+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: New to this all.. have a question (/Thread-New-to-this-all-have-a-question)
New to this all.. have a question - OnlyOnTuesdays72 - 07-05-2023
Hello! I'm new to the cpap game. I was dx'd with severe sleep apnea in early June (suspect I've had it for many many years now). I am 38 years old. I downloaded the OSCAR program and I noticed a new little flag come up along the side. Now it's got something about CSR. Which apparently I had last night. At my hospital based sleep study I had an AHI of about 44.3. The first night of cpap therapy I had 12.64, and its been going down. Its trending around 5.5 or so the past few days. (I have the airsense 11)
Majority of my apneas are central ones. Should I be concerned? I've been faithful to this machine since last week when I got it. And I've noticed a huge difference. I have tried so many antidepressants and still felt tired. I am not moody, I actually wake up and do things (I've been busting my butt cleaning and stuff.), and dont feel like I need to crash mid day. If I do, I wear the cpap (I think once I took a nap, that was the day I woke up at 5 am and couldnt get back to sleep lol).
also last question, I am going camping for a week starting tomorrow. Will my DME freak out about not receiving data from the machine? Should I send a message and let them know I'll be camping somewhere with zero service?
thank you for any and all information!
RE: New to this all.. have a question - OnlyOnTuesdays72 - 07-05-2023
Adding last nights oscar report for good measure
RE: New to this all.. have a question - Sleeprider - 07-05-2023
This forum hosts a free software called OSCAR (Open Source CPAP Analysis Reporter) linked at the top of this page https://www.sleepfiles.com/OSCAR Download and install the program, and use the SD card in your machine to upload the sleep data. You can then post screenshots of your actual results, machine settings and respiratory statistics. Tutorial links are in my signature below to learn how to organize your Oscar Data and post attachments to this forum. We can use that information to help you to optimize your therapy.
A CPAP is not intended to treat central apnea, which is often accompanied by periodic breathing where you alternately hyperventilate and hypoventilate. Resmed CPAPs all label this periodic breathing as CSR (Cheyne-Stokes Respiration), however that label is usually erroneous. It will be very helpful to see a copy of your sleep study results with any personal information redacted. We want to see if central sleep apnea was a feature of your sleep disordered breathing before therapy, and of course see the Oscar data to see the severity of what remains. It is fairly common, and some central apnea is seen is most people, but moderate or severe central apnea is somewhere between 5% and 15% of individuals using positive air pressure therapy. There is a specific bilevel therapy called adaptive servo ventilation (ASV) that specifically treats central and complex (mixed obstructive and central) apnea and periodic breathing. I would like to see your test results so we can judge how to proceed with your doctor if needed.
I would not worry too much about missing a couple days of therapy and being off the grid. There are portable machines that run on battery power. Compliance means using your machine for at least 4 hours in at least 21-days out of 30 days (70% use), and that can be any consecutive 30 days in your first 90 days of therapy. Missing a few days won't affect that, but a week will cancel compliance for the current 30 day period. Discuss with your DME, or find a way to miss less than a week.
RE: New to this all.. have a question - OnlyOnTuesdays72 - 07-05-2023
Thank you for responding! I appreciate any and all tips.
Attached is the sleep study report
RE: New to this all.. have a question - OnlyOnTuesdays72 - 07-06-2023
Added my sleep study for ya
RE: New to this all.. have a question - Jay51 - 07-06-2023
Thank you for posting your sleep study. Sleeprider explained everything in his post, and he may want to comment further also. Your sleep study did say you had a lot of centrals. Also, with bipap, centrals increased. The same thing happened with my sleep study.
You are probably going to fail your current sleep apnea machine (because of too high centrals and AHI). That is a good thing. Get in the required time like Sleeprider said to show your Dr. I read where they may do another titration with you with Avaps (it said this on your sleep study). I have avaps. It looks like they may know what they are doing here - doing another advanced titration if your current machine fails. Sleeprider mentioned the ASV. A machine with a back up rate should in theory reduce or totally eliminate your centrals. Both ASV and avaps have back up rates.
I went through a similar process failing at one machine in order to get moved up to a higher level of machine. It just takes some patience, but then insurance picks up the tab.
Another other questions just ask.
RE: New to this all.. have a question - Sleeprider - 07-06-2023
I agree with Jay51, but when the time comes to evaluate advanced PAP, you should push for ASV (adaptive servo ventilation) rather than AVAPS.(Advanced volume assured pressure support) aka iVAPS from Resmed. I rarely see members achieve successful comfortable therapy with AVAPS/iVAPS. It is intended to serve as a ventilator for advanced pulmonary disease, thoracic neuro disorders and hypoventilation. ASV on the other hand works on a breath by breath basis and facilitates spontaneous respiration (using your own voluntary effort) and providing pressure support only when respiratory volume is insufficient or respiratory effort is not present.
Because this is eventually going to be an issue, I'm going to give you some homework. This link will get you the Resmed Clinical Titration Guide. It is written is fairly understandable language, and describes the differences of all the different positive air pressure (PAP) devices, and the conditions that they are intended to treat. I want you to focus on ASV and iVPAP or the ST-A. Not the health conditions and breathing disorders the manufacturer has designed these devices to treat and how they use pressure support to achieve that objective. Feel free to ask questions. This will help prepare you for a much more informed conversation with your doctor when the time comes to move up to an advanced bilevel device capable of treating both your obstructive and your central apnea. https://document.resmed.com/en-us/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
RE: New to this all.. have a question - OnlyOnTuesdays72 - 07-07-2023
I really appreciate both of your answers and I'm downloading that link. Is that machine harder to get used to VS the cpap?
RE: New to this all.. have a question - Sleeprider - 07-07-2023
ASV has a lot more pressure changes than CPAP. Some find this disruptive but it fully resolves apnea. There is definitely a period of adapting to this therapy but most who need the therapy do well with it.
RE: New to this all.. have a question - Sleepster - 07-07-2023
(07-05-2023, 08:36 AM)OnlyOnTuesdays72 Wrote: Majority of my apneas are central ones. Should I be concerned?
No. As you adapt to CPAP therapy your CA index should drop. If it doesn't, you can be concerned then.
Quote:I am going camping for a week starting tomorrow. Will my DME freak out about not receiving data from the machine?
No. When you plug in somewhere that has cell service the data that was collected during your camping trip will be uploaded.