Variable Breathing/CSR?

[tresero]

Thanks. 

I believe the ramp is turned off. Kind of strange results. That's worse than my original study.

[tresero]

Here is last night, strange that I actually felt like I slept fairly well.

I think the pressure is causing me to get the CA's. I also think the Respironics is not reacting fast enough. I don't have any way to get another machine until I meet with the doctor Dec 18, and I don't have much hope that he will even look at the wave forms. The VA is obsessed with AHI and that is all. It's also a telehealth. I'm just going to stress that I need a new study.

   

Also, for comparison, in case anyone can see a reason this is happening, here is July 16. 

   

[G. Szabo]

Your results are widely changing. 
There is a chance it is the pressure adjustment you tolerate poorly, not the press setting itself. To find it out, you might want to run your instrument with the following settings: 
Minimum pressure: 10 cm
Maximum pressure 10 cm 
Ramp off
Flex none.

[tresero]

Interesting that I just got the results (From June, thanks VA), and this could explain things.

Mild decrease in FEV1 of uncertain clinical significance. 
Normal lung volumes. 
Normal diffusion capacity. 
There is no significant bronchodilator effect.


So I'm having issues exhaling and I assume the pressure is too high and the Phillips is likely interpreting incomplete breaths as obstructive events and keeping the pressure elevated.

[tresero]

I finally met with the sleep doctor (remote) and he set me for cpap mode 14. 
I am still waking up, especially later in the night, breathless and starting to get some stomach issues.

I'll set it to 10 tonight just to check. 

I have a few decent days, but mostly crap. I'm not sure if it's too much pressure causing CA's or physical blockage (I have gained weight).

Just to send last night, I've attached it. I have been in cpap mode since Dec 18 with only 1 day below 5 AHI and 3 days below 10. The rest are very high (20+).

[Jay51]

You are still having a lot of leaks.  This is from our Wiki here at ApneaBoard.  Maybe something in this reading can help you:

• 1Mask Primer
  

[tresero]

Thanks for the reply! I'm very frustrated as you can tell.

I've already tried the few choices the VA gives me. The only one I've been able to tolerate it is the N30i. The nasal mask they offered leaked like crazy and the drool woke me up.

I probably over tighten, but I turn from side to side anywhere from every 15 minutes to every hour (hip and leg injuries). So that means I'm constantly pulling the strap down on the back of my head. I just got the small version, and will try it and keep it looser.

Here is last night. I turned the pressure to 11 and by 4am, got up and turned it back to 14. This is something that has happened in the last few months.

And my overview for the last several years.

I'm hoping that my losing weight will stop this and also allow my breathing to get better in general.

[Jay51]

You have some positional apnea in the OSCAR chart you just posted.  You have some "cluster" of OA events in this chart.  Some things like lowering pillow height, side sleeping vs. back sleeping (and also using something like a pillow, etc. between your chin and chest to prevent chin tucking which can either kink or totally cut off your airway, and finally, using a soft cervical collar during sleep may help the most.  Just measure from your chin to your chest in inches and fractions of an inch to get your correct size.  

With positional apnea, increasing pressure usually doesn't help at all.  No pressure can "break" through the cut off airway. 

Here is some more reading on positional apnea from our wiki:   

• 5.3Positional Apnea
  

[tresero]

Thanks Jay,

I only sleep on my side, and I've felt that it was an obstruction in my mid neck (but hard to place). I have a feeling some of it will go away when I lose 20 pounds or so. At least I hope so.

I did order a pillow for apnea and people with neck issues (military injuries prevent much motion in my neck). Hopefully that will help as well.