Newbie looking to improve my AHI

[BronYrAur]

Hey everyone, been on the cpap 10 days now and I'm noticeably less tired throughout the day but its not insanely drastic (I know gotta give it time). My biggest concern is apart from a couple mornings I still have been waking up pretty tired, difference being by the time I get to work I'm fully awake where pre-cpap I would start to finally feel awake by noon. the couple random mornings though I just woke up and felt completely rested and felt that way all day. I noticed no correlation between those nights and my AHI but after digging into sleepyhead I did notice the nights I had less events in my last hour or so of sleep were the nights I felt the best. I have my first follow-up appointment not with my actual sleep Dr. but her medical assistant in less than a month so I just want to get a little more informed before the visit (I'm not expecting much). my sleep study came back with an AHI in the mid 40's so ill take anything in the single digits if that's the best I can get but after seeing them <1 I'm intrigued if there is anything that stands out to the more educated & experienced members from any of my graphs. don't feel obligated to go through them all but I'll gladly take any input you guys feel is important. thanks in advance my screenshots are all in my album here: https://photos.app.goo.gl/kz6pK17nsxVmuAWP7

[Gideon]

3rd attempt
Wellcome
Please post/attach a copy of your sleep÷p studies because you have a significant number of central apnea events and it will help determine if they are therapy induced.

Your charts here imply you have mixed or complex apnea and not pure OSA

If this is the case you will see a lot of variability in your results which we see.

You also have a positional element evidenced by the clusters of events that is likely caused by chin tucking and can be corrected by a soft cervical collar or an antisnoring wedge or collar.

[Gideon]

Treatment with your current machine is either a very narrow band or the fixed CPAP which you are on.

Rule of thumb is to increase pressure for obstructive events and lower pressure for central apnea events.
A real balancing act.

The best machine for mixed complex or central apenas is an ASV.

You are having issues with the variability of results and I don't want you to improve your numbers to the ]o
Point of not getting a better machine for long term therapy so stay the course for now.

[BronYrAur]

thank you for taking the time bonjour, im a side sleeper so maybe that is the positional issue. I'll see if I can get my sleep study results forwarded to me, honestly don't know why I didn't already.

[BronYrAur]

Oh joy, I called my sleep dr.'s office which is literally in the clinic where I had my study done at and asked for my sleep study to be forwarded to me. Already they are giving me problems about sending it to me, I told them I'm pretty sure that since they are a part of my medical records I am entitled to them. If this is how it's going to be going forward looks like I might be finding a new Dr. and filing a complaint.

[Sleeprider]

You are entitled to copies of your sleep studies under HIPAA. I'm sure they will be provided if you are persistent.

You have a Dreamstation Auto CPAP set at fixed pressure of 12. I think you might get better results in Auto mode with a pressure range of 10-14, which brackets your titrated pressure. This is useful for changes in sleep position or stage. I'm puzzled by the prevalent use of fixed pressure, usually by controlling doctors.

[SarcasticDave94]

Oh joy, I called my sleep dr.'s office which is literally in the clinic where I had my study done at and asked for my sleep study to be forwarded to me. Already they are giving me problems about sending it to me, I told them I'm pretty sure that since they are a part of my medical records I am entitled to them. If this is how it's going to be going forward looks like I might be finding a new Dr. and filing a complaint.

Sleeprider already addressed this, I am just confirming it. Absolutely, you are entitled to copies of the sleep study, titration, script, and etc. I strongly suggest get copies of all these in full not a summary. When you do get these, and I know you will, post them with personal info redacted/blacked out.

[Fats Drywaller]

https://en.wikipedia.org/wiki/Hipaa#Righ...s_your_PHI

(just an overview, not the text of the law itself)

Right to access your Protected Health Information

The Privacy Rule requires medical providers to give individuals access to their PHI. After an individual requests information in writing (typically using the provider's form for this purpose), a provider has up to 30 days to provide a copy of the information to the individual. An individual may request the information in electronic form or hard-copy, and the provider is obligated to attempt to conform to the requested format. For providers using an electronic health record (EHR) system that is certified using CEHRT (Certified Electronic Health Record Technology) criteria, individuals must be allowed to obtain the PHI in electronic form. Providers are encouraged to provide the information expediently, especially in the case of electronic record requests.

Individuals have the right to access all health-related information, including health condition, treatment plan, notes, images, lab results, and billing information. Explicitly excluded are the private psychotherapy notes of a provider, and information gathered by a provider to defend against a lawsuit.

Providers can charge a reasonable amount that relates to their cost of providing the copy; however, no charge is allowable when providing data electronically from a certified EHR using the "view, download, and transfer" feature which is required for certification.

Also, if you don't have the CPAP prescription either on paper or digitally (PDF or whatever), it's especially important to get that. Online retailers usually want to be sent a copy of it when you buy masks. Also machines, but of course you hope that won't be necessary. At least not for years.

[BronYrAur]

I switched to auto with the settings mentioned and I feel like it was a success. I'm not sure if I'm interpreting this correctly but by the looks of it maybe after another night or two if the trend continues, changing it to like 9/15 since i stayed at 10 quite a bit maybe there are instances where 9 would be enough and since i hit 14 and if i continue to hit 14 then upping it would tell me if those specific instances would be better solved with higher pressures but if 15 is never hit then that would tell me that 14 is a good max. Am i close or way off base?

[Gideon]

Real nice numbers here, but you had similar results in the posts above.  The issue with the type of apnea you have is that it is inconsistent.  My money is on the apnea showing inconsistency as before.