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CSR with high AHI sometimes
#1
CSR with high AHI sometimes
My AHI averages about 4 over the last month.
But about once a week I get a CSR of about 20% and AHI then averages 22, with OA and CA the main culprits.
Any idea what could be causing that?

P.S. I am unable to sleep more than about 3 hours before waking up and having to discard mask.
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#2
RE: CSR with high AHI sometimes
Post a couple recent OSCAR charts so we can see what's going on.

We would like to see an organized chart from the daily page. Include the following graphs: events, flow rate, pressure, flow limitation and leak rate.

Include the left side bar, minus the calendar.

There are links below in my signature line to guide you.

Also, if you have a copy of a sleep study, post it here. Please use the Attachment feature.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: CSR with high AHI sometimes
Opal Rose,

Attached is last night's Oscar results.  Also sleep study results from March.


Attached Files Thumbnail(s)
   

.pdf   Therouxpsg123.pdf (Size: 1.04 MB / Downloads: 4)
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#4
RE: CSR with high AHI sometimes
Hello qt9998,

First question... do you have a history of heart problems? There is a pattern of CSR between 1:40 and 2:15, but may be simply periodic breathing, which I suspect is from sleeping on your back.

Try to stay off your back as much as possible. I know that sometimes that may not be possible. What type pillow do you use? Using one pillow compared to using two is preferable, also a thinner but supportive pillow helps align the head and neck, so that chin tucking doesn't occur. This can cut off your air, (like a kink in a hose).

If you can side sleep more so than back sleep, I would think the CA's and Obstructives would come down.

It appears you didn't have a titration study done. Do you have that scheduled?

Your 95% flow limitation is .23. We like to see that far below .10, as this can be disruptive to sleep. FL also causes the pressure to rise.

The use of EPR can lower FL, but can also trigger more CA's in some folk.

For now, I suggest concentrating on your sleep position, and see if that makes a difference in the number of Obstructives and CA's.

Post another chart tomorrow.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: CSR with high AHI sometimes
Opal Rose,

Thank you so much for your detailed response.  I'll try to answer.

I had a massive heart attack about 10 years ago and have a stent in place.

I use a single firm pillow.  I sleep on my back because whenever I try side or stomach
sleeping (which I actually prefer) the mask "sounds" like it's leaking.  When I do
sleep on my side/stomach I actually prefer to use no pillow at all. 
Do you think I should switch to a N30i instead of my F30i?

Test takers said my results don't allow a titration study and I guess the doctor
agreed during my visit last month.  I guess they're going by Medicare guidelines (I'm 82).

How can I get the flow limit to come down?  Doctor lowered the EPR to 2 last month.
I looked at my daily results for the last month.  Flow limit was in the teens but lately in the 20's.

My AHI was 0.94 with no CSR last night so I'm not sending results.

Will sleep on my side or stomach and see what happens.  Let me know about mask type please.
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#6
RE: CSR with high AHI sometimes
The trick to sleeping on your side while wearing a full face mask is to sleep at the end of your pillow with the mask hanging off the side. But you do need a pillow. Smile

Switching to a nasal mask is a personal preference, but if you mouth breathe, you'll end up with high leak rates and probably a very dry mouth.

I really think the FL is from the back sleeping. You can line up the FL rising at the same time we see the apneas occurring.

You could try EPR 3 and watch for a couple days to see if the FL drops. But it may cause more CA's. If you use EPR 3, you may want to move your minimum up to 9cm.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: CSR with high AHI sometimes
OpalRose nailed it! All I have to do to eliminate CSR completely is sleep on my side or stomach.
AHI now 0-1 every time.

If only I could stop waking up after 2-4 hours & then having to remove my mask to go back to sleep.
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#8
RE: CSR with high AHI sometimes
(07-12-2023, 02:30 PM)qt9998 Wrote: If only I could stop waking up after 2-4 hours & then having to remove my mask to go back to sleep.

When sleeping on your side, try to use a pillow. You can then position your head so that the mask hangs off the end of the pillow. You might be able to keep it on longer that way.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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