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12-21-2024, 10:38 PM (This post was last modified: 12-21-2024, 10:40 PM by Ptee8899.)
Review my charts?
Hi, can someone review my data for one day? I have a day in September where I first starting using the machine. That one was a 7 hour night, I would usually only use it for 2-3 hours.
Recently, I have been using a nasal spray and breathe right strip and I think that helps me tolerate the CPAP more. I uploaded Dec 18 2024 which I think went much better than in the past.
Also is there any way to tell from this data what treatments I should consider? I have been consulting with ENTs and airway dentists, and starting to consult with jaw surgeons. ENTs say to do septoplasty and turbinate reduction. They say it's a no brainer and it will also help me tolerate the CPAP better.
Airway dentists and some jaw surgeons and some ENTs say I should do palate expansion (MARPE) to increase my airway laterally. I have an extremely narrow palate. But according to my CBCT scan, I should consider MMA jaw surgery as well to move my jaws forward and increase my airway behind my jaw/tongue.
12-21-2024, 11:24 PM (This post was last modified: 12-21-2024, 11:26 PM by staceyburke. Edited 1 time in total.)
RE: Review my charts?
Welcome to the board. I am no Doctor so all I can say is I can explain a couple of things that might help. First, you have a number of CA or central types of apnea and that means you are just not trying to breathe when these happen. A special type of cpap is needed if you really have this many centrals. BUT central apnea is not something the cpap always detects correctly. If this were a sleep lab we would have belts around you chest and 12 (or more) wires hooked up to you to tell if you are really trying to breath.
The way your centrals are clumped together and then periods there are no centrals makes me wonder IF you have positional Apnea incorrectly marked and they are O events. You ARE having positional apnea, you can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.
I would suggest you try to control your positional apnea and see if that helps the number of central apnea you have on the OSCAR charts.
Thanks for taking the time to review this. I haven't made any changes with my pillow or bed at all for long time. My wife says I sleep mostly on my back but do toss and turn a lot. Any other insight you have regarding this? I don't know if this is relevant, but I have a forward neck posture and rolled shoulders too. I'm sure that is not good for breathing. I tried to do more upper back exercises and foam roller stretches to help with this but haven't kept this up.
Read the Positional Apnea wiki that describes how "chin-tucking" leads to obstruction of the airway. https://www.apneaboard.com/wiki/index.ph...onal_Apnea What you describe as your neck posture is certainly in that realm.
Your doctors seem a bit to eager to seek a surgical solution. Our experience with these surgeries is that they are painful, and rarely lead to significant improvement of OA and have no effect on CA events. Your current pressure is set at minimum 5.0, maximum 20 cm with EPR full-time at 3. To effectively use EPR 3, you will need a minimum pressure of 7.0 resulting in 7.0/4.0 pressure (inhale/exhale). I would set maximum pressure at 12.0 for now.
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.
Did you have a large number of CAs in your sleep study? If you don't know, please post a copy of your sleep study. If you don't have a copy, ask your doctor's office to give you one. US law requires them to provide it if you request it.
12-22-2024, 07:17 PM (This post was last modified: 12-22-2024, 07:18 PM by Deborah K..)
RE: Review my charts?
Oh, good! Your CAs are treatment-emergent and will lessen on their own as time passes. They will give you a high AHI right now, but I would ignore that. Keep your EPR at 3, change your pressures as others have said, and work on your positional apnea. You should start sleeping better as you make those changes and adjust to your therapy. It takes most people a while to adapt.
(12-22-2024, 09:37 AM)Sleeprider Wrote: Read the Positional Apnea wiki that describes how "chin-tucking" leads to obstruction of the airway. https://www.apneaboard.com/wiki/index.ph...onal_Apnea What you describe as your neck posture is certainly in that realm.
Your doctors seem a bit to eager to seek a surgical solution. Our experience with these surgeries is that they are painful, and rarely lead to significant improvement of OA and have no effect on CA events. Your current pressure is set at minimum 5.0, maximum 20 cm with EPR full-time at 3. To effectively use EPR 3, you will need a minimum pressure of 7.0 resulting in 7.0/4.0 pressure (inhale/exhale). I would set maximum pressure at 12.0 for now.
Sorry, are you saying I should set minimum pressure to 7.0 and max to 12.0? I will say I feel some challenge or resistance when exhaling with the CPAP currently, is this related to the minimum pressure? will increasing the minimum pressure make it even harder to exhale?
4 is the absolute lowest a cpap machine can go. EPR is exhale pressure relief and what it does is lower the min pressure on exhale to the min - EPR... So the suggestion was min 7 with EPR 3 which would make the inhale would be 7 and the exhale would be 4 the absolutely lowest the machine can be.
(min 7 minus EPR 3= 4)
The minimum pressure at 7.0 and EPR 3 resulting in exhale pressure of 4.0 gives the most contrast possible between inhale and exhale. If you resolve the positional problems, you can likely try fixed pressure at 7 with EPR 3.
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.
