my first report, ahi down to 15, is cpap working?

[chicken]

my resp rate went up around the same time as the OA'S

[Walla Walla]

To one of the Advisors. I'm just tagging along trying to learn something. Looking at the chart above why wouldn't a collar help with the OA's and how do you tell it's central?

[pholynyk]

Hi WallaWalla, first off, all of us so-called Advisors are really advisors about the running of the Apnea Board, not apnea advisors... However, most of us have been around for a while, and are quite willing to pass on whatever we have learned; just don't think of it as medical advice - it's just our experiences.

With that out of the way, I'll try my hand at your questions. The increased breathing rate and greater variability indicate to me a period of REM sleep, which is often accompanied by more obstructive events. Notice also, in this case, that the pressure is at its maximum. The usual fix in this case is to increase the max pressure; that's the whole point of using an APAP. Just why there are more obstructive events during REM sleep is a mystery to me, but increasing pressure usually cures it. I don't know if a collar would help during REM sleep.

As for telling a central (or clear airway) from an obstructive event, usually we just rely on the machine's flags... But a close-up examination of the flow graph will reveal (in the easy cases) that an obstructive event usually ends with a large, sharp inhale, while a central event usually ends with a resumption of the previous steady  breathing. Roughly speaking...

[Walla Walla]

OK, Thanks for taking the time to answer.

[chicken]

[Walla Walla]

Wow! Now I know why the talk about Clear Airway's and Periodic breathing.

[chicken]

THE last screenshot is from a different day, just wanted to get a screenshot of lots of ca's.
i am going to try the 11/13 range then if i have high OA'S ill try a 11/18 range.

[quiescence at last]

I noticed that the night of Jul 17 had very little CA events, I hope that is a trend starting.  Many have shown more CA present at higher altitudes.

Congrats on getting imgur stuff and posting done.  Sweet success!

Charting changes you may consider -

changing your y-axis default high and low values can make better use of the space, make each day easy to compare to others, and allow narrower bands for each data type (flow rate, tidal volume, resp rate, etc.)

I suggest flow rate axis at -60 to +60, tidal volume at +200 to +700, resp rate at +6 to +26, insp time and exp time at +0 to +6.

picking pressures - you mention possible setting change from 11/13 to 11/18.  I would suggest better changes are slow and those that adjust the minimum, such as from 11/13 to 12/14.  Have you considered changing the ramp start pressure?  You have gotten used to the feel of higher pressures now.  I have a min pressure at 10.5, but have my ramp at 9 cm.  I rarely use the ramp button.

Good luck!

QAL