Pugsy wrote: ↑Sat Apr 21, 2018 8:05 am
It's not so much the machine couldn't determine OA or central but the fact that this particular model of machine simply doesn't distinguish between central vs obstructive apnea. One of the things I don't like about these high end ResMed machines.
We assume obstructive but can't prove it. Even in cpap mode it doesn't use FOT to decide open vs closed airway. You get UA flags.
I know because I had this machine to try and tried cpap mode.
Central apneas and obstructive apneas all get tossed in the generic "Apnea Basket"...so you get AI without any sub categories.
AHI is composed of AI plus the hyponea index and not the usual 3 categories.
If using ResScan it would be called "unclassified".
The hyponeas...most likely obstructive but would not be totally impossible for them to be central in nature.
And if obstructive most usually IPAP is what we look at but there's more than one way to obtain more IPAP than just increasing IPAP all by itself.
If we increase IPAP alone that increases PS and more PS might cause too much carbon dioxide blow off which could potentially make centrals worse.
If it were my report I would be increasing IPAP but I would do it by increasing EPAP so that it pushes IPAP up and not mess with PS.
All this after I zoomed in on the hyponeas to try to make sure they looked obstructive in nature and not central.
If new to therapy...and I assume has a follow up visit with the sleep doctor scheduled sometime soon...I would make sure that these results are brought to the attention of the sleep doctor.
If no follow up appointment is on the books for anytime soon...I would call them up and make one.
These settings aren't optimal and some adjustment is necessary. Ideally the sleep doctor should have his thumb on things and not let this slide.
UPDATE I increased the EPAP from 10 to 10.2, and continued the IPAP at 15.2.
The average AHI for the previous pressure of 10 and 15.2 was 8.92. The average AHI for the pressure 10.2 and 15.2 for the last 37 days was 5.52. The improvement of of about 3.4 per night with no mask or pressure discomfort was welcomed .
Attached is a AHI summary for the last 30 days, and a event detail for 2 very different days. I've been trying to find a reason for the wide range of the AHI. I'm looking at timing of meds, naps taken, fatigue level, meals, or anything else that could improve it. (50% of days below 5 and 33% below 6 with some high numbers mixed in) Is a range for 30 days between .9 and 12.5 considered normal?
I do have an appointment with my sleep doctor in 5 weeks. I was hoping that I could tweak the pressure one more time to establish a better AHI record before I see him. I was thinking increasing EPAP to 10.3 and continuing the IPAP at 15.2?
And finally, although it should be obvious
, what is the abbreviation PS? Thanks for your patience and help.
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) with a wall of very large heavy pillows behind me. It isn't totally effective, RLS(controlled with pramipexole) sometimes wins the fight.