Machine Diagnoses

I believe my sister might have sleep apnea. I’ve advised her to have the matter checked. However there is so much going on in her life that she’ll probably put this indefinitely on the back burner.

So I’m thinking of pushing the issue, thusly:

(I use a BPap Asv machine at home and my old CPAP machine on the road.) I have an extra CPAP machine (with a card). I’m thinking of sending it to her (with mask, etc); asking her to use it for a while; and then having her send me the data on the card (or the card itself, if she doesn’t have a reader). I figure that by reading the data I can get a good idea, supported by evidence, whether she should further pursue the issue.

The CPAP machine’s set to: Auto CPAP Mean: 5.9; Auto CPAP Peak Avg: 7.5; Avg Device Pressure: 6.9. I understand these settings to be close to the norm. (If anyone has more appropriate “norm” settings please let me know.)

My questions:
1) Can (continuously, say every night for a month) using a CPAP machine cause a person who does not have sleep apnea any harm?
2) Is reading the results of this machine use of any value in ascertaining if that person does have sleep apnea? If not, why?
3) (Out of curiosity) If Sleepyhead reports Central occurrences (as well as Obstructive occurrences) is that an indication that the subject does have Central Sleep Apnea?

AfibApnea wrote:Auto CPAP Mean: 5.9; Auto CPAP Peak Avg: 7.5; Avg Device Pressure: 6.9.

These aren't settings...they are just pressure results from your own therapy.

Which brand and model APAP is this machine?

Answers to your questions.

1...not unless she has some unusual problem especially some prior lung disease. Contraindications are shown in the provider manual for all machines
2...it depends. It's usually pretty easy to spot OSA when the machine increases the pressure in response to what it senses that it needs to prevent. The machine won't increase the pressure if it doesn't think there is a reason to increase. The only caveat to this is that the machine can't go lower than 4 cm pressure and while that is a relatively low pressure it does have some therapy value and if she has OSA AND she happens to be someone who only needs 4 cm to hold the airway open then it is possible (at least in theory) for someone to have OSA and that 4 cm pressure be enough to get the job done and the machine won't increase the pressure. The chances of this are slim though. Most people are going to need more than 4 cm pressure.
3...The presence of a few centrals being reported doesn't necessarily mean that central apnea is involved.
Some centrals are just normal and to be expected. The Central Sleep Apnea diagnosis comes about when someone has a lot more than the normal number of centrals....like over 5 per hour.

Which brand and model APAP is this machine?

Philips Respironics System One (60 Series)
RemStar Auto with A-FlexModel 560P - P094670371FB2
PAP Mode: APAP (Variable)
Min 5 Max 8 (cmH2O)

AfibApnea wrote:Min 5 Max 8 (cmH2O)

If I were thinking about doing what you are thinking about doing I would set the machine to 4 cm minimum and 10 cm maximum and see where the machine wanted to go and if it wanted to go somewhere.
Then evaluate the pressure line on the software graphs to see if it did anything beyond the normal little spiky test pressure probes.

So the first thing I would do would be to try to establish the need...then worry about fine tuning the pressure if it needs it.

I actually did this to my sister and her husband...her pressure never increased or varied at all but with her husband it went to 9 cm and stayed there pretty much all night.

I applaud your desire to help your sister. While an auto machine can be very useful for diagnosis, the toughest part is always the mask and this varies for each person. You can see the results for the poll I recently posted here: viewtopic/t104873/viewtopic.php?f=1&t=104522

My point is that adjusting to sleep with a mask can be very difficult when first starting out. How about trying another approach? There are apps for both android and iphone that attempt to detect sleep apnea. Do you think you could get her to try some of those?

Another low tech approach is a simple voice recorder left running next to the bed. This is the approach I used to self-diagnose many years ago. You can hear the breathing stop and gasping and snorting as the person starts breathing again. It is very pronounced for many people and can be a great motivational tool.

Also, have you had her take some of the many online sleep apnea questionnaires? These can make some people realize that they have a problem when they recognize many of the symptoms in themselves.

Good luck!

Thanks for your reply, yaconsult. I'd never considered looking for a Droid or iphone app because those apps fail abysmally where my afib is concerned!

She'd come over for a week and I was able to hear some kind of violent snort (not snoring) occasionally (from the other room!). It was if the snort marked a moment when she was 'coming back' to breath.

AfibApnea wrote:

Which brand and model APAP is this machine?

Philips Respironics System One (60 Series)
RemStar Auto with A-FlexModel 560P - P094670371FB2
PAP Mode: APAP (Variable)
Min 5 Max 8 (cmH2O)

After reading the stuff on this forum for a while, I have concluded that many of us have diagnosed ourselves. Either when we first started and certainly thereafter. I did exactly what you are thinking of doing to myself. I have a few friends who have done the same thing. My pressure went from 4 cm to 9 cm with an AHI of 3.8. Adjusted for the time I was awake gave me a result of AHI=4.5. So I definitely have it. Since then I have continually monitored myself with the help of this forum. I believe that the best test is to get a machine for about a month and monitor the results. Sleep tests can only give what happened that night. A month of monitoring can give the entire month and you will see how she feels after a few days.

AfibApnea wrote:Thanks for your reply, yaconsult. I'd never considered looking for a Droid or iphone app because those apps fail abysmally where my afib is concerned!

She'd come over for a week and I was able to hear some kind of violent snort (not snoring) occasionally (from the other room!). It was if the snort marked a moment when she was 'coming back' to breath.

there's this for an android:
https://play.google.com/store/apps/deta ... g_analyzer

certainly worth a try... I haven't used it, everybody here is on pressurized air of some sort.

AfibApnea wrote:Thanks for your reply, yaconsult. I'd never considered looking for a Droid or iphone app because those apps fail abysmally where my afib is concerned!

She'd come over for a week and I was able to hear some kind of violent snort (not snoring) occasionally (from the other room!). It was if the snort marked a moment when she was 'coming back' to breath.

Yes, that's it exactly. I did the same thing. It is our body's reaction to lack of oxygen. The amazing thing is that it's just below our level of consciousness so we don't even know that it is happening.

Snoring, in itself, is fine when it's regular and the person keeps breathing. But those of us with apnea stop breathing and then you will hear the gasping after the airway has been cleared to make up for the time we weren't breathing. It is all of these small arousals that we are not even aware of that keep us from getting the rest we need.

Here is a great youtube video that shows the breathing while sleeping problem: https://www.youtube.com/watch?v=-gie2dhqP2c Some people understand better when they can watch a video illustration.

I frequently suggest the audio recording route to people as a harmless, cheap first step to a diagnosis. Once I listened to my recording, I knew that I had a problem that had to be solved and set things up with the doctors. I even found a youtube video of someone who did the same thing for a friend - check it out here: https://www.youtube.com/watch?v=9bFTcmREtqQ

Only you know what approaches might work with your sister. Unfortunately, many people do not realize just how serious apnea is. It's associated with high blood pressure, arrhythmia, stroke and heart failure. And we have no idea how many auto accidents it is a factor in. If she has apnea, it's very important that she get treatment. And it will greatly improve her quality of life - that's the way to sell it.