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Still many apneas on CPAP - MacLeodZ - 05-23-2024
Hi, I'm new to the forum, 29yo male. I had a sleep study and was told since I have mixed apneas, that CPAP was probably not going to work and that I should rent my machine since I would be switched to something else after a follow-up study. I haven't received a sleep report from the original study and the letter to my doctor only said that I had a "number of central sleep apneas the night he came in" but did not specify how many. My AHI then was 48.6.
I've had long covid for 3.5 years with my primary symptoms being POTS (postural orthostatic tachycardia syndrome), fatigue, and shortness of breath. Congestive heart failure was ruled out in 2021.
My LC symptoms had been improving but since starting CPAP my fatigue has worsened and I'm getting shortness of breath in the day much more frequently than before starting CPAP. As predicted, the CPAP hasn't resolved the apneas - mean AHI over the past 5 weeks has been 15.7 and 22% have been above 20. The vast majority of reported events are CA. My follow-up appointment to discuss the 2nd sleep study and hopefully switch me to BIPAP-ASV isn't scheduled until September (which means another $300 in rental fees!). I've asked to be put on the waitlist for a cancelled appointment. There's been no discussion about testing to better understand the underlying mechanism and rule out any comorbidities so I reached out to my cardiologist (who is seeing me for the POTS) and my family doctor to move forward with that.
After one month with no relief, I played around with the minimum pressure on the machine (originally set at 6.4) - setting it higher (7.6) made things worse, so I then tried lower (4) which has only been for 3 days but so far hasn't helped and feels a bit uncomfortable.
The machine is reporting high levels of CSR. I've attached a zoomed in image showing my breathing pattern while falling asleep vs during a window where CSR is reported. The two images don't look strikingly different??? That said, there's definitely a correlation between high AHI and high CSR over the past 5 weeks. Would like to know what people think that breathing pattern is and if anyone has any advice for anything I can do while waiting for a switch to another machine.
Thanks
RE: Still many apneas on CPAP - Jay51 - 05-23-2024
Welcome to ApneaBoard. I don't see anything that could help with your current machine or set up (you have a lot of CA's at high pressure, and a lot of CA's at low pressure). The best thing to do seems to be wait of the sleep study for bipap/asv.
That said, I remember one member who was in a similar situation and set his machine to straight cpap (no moving apap range). He had decent results. You may not. You could try a static 10 or 11 or even 9 or so just to see what happens.
If anyone sees any other way to optimize therapy with this current machine, please post.