second PSG result is so much worse

[mugen4u]

TLDR: 2nd PSG research result much worse than 1st PSG and I have a few questions about this.

My first PSG examination a year ago gave an AHI of 8.2, of which 7.2 was central apnea and many waking moments in the hypnogram. 
This is the link to my first topic here from over a year ago when the results of the 1st PSG were in:
https://www.apneaboard.com/forums/Thread...shocked-me

Despite this result, I was told that the result 'is not that bad' and that my complaints are not due to sleep apnea because REM and DEEP sleep was sufficient, 
I didn't trust it because I have no mental complaints that could explain my sleepiness.
Yes, it could have been my job as a last option, but I enjoyed my job a lot, so I can't/can't/won't just quit.


Anyways, that's why I beg to be referred to another hospital for a second opinion and finally, after six months of waiting, I had the 2nd PSG a month ago and received the results yesterday.




I was very shocked because the AHI is twice as high as a year ago and several things were a lot worse than a year ago.
I was very angry because I actually had to be treated last time and it is now 1 year later and I am back to square one.
I was very sad because I quit my job 2 weeks ago 'because that's the only thing that could cause mental fatigue'.


My questions:

1: I don't understand that my AHI is twice as high as last time and that this time, strangely enough, there are a lot of obstructive apneas, how is this possible?
2: Did I have a 'good night's sleep' and the fewest possible number of apneas during my 1st PSG examination compared to other nights? 
3: Hypnogram shows a lot of awake moments, why didn't they see this in the first PSG sleep study? 
4: After my 1st PSG I bought a CPAP (Resmed Airsense 10) but despite many tips from you and adjustments and other masks I could not possibly sleep with it, not even for a minute and not even after some sleeping pills from the doctor. Since everyone (doctors, friends, family) said I was depressed, I sold the device. 
But they send me to the lung department and I'm pretty sure I'll get a CPAP machine again, but since I couldn't sleep with it then, it won't make any difference at all this time, right? Besides lots of sleepless nights?

[SarcasticDave94]

I believe "having a good night's sleep" is something you have to decide personally. Data can help decipher whether it was or not, but ultimately it's how you feel.

How are the two test results possible with differences? All these are possible: Each night things change somewhat. You might have had where Apnea Board calls Positional Apnea where you're chin tucked into your chest and externally produced Obstructive Apnea.

Also note that the CPAP you have/had can't treat the Central Apnea that were counted both tests. This too may need to be treated if you really want to get a good night's sleep. Central Apnea can change drastically each night itself.

Central Apnea treatment that's shows in the test will probably require the specialized ResMed AirCurve ASV to actually treat. Other machines will only be able to avoid some Central Apnea. This new test had 17.5 AHI of which it appears 11.8 of this was Central, at least as I'm seeing it.

All the above might be true, individually or all of them together, on why you're not getting a good night's sleep.

[SarcasticDave94]

PS your other thread indicates that ASV was discussed and dismissed by your super smart doctors. They might be wrong. Central Apnea must also be accounted for, and absolutely no to the myth that CA are only brain damage or other neurological issues. I have Central Apnea that will show up on most sleep studies I've taken. I do not have brain damage, they're idiopathic as in medically unknown cause. Just maybe yours are as well.

Get another doctor or buy the ResMed AirCurve ASV. Make sure to update OSCAR so you can track therapy. Post the results and we'll help you tune the ASV to treat.