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+--- Thread: [CPAP] Can you see any problems? (/Thread-CPAP-Can-you-see-any-problems)
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Can you see any problems? - BlahBlahBlah - 05-21-2019
Hello,
I've now been three years on Resmed AirSense 10 AutoSet. I was diagnosed with an AHI of 74, consisting mostly of hypos but also obstructives. Currently my average AHI for last six months is 3, with 0.3 OA, 0.3 HA and 2.4 CA.
I had a sleep study in March while using the A10. My sleep efficiency was very low at 60%, AHI 2.5, arousal index 24, ODI3 was 13, average saturation 94% and lowest saturation 88%.
The doctor said everything's good, but the thing is I am still very tired.
What I've noticed is that my flow rate curve is not always very steady, it waxes and wanes and has some "garbage", and these are not registered as apneas. I am not sure if these are caused by some other sleep problem and me waking up or maybe these problems in the flow are causing my arousals.
Most of the nights I have some longer bouts with breathing seemingly being quite steady.
I've mostly been on 6-15 with EPR on 1. Without EPR I get air in the stomach.
I'm on my second machine and think I had sligtly better results and less leakage on my first A10 which developed a whining noise and had to be replaced, not that it makes difference.
Any ideas what is going on or if those are serious problems?
Thanks to everyone here bringing information to people!
RE: Can you see any problems? - sheepless - 05-21-2019
folks here may be able to coach you to better results. meanwhile, 1) your ahi is considered adequate treatment by the docs and insurers, and 2) if you still have ca after 3 years of apap, you might have to get a different machine that treats ca to reduce them. if you complain (assertively, do not let your complaint be dismissed) of not feeling well and continuing to feel tired and you have a responsive doc, the system might enable additional treatment for you. if not, it's up to you to decide if you will forge ahead without them. in my experience, ca leaves me feeling sick and tired.
edit: you also have some flow limitations that might respond to some setting tweaks. let's see what the more-experienced types have to say.
RE: Can you see any problems? - Gideon - 05-21-2019
Try this, only because of your complaints. You do not have RERAs, at least you are not recording any. This is to try to reduce some of the Flow Limitations and see if that is troublesome for you
Increase your Min Pressure from 6 to 7 and increase your EPR from 1 to 2.
Very important that you look for differences in your nights sleep.
RE: Can you see any problems? - BlahBlahBlah - 05-22-2019
Hello, thank you for your tips!
Do you know if ResMed AirSense detects RERAs, I've never seen one in my charts in SleepyHead and now OSCAR?
I have the USER FLAGS #1 and #2 data calculated in SleepyHead. For the last year #1 is 0.5 and #2 is 1.7.
Attached is the same day from SleepyHead with the user flags. I noticed I had slept later than noon so there's more data in the SleepyHead screenshot.
RE: Can you see any problems? - mesenteria - 05-22-2019
In order to detect RERAs, the unit must have a motion and an EEG capability, which none of them do...they're separate measurements, meaning separate devices. As in, what happens at a sleep lab.
This is not to say you can't find a way to determine if you turn a lot, especially coincident with events of a kind. If such events are also coincident with leaks of a substantial kind, which you appear to have now and then, we can be quite secure in assuming you are being at least partially awakened. That's essentially always undesirable when trying to get good therapy and decent sleep.
You can get motion detectors and position/orientation detectors. The EEG part is much trickier.
RE: Can you see any problems? - BlahBlahBlah - 05-23-2019
Hello, I got full details of my sleep study with my machine, here are some details:
When sleeping I had N1 27%, N2 32%, N3 36%, REM 4%, but I only slept for 60% of the total time. In the initial study I had no REM sleep at all.
All arousals 24/h, Respiratory Arousals 0/h, RERA 0/h, ODI 13/h.
Total AHI 3,2, Central Apneas 2,1/h, Central Hypoapneas 1/h.
I think there were two SpO2 sensors: SpO2 Average 94%, minimum 88%, averarage drop 3,7%, ODI 13/h
Sentec (this was on the ear lobe) Average 95%, Baseline 96%, Lowest 91%
PAP info:
Average Pressure 6,3
Maximum 10,3
Median 6,1
95% 9,5
As a layman, zero respiratory arousals seems like everything really is working well despite my suspicions? Though I don't understand why desaturations are 13/h.
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I tried the first night with Min 7 and EPR 2, results seemed a bit better, not sure if it gave me more aerophagia or not.
RE: Can you see any problems? - sheepless - 05-23-2019
24 arousals per hour, none respiratory. to what does your sleep study attribute these arousals?
RE: Can you see any problems? - BlahBlahBlah - 05-24-2019
Says the study doesn't tell reason for bad sleep, might be insomnia. So no reason found for arousals.
RE: Can you see any problems? - sheepless - 05-24-2019
besides avoiding the negative effects of apnea on our health, avoiding arousals is the name of the game. you might want to ask your sleep doc about it. as an example, i had_have notable arousals due to periodic leg movement but it didn't show up in the summary they gave me & the doctor never mentioned it, even after i complained of severely fragmented sleep & asked about restless legs (often associated with plm but different). probably not what's your problem as it should be noted somewhere in your sleep study but something is causing the arousals.
RE: Can you see any problems? - BlahBlahBlah - 05-24-2019
Thank you sheepless for your comment.
I have the PLMS statistics here:
PLMS during wake 54/h
PLMS in N1, 44/h
PLMS in N2, 17/h
PLMS in N3, 0/h
PLMS in REM, 0/h
PLMS Arousals, 0/h
Seems like my legs are restless but still not causing arousals? Weird.
How were your statistics on PLMS and have you found relief?