not to have to go to a face mask.
