[Treatment] I don't even know if I have apnea

[rev0lted]

Hello everybody. Recently, after several blood tests and everything possible I started to suspect apnea, I am constantly tired and yawning, dark circles and very tired. I knew there was something wrong with my sleep, as I always woke up with the feeling that my sleep wasn't restorative. Memory and concentration problems point to apnea. I went to the sleep doctor and he suspected apnea too and I scheduled my sleep test, but the test takes more than a month here in my country. I recorded myself sleeping and noticed a lot of snoring and at times I was panting. I was desperate and bought a ResMed AirSense 10 autoset, started therapy 3 days ago and haven't noticed any results yet, I'm analyzing my Oscar data every day and I seem to be having some central apnoeas. In the other reports, he accused hypopnea, RERAS and obstructive, but not in the last. I'll leave a screenshot of the last report, if anyone can help me I appreciate it.

NOTE: The Oscar is in Portuguese, I believe it will not interfere with data reading

[Dormeo]

Welcome to the forum, Revolted, and congratulations on starting PAP treatment and on using Oscar.

Before you have your sleep study, you might want to stop using your PAP machine for several days in advance. This will help to ensure the most informative results from the study.

It is not at all unusual for people to require more than three days before they feel benefits from PAP therapy, so you'll need some patience with this. You can speed up the process of adapting to the new experience by setting your machine up during the day or evening outside your bedroom and using it while you read or watch TV.

Central apneas are pauses in breathing of 10 seconds or more that don't involve obstruction in the airway. Such pauses are fairly common when we're awake, and some of the CA flags that you see may be during periods of wakefulness.

In addition, CAs are not uncommon during the period when our bodies shift the neurochemical controls for breathing from the waking state to the sleeping state. My suspicion is that the flurry of CAs at the beginning of the night (and maybe at the beginning of your final session) are sleep-transition CAs. I wouldn't worry about them at this point.

To my eye, what is most striking is that you have long gaps in therapy. What was responsible for those intervals? Also, does the total using time of 5+ hours indicate how long you spent in bed? Most people need at least 7 hours of actual sleep, and some need 8 or even more.

[Gary1of2]

Have patience.  It can take weeks to months to show a difference.  Doesn't happen over nite.

[rev0lted]

Dormeo,


Thanks for the answer and the explanations. The gaps are when I took off the mask at night, went back to sleep, woke up again and put it back on. My goal is to sleep through the night with her to see if I see any benefit, but this is difficult at the moment. Do you think that using apap can influence the sleep test?

[Dormeo]

I think no one is completely certain whether using the machine right up to the last minute can distort test results, but there are suspicions that it does. And if you're used to using it, at the very least the change could disturb your sleep.

[Gary1of2]

If your taking it off in your sleep.  Try watching AR reading several hrs with it before you go to bed.

[Geer1]

When I had a follow up sleep study they recommended sleeping 3 nights without PAP prior to the sleep study.

You are having the odd central apnea but that isn't uncommon when starting PAP treatment. It is your brain trying to figure out what to do with the extra air being supplied and its first thought is that it doesn't need that much air so it will just take a break from breathing for a few seconds. Eventually your body may realize that the extra air is good and the centrals may stop. In short at this point there is nothing to worry about unless they get noticeably worse or are still present in a couple months.

As Gary stated it can take weeks/months to really see benefit and it literally took me a couple weeks before I felt like I was actually sleeping as good as I did before I started PAP. Key now is to make it a habit, get comfortable with wearing the machine, sleep full nights with it and then your body will slowly adapt.

[quiescence at last]

There is a recognizable pattern of flow restrictions that come and go, so it is likely those would have spawned actual obstructive apneas at much lower pressures.

If you want to be assured of that, then set your machine to a very low pressure that will not assist you in breathing, but will record what happens. I would never suggest this for a treatment option, just a poor man's way to record sleep disturbances without treatment.

So, if you are game, set min pressure to 5, max pressure to 5, and EPR to 1.  I would not advise lower, as I think it would cause unintended disruptions you would normally not have when not using the gear at all.

Whatever you do, please keep us informed and post post post.

QAL

I will predict that your OA will go to 15 or above per hour and the CA will mostly go away. Award me a prize if I am right.