Results review - any thoughts?

[devonbound]

Hi Everyone, Kinda new to this forum - Great Forum BTW!

Been a Hose-Head for around 4 years, just been prescribed with a new S9&H5I Humidifier and Climate line - this means that I can now review my own data - as Tech staff here in the UK do not concern themselves with data, they are only interested whether you are compliant or not.

Downloaded the RESCAN software and have been perusing through 60 days of data and wondered if I should be concerned by the seemingly high number of CA events.

My pressures are set at 8-16, my average AHI are 7-10 most evenings with a 50/50 split between CA & OSA....

My question is this though. I read alot of people having events lasting 45-60 seconds, my events; whether OSA or CA last between 11-15 secs 95% of the time. So although my AHI Reading is relatively high as is my CA Reading to the norm, should I be unduly worried due to the time the events last for being relatively short in comparison to most peoples....

I guess a question someone will ask in response is 'how do I feel in the morning' and I would answer that with the response 'that I could always feel better and rarely feel totally refreshed' but that's just a part of my life now after so many years suffering pre-treatment that anything is better than pre-APAP....So whether I am truly effected by the results I guess not, but would be good to get others perspective on these results.

Look forward to your responses.

Regards
DB
and

[PaulaO2]

With that many central events, an ASV sounds like it would work better. Resmed's version is the VPAP. Especially if you are not feeling rested.

You could try to narrow the range. I assume you have the S9 Autoset? not the Escape Auto? Narrow that range, especially the upper one. If most nights you only go as high as 10, lower that 16 to 12.

At what pressure do you CA events happen?

[trish6hundred]

Hi devonbound, First, WELCOME! to the forum. I don't know the answer to your questions but hang tight and you'll get other suggestions. Best of luck to you.

[zonk]

We cannot tell for sure if the CSA recorded by the machine are real or not. The machine don,t know if you were sleep or not so it might just flag them while you,re wake. You've just got the machine ...it can take some time adjusting and getting used to the new machine.
Concentrate on not the numbers

[jdireton]

Devon,

AHI at 7-10 is a little high compared to the <5 Normal standard, but nothing really alarming. The S9 Autoset is a nice machine and your numbers may improve the longer you use it. You can at least see your data and get a better idea of your treatment status.

Central and Obstructive apnea events, and machine interaction with them, are complicated and I don't really understand xPAP efffect on this, nor do I think there is really a "conclusive" consensus. If your 95% pressure reading (data from software) is lower than your upper pressure set limit by more than 2 cmH2O, some people have seen a lowering of CSA by dropping the upper limit.

Short is good! During any type of apnea event, your blood oxygen level will start to drop. The longer the event, the lower it can drop. Most of the physiological damage from sleep apnea is directly the result of these low blood oxygen events. Try holding your breath for 45 - 60 seconds, likely a very unpleasant experience that many of us go through multiple times each night if not on xPAP treatment.

Many of us have used pulse oximeters to monitor blood oxygen levels at night. I've found that, even when the xPAP shows a very low AHI, I sometimes have successsive multiple <10 second apneas and still can get to a low blood oxygen level. Something you may want to try (the monitor, not the low blood oxygen).

Hope this helps!

[devonbound]

Thanks for the replies.

I give lowering the upper limit to 14 (slowly, slowly) and see whether this affects the numbers....

I'll go cautiously, because when I had a previous machine, if I left the upper limit at 20 it would hit 20 every night without fail.....the Autoset seems far more responsive and will drop the pressure as soon as the event is done, hence lower average pressure despite pressure sometimes hitting 15+......so will try lowering to 14 and monitor the effects.

Should have said, that I have lost 2 stone recently, so wasn't worried by my short durations, more over asking whether this could be a sign of OSA subsiding, but without previous data from the old machine I guess I will never know and just have to monitor to see whether the numbers continue to drop the more weight I lose and the fitter I get....

Incidentally, has anyone experienced this.....when my wife goes to bed I will switch my autoset on (warming up only) so as not to disturb her when I go to bed.....but the data shows Hypopneas from that time rather than when I donned the mask....curious! The effect of this was that my AHI was reportedly higher than I thought or than it should read as it was taking into account these phantom events....So tonight I will not switch on until I go to bed and let you know the result.

Oh and another thing, when I had the Autoset on 4-20 with 27 degree humidity I never got a dry mouth and the mask was perfect.....now I have adjusted the pressure to start at 8 I wake up early hours with an incredibly dry mouth I guess due to the presssure drying my mouth out, any remedies for this?

[devonbound]

Hi jdireton,

You mentioned an Oximeter - any ideas where I can pick one up at a good price?

DB

[Sleepster]

Downloaded the RESCAN software and have been perusing through 60 days of data and wondered if I should be concerned by the seemingly high number of CA events.

That's a great start. We need to see many days of data to draw valid conclusions.

My pressures are set at 8-16, my average AHI are 7-10 most evenings with a 50/50 split between CA & OSA....

Were you diagnosed with simple OSA, or was there a central apnea component? If you have simple OSA then it might be worth looking into the possiblility that the central events (CA's) are caused by too high of a CPAP pressure. You could look for clusters of CA's and see if they are accompanied by high pressures.

You could lower the pressure and see if it reduces your AHI. You could try setting your machine in CPAP mode at the fixed pressure you used to be on and see what happens to your AHI. It could be that the fluctuations in pressure from your APAP are causing the elevated CA index.

Also, it may be that too low of a pressure is elevating your OA index. Look for clusters of OA's and see if they are accompanied by low pressures. It could be that the algorithm that adjusts the APAP pressure just doesn't work for you and you'd be better off setting the machne in CPAP mode.

My question is this though. I read alot of people having events lasting 45-60 seconds, my events; whether OSA or CA last between 11-15 secs 95% of the time. So although my AHI Reading is relatively high as is my CA Reading to the norm, should I be unduly worried due to the time the events last for being relatively short in comparison to most peoples....

It's good that the events are shorter rather than longer. You could get an oximeter and see if they are accompanied by a drop in your blood oxygen level. The other potential damage caused by these events is that they may be causing arousals which interfere with the quality of your sleep. The only way to determine that reliably is a sleep study.

I guess a question someone will ask in response is 'how do I feel in the morning' and I would answer that with the response 'that I could always feel better and rarely feel totally refreshed' but that's just a part of my life now after so many years suffering pre-treatment that anything is better than pre-APAP....

Well said. I feel exactly the same way.

[jdireton]

Devon,

There is a supplier list on this forum (look for the line at the top of the web page right now). The forum doesn't allow commercial references, but check out Supplier #9's web site. This will give you enough information to see if you can find a more local source or just have them ship it to the UK.

Best of luck!

[jdireton]

DB,

Sorry, I should have mentioned that there are reviews of a few pulse oximiters in the Product Reviews Forum section. They have very subtle differences. Ask here if you want a recommendation. The CMS 50D+ & CMS 50E are popular. Just make sure that you get one that records over a nightly period. Some of the more economical ones only have instanteous reading capability.