Need help with Data

[Lead Miner]

[attachment=57943][attachment=57943]First of all I appreciate anyone that takes the time to read this and give me your .02.
Im a 35yo M big guy 6'3" 278 lb when diagnosed in October but down to 260lb now Im definetly not skinny but I am very active, I had covid November of 22 and ever since then I have been battling an illness no Dr. can seem to diagnose. Started off with slight tremors in the hands and then twitching started mainly in my face but randomly all over my body. Then extreme muscle fatigue set in. I was pretty worried went to the dr and they sent me to a Neuro. They did an MRI of my brain and checked everything out and diagnosed me with essential tremors but brain and everything looked ok. They ran a ton of bloodwork on me and everything seems to be fine so the dr just wants to follow up every 6 months cant really seem to find a problem and said it was most likely just stress. Symptons get a little better and then worse over the course of the past year untill around October and things go down hill. Tremors get worse, twitching all over my body but still mainly in my eye brows, muscle fatigue gets way worse to the point i get winded walking a couple hundred feet. I go back to the dr October of 23 and they want to give me a sleep study. I take the at home study and it shows and AHI 32 of OSA. So my new machine comes in a resmed airsense 10 autoset about 1 month ago. I am feeling pretty rough at this point so I take it home hoping to see a difference. First couple of days I woke up feeling alot better it was like I got my wind and strength back over night and I really thought this was my issue, but since about the 3rd day of using my cpap I have been steadily on a downward spiral again. Still have all my same symptoms but also having some serious problems not fumbling my words and my short term memory is about non existent at this point and tinnitus. I am 30 days in using my cpap every night and I call my sleep tech and they tell me im probably just adjusting and the machine is auto so it will take care of the rest. So I start digging on reddit and then found this board and I have been really researching. So I got an 02 ring and downloaded OSCAR so i could see my own data. From what I am seeing I am only having 1 or 2 OSA per night but many more CA per night usually in clusters. O2 gets down in the mid 80s several times a night typically and I just dont feel like I am getting sleep I toss and turn alot. I accidentally slept without my machine 2 nights ago and I felt better the next day than I have since the first day with the machine and 02 stats looked better. So I am curious if my pressure is causing me to have the CA's or what the heck is going on. I am trying my best to learn about treatment and what I can do to improve. I took some screenshots of what I thought might be important. Any info would be greatly appreciated. Thank you

[PeaceLoveAndPizza]

Please post an entire nights chart with the following:

Events, Pressure, Flow Rate, Flow Limitation and the Leak Rate Graph.  Always include the entire left side bar, minus the calendar and pie graph.  


Set your display to the Standard view.  
(View > Reset Graphs > Standard)
Take a screenshot of your Daily screen.
   * For Windows or Linux: Use the F12 key
   * For a Mac: Use Fn+F12

[Lead Miner]

Ok thanks for the info. How is this?

[CPAPfriend]

What was the breakdown of your sleep study?

Your leaks are not insignificant. You have a somewhat volatile leak graph, and getting those under control could potentially help with your symptoms.

Your centrals could be treatment-caused, but there is no way I can be sure. That said, they're few in number.

You could be having many other smaller breathing disturbances that are simply not accounted for, some of which may be coinciding with the periods of the night with more leak. I see you're using a nasal mask, which often times if problematic for patients as they tend to open their mouths.

[Lead Miner]

Here is the notes from my study. I didn’t have any CA’s during it. Now one month later I am having almost solely CA’s but no OSA’s. And yes I have a ton of 5-8 second episodes that aren’t flagged.

[Lead Miner]

I think i am moving my mask in my sleep which is causing the leaks. I am having a lot of shorter episodes that aren’t flagging and the weird thing is I almost have no episodes when my mask is leaking. I think the pressure is curing my obstructive issues but it’s causing me to have a lot of central issues. Is there something I can do about that?

[Lead Miner]

Here is some of last nights data. I adjusted my mask tighter and think I have the leaks under control now. Is there anything I can do with this central apneas? I having a ton of them that are short enough they arent getting flagged. The obstructive apneas have dissapeared. I just dont feel like I am getting any rest.

[paulag1955]

FYI, when you post charts, we always want to see the full night as well as the zoomed in graphs.

[Lead Miner]

Sorry about that. I took about 7 screen shots and accidentally posted 3 without the full night. Here it is. My pressures are set 4-15. I havent messed with any settings yet. What do you think is causing all my central apneas?  Thanks

[CPAPfriend]

Your AHI came way down, which is good.

Yes, your leaks are the primary issue here, and they should not be neglected. The leaks are likely not only waking you up, but they're also compromising the machine's ability to properly flag events and respond to obstruction. It's normal that you're not seeing events during times of leak. Leaks can also cause centrals.

You're using a nasal mask, and I see the same pattern occur over and over where patients essentially can't keep their mouths closed in one way or another, allowing for leak. Solutions to this issue, provided you're having this issue, is to use a full-faced mask, or mouth tape, or soft-cervical collar with or without mouthtape, or chinstrap, or reduce pressure.

Turn EPR off and narrow your pressure range from 5-8cm and let's get some more data points.