RE: Need some advice- first week of CPAP
Hello All!
I has been a long time since my last post. Unfortunately my results are very similar to the one I had in the first week of the therapy. My AHI went down below 1 only once during three months. I usually stay around 3.5. I understand that this is by no means a horrible number and my sleep specialist was happy with it but I don't feel better. I'm am still tired. Still can't wake up in the morning. My primary physician said that at this point I should feel that the therapy is working and that my issue may be RLS. He actually suggest to try a medication (requip) and see if that helps. I have to admit trying that med kinda scares me after reading the reviews... Last thing I need is a gambling addiction.
My sleep study indicated that:
LIMB MOVEMENTS:
There were a total of 49 periodic limb movements (PLMS) during sleep, of which 41 were PLMS arousals.
This resulted in a PLMS index of 7.1/hr and a PLMS arousal index of 6.0/hr.
INTERPRETATION: A. The nocturnal sleep study was consistent with mild obstructive and central sleep
apnea.
B. Mild Periodic Leg Movement Syndrome.
However, none of the sleep specialist was concerned with that or at least never raised the issue. Not sure what to think about it.
Please take a look at my screens and see if you can suggest something new that we didn't try. I would be great you guys/girls can help.
https://imgur.com/1GOkKxg
https://imgur.com/0Lezmxh
https://imgur.com/tqImXBy
https://imgur.com/b3bCIYr
https://imgur.com/ZEyghZJ
https://imgur.com/46onqah
RE: Need some advice- first week of CPAP
Once again try setting your pressure at 8.5cm fixed. That means taking it off Auto mode. Sleeprider gave you this advice back in August and nothing has changed.
RE: Need some advice- first week of CPAP
(11-08-2017, 09:37 AM)Walla Walla Wrote: Once again try setting your pressure at 8.5cm fixed. That means taking it off Auto mode. Sleeprider gave you this advice back in August and nothing has changed.
He posted 4 charts on the last page at fixed pressure 8.4 with AHI ranging from the mid-2.6 range to about 5.25 using this scheme. The worst one was this:
![[Image: AfOxjT5.png]](https://i.imgur.com/AfOxjT5.png)
The problem has been we optimized events to about 3.5 average, but didn't solve the fatigue problem. I suspect events are still mixed to mostly central, and if the lack of satisfying rest is related to PAP therapy, then we are back to ASV as a solution.
We will be glad to help, but the tool you are using has limits. We may have done you a disservice to get your results below 5 AHI because it will just be harder to get a prescription, and especially insurance coverage for ASV therapy.
RE: Need some advice- first week of CPAP
Sorry I missed those!
11-08-2017, 03:50 PM
(This post was last modified: 11-08-2017, 04:01 PM by Chicago.)
RE: Need some advice- first week of CPAP
Hey Walla Walla o worries
https://imgur.com/cVUdUEd
How do I approach my doctor? he was very happy with my numbers...
I wonder If I should go and have that second study done (with CPAP) which I never did.
RE: Need some advice- first week of CPAP
I'm starting to feel like the guy who has a hammer and sees every problem like a nail....but Chicago's charts look pretty similar to mine (before mine got inconsistently over 5). And I was also knackered with fatigue.
I had just about the same ratios of CAs.
For me, ASV has been extremely helpful.
The under-5 nights, I suspect, will make doctors and insurance unsympathetic, but I do wonder what an ASV sleep study would show?
Bill
11-09-2017, 02:48 AM
(This post was last modified: 11-09-2017, 03:00 AM by ajack.)
RE: Need some advice- first week of CPAP
I have PLMD and had a bunch of arousals on my first sleep study. There are a few meds for it, I use lyrica, which is also good for nerve pain. (if you have any) anyway my last sleep test had PLMD at 1 arousal an hour, which a bunch of mild ones that didn't arouse me. Any arousal should be taken seriously in the sleep architecture, be it PLMD or AHI
I can't see insurance forking out for 2 ca an hour. There might be some mouth breathing and it may pay to wait a month on the CA and see how they go. For pressure I would raise to 9 or 9.4 to get rid of the OA with a bit of luck it might blow your CA numbers
RE: Need some advice- first week of CPAP
Hello Friends,
It has been few months since I posted and my therapy seem to stay at the same AHI level. I don't feel any better and wonder If I should continue it or maybe get another sleep study? I never had a study done with an actual cpap machine, just the study without, that showed higher number of HA and no obstructive apneas. I don't mind using the machine but if it doesn't help with my sleepiness I'm not sure why should I continue. If you can please take a look at my graphs maybe you see something that I don't? Would getting a new study be a good idea?
https://imgur.com/7wkr39G
https://imgur.com/7w12n54
https://imgur.com/5CJDGcm
04-19-2018, 09:11 AM
(This post was last modified: 04-19-2018, 09:14 AM by Ron AKA.)
RE: Need some advice- first week of CPAP
(04-18-2018, 11:06 PM)Chicago Wrote: Hello Friends,
It has been few months since I posted and my therapy seem to stay at the same AHI level. I don't feel any better and wonder If I should continue it or maybe get another sleep study? I never had a study done with an actual cpap machine, just the study without, that showed higher number of HA and no obstructive apneas. I don't mind using the machine but if it doesn't help with my sleepiness I'm not sure why should I continue. If you can please take a look at my graphs maybe you see something that I don't? Would getting a new study be a good idea?
Your numbers are very similar to mine, and you are using the same machine and the same mask. I also will admit that I have not had a life changing experience with using the CPAP. The benefit I am getting from it has been largely offset with the hassle of using it. But, that part is getting better. My wife likes the lack of snore though. Like me, a significant part of your AHI is caused by central apnea, and CPAP does not really reduce that. I have accepted that I will never get an AHI in the range of 1 or under that like others, including my wife does. Just not going to happen with a standard Auto CPAP. I just have to have faith that 2-3 events per hour is much better than 30+ per hour.
That said I would suggest you could get a small improvement with a couple of tweaks to your settings. I would suggest moving your minimum up to 9.6, and your maximum to 11.2. Leave everything else the same.
RE: Need some advice- first week of CPAP
Take a look at the link in my signature for organizing and posting charts. eliminating the monthly calendar, and including Events, Flow Rate, Pressure, Flow Limitations and Snores would be a big improvement to allow us to see more important information.
You are using a ramp with EPR enabled, and not using EPR during therapy. Was EPR a problem resulting in more CA?
