Tried CPAP while waiting for sleep study, need help to understand OSCAR results

[jovaton]

Hey everyone! 

My name is Jovani, 27yo. 

About a month ago, while talking with a good friend, I told her that I usually feel tired during the day even when I sleep 7 / 8 hours. 

She told me her story with Sleep Apnea. She was diagnosed 10 years ago when she was 18, and it was a huge psychological shock for a bit. She was healthy and wasn't overweight, but always felt tired, and it was easy to fall asleep during the day. It took her a few days to get used to the CPAP, but after that, fell in love with it and never felt so energized before. 

She recommended me to record my sleep for a few days to see if I snored and stopped breathing during the night. I did, and I was quite surprised that I snored more and louder than I expected. Thankfully, I didn't seem to stop breathing, at least on the parts of the recording we listened, but recommended me to consult a doctor anyway.

After some tests, I was told to do a Sleep Study, but it won't be until Dec, 15,

Talking again about the topic with my friend, she told me she had a spare Auto CPAP barely used and asked if I would like to try using it for a few nights and see how it goes. I wasn't sure, but I didn't lose anything to try, so she helped me to get a new mask for a good price and teach me how to use the CPAP.


On the first night. We set the Pressure between 8 and 20 and a mode called A-Flex at Level 1. I had a hard time falling asleep and woke up a few times, suffocating. We checked the results on OSCAR and my AHI was 9.40. Had many Clear Airway and Hypopnea. She advised me to disable the A-Flex to try to improve the Clear Airway events.

   



The second night was a lot better. Falling asleep was much easier, and the only problem was that woke up one time suffocating. With the A-Flex disabled, didn't have a single Clear Airway event, and my AHI went down to 2.53.

   



The third night, I decided to increase the Min Pressure to 9. It was a pretty good night, but woke up once suffocating and decided to increase the Min Pressure to 9.5 for the second half of the sleep. 

   



The fourth night suffocated once again, but overall it was a pretty good sleep. Increased the Min Pressure to 10 for the second half of the sleep, and my AHI went down to 0.30.

   


I decided to stop using the CPAP after the fourth night and wait for the sleep study. I don't think it was a bad experience, and actually felt like I rested a bit better, even with waking up suffocating once every night. 



What do you think of the experiment I did and the data I posted? 

Given that with CPAP I had 22 Hypopnea the first night and 17 on the second night, can I assume that I might have many more than that when I sleep without CPAP? Is it dangerous?


Thank you!

[mesenteria]

We'd really need to see the titration results suggested by a sleep lab.  As things stand, your largest obvious changeable parameter is the leaks.  They are frequent and sizeable to the extent that what we see in the report is almost meaningless.  The mask might be inappropriate, the fit might be horrible, you might be a mouth breather, the machine might be unsuitable for the type of apneas you have, or will have as the months of treatment go on....where do we start?

Your results show the machine you're using topping out near 13 cm H2O, with a lower limit of 5.5 and on up.  Those numbers will almost certainly change once we have a better idea of 'what's wrong, or going on.'  I do see that there was substantial improvement in the latter couple of reports.

When you felt suffocated, was that due to central apneas? How can you tell?  Or, was it due to mouth-breathing and poor/no real therapy?  Was it due to insufficient pressure support at the lower end?  A sleep study should help us out there.  Or, were you stuffed-up?

[Sleeprider]

Looks like your best pressure with the Philips was at 9.0. I'll disagree with mesenteria that leaks are a problem. The Philips data shows both total leak and excess leak, and the excess leak is actually quite good. When pressure was below 9.0, most events were hypopnea, and that mostly resolved as pressure was increased and you adapted to CPAP therapy. It will be interesting to see your diagnostic results when you get a sleep test, but it appears CPAP has some pretty significant benefits for you. If you have a choice when it comes to selecting a machine, the Resmed seems to be more comfortable to most people because it uses exhale pressure relief (EPR) which is much more like bilevel pressure than the Philips Flex. This seems to have a positive effect on hypopnea and flow limitation, so I'm certain you would find the Resmed more comfortable and effective.

[jovaton]

Looks like your best pressure with the Philips was at 9.0. I'll disagree with mesenteria that leaks are a problem. The Philips data shows both total leak and excess leak, and the excess leak is actually quite good.  When pressure was below 9.0, most events were hypopnea, and that mostly resolved as pressure was increased and you adapted to CPAP therapy.  It will be interesting to see your diagnostic results when you get a sleep test, but it appears CPAP has some pretty significant benefits for you.  If you have a choice when it comes to selecting a machine, the Resmed seems to be more comfortable to most people because it uses exhale pressure relief (EPR) which is much more like bilevel pressure than the Philips Flex.  This seems to have a positive effect on hypopnea and flow limitation, so I'm certain you would find the Resmed more comfortable and effective.

Thank you for your kind reply, Sleeprider. I'll definitely post the diagnosis from the sleep study as soon as I receive it next month. 

My doctor told me that with my symptoms it's quite probable that I have Sleep Apnea, the only problem was that I would have to wait 2 months for an in-lab Sleep Study… 

I only used the CPAP for 4 nights because I wasn't trying to self-diagnose myself, and I prefer waiting for a proper diagnosis. In that short time, I couldn't feel a big improvement in my lack of energy during the day, but I certainly felt that on the 3rd and 4th day I was resting a little better than I normally do. It also helped me to be less anxious about it. Adjusting to sleeping with a CPAP was much easier than I expected.

About the machine, my friend also recommended the Resmed. She actually uses a "Resmed AirSense 10 for Her" and says it is much better than the Respironics she lent me and uses when she travels. 


Thanks, stay healthy!