My Journey Begins

[MediocreOpie]

Heh...if that's the case, I find it a little humorous. Growing up, my dad always said I had to make things interesting and over-the-top. 

Last night was my fourth night and the best yet. Less than 1! I'm not sure if we had a power flicker or not. None of my clocks are flashing, but it appears my machine restarted just before 2am. Only a few events last night and my nose doesn't hurt, so I think I finally got my mask adjusted where it needs to be.

And, again, I am so grateful this community exists...

[attachment=11961]

[Sleeprider]

Well, this is the reason insurers require anyone with complex or central apnea to be started on CPAP rather than more expensive therapy that specifically targets complex and central apnea. Some people (about 15%) succeed with less expensive CPAP and do very well. You appear to be one of them, however I have never seen such an excellent example of a person with mostly central events experiencing consistently good and improving results on CPAP. I need to get back to my disciplined attitude that no one of us is necessarily like every one of us. There is a great deal of individual variation in how we respond to this therapy and its permutations.

[jaswilliams]

My guess is you moved your mask off your face or had a large leak so your machine turned off automatically then you started breathing back into the mask and the machine turned back on, the reason I say this is there was some large flow just before the therapy break that could be arousal related

[MediocreOpie]

Well, this is the reason insurers require anyone with complex or central apnea to be started on CPAP rather than more expensive therapy that specifically targets complex and central apnea.  Some people (about 15%) succeed with less expensive CPAP and do very well.  You appear to be one of them, however I have never seen such an excellent example of a person with mostly central events experiencing consistently good and improving results on CPAP.  I need to get back to my disciplined attitude that no one of us is necessarily like every one of us.  There is a great deal of individual variation in how we respond to this therapy and its permutations.

Well, I know it will take time and effort. I've been pretty optimistic since I felt so good Saturday, Sunday, and even made it through a majority of the day yesterday feeling great. Last night was my best of the four so far, but today I feel like I'm right back where I started. This constant fatigue sucks...

My guess is you moved your mask off your face or had a large leak so your machine turned off automatically then you started breathing back into the mask and the machine turned back on, the reason I say this is there was some large flow just before the therapy break that could be arousal related

I very well may have. If I did, I don't remember waking up, let alone removing my mask. Seemed awkward.

[MediocreOpie]

So, yesterday was another struggle from about 1:00 pm on. Got my "second wind" at about 7 pm. I get by at work by just getting up, getting out of the office, and walking around.

Still seeing good results, statistically speaking. For the past five days I have:

AHI: 2.89
Obstructive: 0.15
Hypopnea: 0.67
Clear Airway: 2.00
RERA: 0.18

My indices are pretty good, but I am still waking up at several points during the night which could certainly be why I am getting fatigued in the afternoon. I think, at this point, I am just going to attribute it to my mind waking up and asking, "What the heck is this thing on my face?!" I have certainly noticed that my side of the bed keeps the fitted sheet in place now, so that means I am not moving around as much as I had been. Overall, I think I'm on to something good.

Found out yesterday from my provider that it is, in fact, central apnea. Being military, I have a 90-day compliance follow-up in August and then onto a medical evaluation board to determine my fitness for duty. As long as I keep seeing good results, I think all will be well. Certainly glad my doctor dug deeper into the fatigue issue and happy, regardless of any board outcome, that I am working to curb this apnea thing. Time will certainly tell!

[ajack]

It's a shock to the system, it can take a few months to get use to CPAP.
You could take up drinking, i find it helps

[MediocreOpie]

It's a shock to the system, it can take a few months to get use to CPAP.

That's what I assumed...and certainly not expecting a miracle in a week.

You could take up drinking, i find it helps

Ha!

[MediocreOpie]

So, the first full week in the books. I started trying to sleep "normal" on Thursday night through last night and I noticed that my mask leaks like crazy when I do. By "normal" I mean on my side and not on my back. From last Friday to Thursday, I was sleeping only on my back to try getting used to having the CPAP on. Does anyone else have problems with leaks when they side sleep? Should I just stick to my back? If I lay on my back, I don't move at all. I just wasn't feeling any better, so I thought I would try to just be as normal as possible. It helped, but could also just be me getting used to the CPAP as well.

Another observation I find interesting: my AHI values are higher on the weekends than during the week. I had 2.31 (5/11), 2.99 (5/12), 2.58 (5/17), and 1.75 (5/18). During the week, it was right at 1 or less. Seems like I drag more on the days when my AHI is low than I do when it's high. Just found that interesting.

[MediocreOpie]

Pulled this over from: http://www.apneaboard.com/forums/Thread-...#pid296199

is there a method to the madness of putting you on apap which doesn't treat central apnea?  do you also have obstructive apnea and the thought is that the ca is pressure induced / treatment emergent?

the literature is replete with references to all the horrible conditions associated with central apnea.  however, I was diagnosed with central apnea as a young man in 1987.  in my (very limited) experience, idiopathic or what I call 'native' ca is common.

start your own thread if you haven't already; post some charts.

I don't know what the method to the madness is. Per some earlier discussion, it may be that they want to see how I respond to CPAP before potentially moving on to ASV. At this point, I am responding pretty well. My AHI rage for the past week is 0.36 to 5.98. I have attached a bunch of screenshots. My actual sleep study is attached earlier in this thread.
I am thankful I am responding well to CPAP therapy; at least, I think I am. I say that because, well, I'm not ready to end my career just yet. And, that is a key to the doctors allowing me to continue doing what I love...

[sheepless]

I'm a little confused. I don't think you were dxed with central apnea (indicated in your post from that other thread) but rather with treatment emergent central apnea. 'why' is what's confusing to me because if I'm reading your test summary correctly (and I may not be) you had central apnea but not obstructive apnea both before and after treatment. I didn't see any determination of whether the many hypopnea you had were obstructive or central; if obstructive, that may account for an osa dx.

your ahi's have been pretty good in your posted charts but somewhat variable to above 5. if you have complex apnea (treatment emergent), the ca will disappear. if you have mixed apnea, you will find your treatment results with apap will be variable. in the meantime, members can coach you to your best possible results with the apap.

for comparison: I was dxed with central apnea in 1987. no effective treatment was offered. older and fatter, I was dxed with obstructive apnea in late 2016, despite the earlier dx and despite having nearly equal numbers of oa and ca events during my sleep study. they put me on apap which after about 1.5 years failed to produce a long term ahi less than 5 (it was between 5 and 6). doctor couldn't explain the near equal drop in my ca as well as oa via apap but felt everything was terrific such that he early on advised me to buy the apap I was renting. notably, after 1.5 years of this I still felt awful. with guidance from forum members I picked up an asv, doubting the 'system' would have supported that decision. the result has been stellar: my ahi for the last 38 days on asv is 0.24 and I'm finally beginning to feel better, even reducing the terrible fragmentation I've long experienced.

something along these lines may or may not be in store for you but keep it in mind as you progress. your numbers aren't terrible by any means so it comes down to how you feel and whether you are satisfied with the apap treatment. and whether your ca dissipates or continues.