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+--- Thread: [Treatment] One year in, need a reality check (/Thread-Treatment-One-year-in-need-a-reality-check)
One year in, need a reality check - BuzzaJim - 03-30-2024
I’m just 13 months into Bi-level PAP therapy and would appreciate any suggestions. My first year follow-up with the sleep doc is coming up in a few weeks. In that period I’ve made several slight changes to my settings based on suggestions given to others on this forum. These changes all fall within ranges prescribed by the sleep doc. I just didn’t bother with the DME.
I’ll avoid a lengthy version of my medical history and just say I came to CPAP and this forum because Afib was reoccurring with increasing frequency. I’d made all the recommended lifestyle changes, got my weight under control with a better diet and was exercising like a fool. I had two ablations in three years. After exhausting everything else the cardiology center suggested we look at sleep apnea as a trigger. It was last on their list.
The diagnostic sleep study indicated my AHI was only 14.8 but I had desaturations as low as 72%. Two months later they did the titration sleep study and I had the best sleep in years. I set a personal best during my morning workout when I got home. I could hardly wait to get my own machine. That’s when I discovered this board.
Things have gone pretty well this first year. I’ve always had nasal congestion and that worsened after starting CPAP. Flonase and frequent saline spray help but not enough. Recent turbinate reduction has been a tremendous improvement. Hopefully, I’ll have a better chance finding a more comfortable mask.
I attached a screenshot of my most recent sessions. The AHI is well below 1, but I still keep waking up about every hour or two. I rarely have a night over one and began therapy below 5. I think this has mostly been because I’ve managed to train myself to sleep on my side. From my experimenting, my AHI would be serious on my back.
My concern is with the AHI that low, the sleep doc will think the numbers are good, he’s done his job and tell me his office will be contacting me for the next appointment. My heart may have settled down and I’m waking more rested, but it’d be nice to sleep for longer periods.
Is this as good as it gets? What other things can make a person wake up every few hours?
Other settings:
Ti Max 2.0s
Ti Min 0.5s
Trigger High
Cycle Med
I think I made a change to trigger that resolved CAs.
RE: One year in, need a reality check - PeaceLoveAndPizza - 03-30-2024
During your sleep study, did they note any movement? Things look good from a settings perspective, so looking at possible causes for the arousals e.g. periodic leg movement or hypnic jerk syndrome may be the next step.
RE: One year in, need a reality check - BuzzaJim - 03-30-2024
Thanks for the question.
Under “Myoclonus Information” it lists PLMS Index to be 38.4. It also has Interpretation that says something about having a high PLMS index, but not endorsing symptoms of RLS.
There is also a statement that “Clinical correlation is recommended”. Nothing was ever said about it and I was elated with the improvements to my heart rhythm. Not sure how to apply to my situation.