06-12-2023, 11:54 AM
Treatment-emergent CSA happening 1 year after being on BIPAP-ST?
I got a diagnosis with OSA over a year ago. The doctor noticed that centrals started happening after they gave me PAP therapy during the night of my polysomnography. Because of this they prescribed me with a Resmed Aircurve 10 ST with pressures of 12.0 and 8.0 and gave me a backup rate of 10 breaths per minute to fight the centrals. My AHI has averaged at about 1.0 in the last year and I've felt pretty good (better than before). I just did a 1-year follow-up appointment (the first follow-up appointment since they put me on PAP therapy) and the doctor noticed that there didn't seem to be any centrals happening anymore after looking at the SD card data and decided to remove the backup rate making the assumption that my brain has adjusted to PAP therapy. This was only 3 days ago. My AHI has now tripled with last night having an AHI of 3. The AHI is getting worse everynight. I looked at the oscar data and these "flatline" events are happening all throughout the night now (not in clusters) and seem to be getting more frequent each night. See picture attached.
The algorithm is not calling these CSA events (or open airway events, more specifically), however those are pretty apparent CSA events to me? I just completely stop breathing. My typical hyponena events look like this (see other picture attached).
If any other OSCAR data is needed I can attach more screenshots.
These flatline events hardly happened before the settings change.
So first of all, is this TECSA re-emerging like with my initial polysomnography? Just trying to get a second opinion here. I won't get another appointment with the doctor for a little while and I'm wondering if I need to take the machine back in to get the settings reverted by a tech or if I need to wait this out and see if I adapt and my brain starts learning to breathe again by itself without a backup rate. I've noticed a marked decrease in energy (mentally and physically) and my sleep app for my Apple watch seems to think my deep sleep quantity is taking a dive since the settings changes. Does anyone have any experience or information on TECSA clearing up or should my brain not be doing this after 1 year of PAP with a backup rate?
The algorithm is not calling these CSA events (or open airway events, more specifically), however those are pretty apparent CSA events to me? I just completely stop breathing. My typical hyponena events look like this (see other picture attached).
If any other OSCAR data is needed I can attach more screenshots.
These flatline events hardly happened before the settings change.
So first of all, is this TECSA re-emerging like with my initial polysomnography? Just trying to get a second opinion here. I won't get another appointment with the doctor for a little while and I'm wondering if I need to take the machine back in to get the settings reverted by a tech or if I need to wait this out and see if I adapt and my brain starts learning to breathe again by itself without a backup rate. I've noticed a marked decrease in energy (mentally and physically) and my sleep app for my Apple watch seems to think my deep sleep quantity is taking a dive since the settings changes. Does anyone have any experience or information on TECSA clearing up or should my brain not be doing this after 1 year of PAP with a backup rate?
