Sleepyhead Results (New User)

[Sleeprider]

Flex and EPR are the first thing we turn to when CA is present. The fact you have significantly reduced CA events by turning that off is encouraging, because it leaves us with the need to resolve obstructive events using simple pressure, however, your event rate is actually not improved with increased pressure based on this chart. in fact it is just the opposite. The lower your pressure was, the lower your event rate was. Based simply on what we're seeing here, a fixed pressure of 7 may work okay, but this chart strongly suggests, you do not have simple obstructive apnea.

Your flow chart and respiration statistics have some really strange anomalies. Your inspiration time is 3X your expiration time. The Flow Rate chart has an imbalanced appearance between inhale and exhale. It may be interesting to look at that chart zoomed in to about a 2-minute period so we can see what the respiratory flow actually looks like. You have very little flow limitation events, and almost no snoring. This is telling us your apnea may not be obstructive. Do you have a copy of your sleep study and/or titration study?

[jrdnduvall]

Thank you for the help. The pressure is still set at 6-15 cm H2O. I turned on VS2 as well. I now see what you are talking about a times there is a big difference in the inspiration vs expiration time. Thats puzzling. I do have issues breathing through my nose when lying down. Attached is a screenshot of a two minute window. Let me know what you think. I can take more screen shots in different areas if needed. Thanks. 

Also, I don't have a copy of my sleep study as of yet. I plan on getting it my next appointment. 

[img][/img]

[Sleeprider]

Thanks! I'm seeing inspiration flow limitation that the machine is not picking up, with a very quick exhale, and it looks pretty good in terms of volume. I'd like to see you bump up the minimum pressure to 7.5 and see if we can work out some of the obstruction and flow limit. I think this screenshot is particularly good because you are apparently sleeping here, your leak rate is okay, and pressure is just returning to minimum. This is the setup for the hypopnea about to happen in the next couple minutes.

[jrdnduvall]

I was thinking that would be a good screenshot to start with. I will try increasing the pressure and report back in a few days. Appreciate the help.

[jrdnduvall]

Finally received my sleep study and CPAP prescription. It is as follows: 

DATE OF HOME SLEEP APNEA TEST
09/07/17

INDICATIONS: 
Fatigue and snoring. 

RESPIRATORY DATA 
The Alice NightOne unit was employed. The primary hypopnea scoring rule was utilized. Monitoring time is 474 minutes. The respiratory event index was 39.7. We recorded 314 abnormal breathing events. There were 13 hypopneas, 64 mixed apneas, 234 obstructive apneas, and 3 central apneas. O2 nadir was 87%. The oxygen desaturation index was 29.8. 

No significant brady or tachydysrhythmias are noted. 

DIAGNOSTIC IMPRESSION 
AXIS A: 
Severe obstructive sleep apnea (G47.33) with mild nocturnal oxygen desaturations.
AXIS B:
Polysomnogram, type III, home sleep apnea test. 
AXIS C:
Overweight. 

PLAN
Begin a 90-day trial of auto-titrating CPAP. Such CPAP to fluctuate between 4 and 20 cm of water pressure. Office visit in 3 weeks to begin troubleshooting. 


Okay so some changes since last time. Went to my 3 week follow up appointment with the doctors nurse practitioner. Talked about AHI and pressure changes. They seemed very unknowledgeable about anything I mentioned. Even mentioned they didn't know what OPTI-START was on the CPAP until they googled it... So at this point I am taking matters into my own hands. After all it is MY health and well being. have been experimenting with pressures for a couple of weeks. My AHI is best when at higher pressures and I have less events overall. At 14-20 cm of H2O my AHI is 2.85 and this is with virtually no major leaks.

 [img][/img]

Weird how much better I feel when I wake up. Before I felt a little better, but not significantly. A little history on me and my family. My grandfather, uncle, cousin, and father all suffer from sleep apnea. So definitely a genetic thing. My father was prescribed a Bi-Pap several years ago set well over 20 cm of H2O. He couldn't handle the high pressures so they lowered it as he refused to wear it if they didn't. Same story with my uncle and grandfather. I am 23 years old. I also suffer with depression/OCD/Anxiety although these are clinically treated I still suffer at times. My doctor seemed to think that untreated sleep apnea could have played a big factor in these disorders. So far though CPAP has made a big difference and I hope it continues too. I'm very grateful for all the help I have received from this site thus far. 

- Jordan