any advice greatly appreciated

[sue60]

Hello,

I've been on therapy 3 months now. I hope someone can give me some insight as to why I am still having high AHIs and what I might try. They vary wildly from 1 to 52. Only about 10% of them are below 5, so 90% of the time they are not in the therapeutic range. I do not seem to have much OSA ever but mostly central. Am I right in seeing I'm better early in the night when my pressures are low? Are the higher pressures causing the central events? Is sleeping on my side causing the events? The MD said I had no central events at either of 2 sleep studies. She asked what was different from those nights and only thing I could think was I took Ambien both nights that she prescribed for study nights only and that they forced me to sleep on back and this showed enough OSA to put me on therapy. I am going to try sleeping in a recliner tonight to see if sleeping on my back changes the numbers any. I feel like I need to try something different or she will send me for yet another sleep study I 'm guessing. I am not comprehending how this all works yet so I am afraid to make any changes without advice. Thanks anyone-

Here are some screenshots from last night

http://imgur.com/a/kM9Ue

Susan

[LSAT]

It appears that your problem is with Central Apneas. You should be specifically checked for that. You may need a different machine since the CPAP you have does not eliminate Centrals. Changing pressures may not help.

[lilly747]

To take a better screen shoot try this:

Here, in order, will show you how to take sleephead images and post them tof Captalk.com:

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/resources/sleepy ... screenshot
https://sleep.tnet.com/reference/tips/imgur

[palerider]

and, give us a zoom in between 1:00 and 1:05, please.... in the format that Lilly suggested.

also, turning down EPR may help.

[Wulfman...]

When you had your sleep studies, did they come up with a specific pressure that treated you?
I guess what I'm wondering is how did they come up with a pressure range of 4 - 10 cm. ?
Something isn't right with your setup, machine or "whatever".


Den

.

[lilly747]

It appears that your problem is with Central Apneas. You should be specifically checked for that. You may need a different machine since the CPAP you have does not eliminate Centrals. Changing pressures may not help.

LAST is right. If you have been on APSP fpe 3 months it is time to be checked out for centrals. Is your machine set wide open?? 4 or 5 to 20?/ Pressure changes can cause centrals in some people and your pressure making wild swings.....

can you post some better shots of your data, see post above...

[sue60]

Yes , the machine is just set to default of 4-20, I started with EPR off but the air swallowing made it intolerable so I turned it on at 3 and now down to 2.

I reordered the graphs as asked I hope- and zoomed in on 1:00 to 1:05

http://imgur.com/a/pjG1v

Thank you all for your time and input-


Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 10.37 4.00 10.68 13.40 14.48
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.02 0.00 0.00 0.14 0.44
Leak Rate Rate of detected mask leakage (L/min)
W-Avg: 0.77 0.00 0.00 3.60 40.80
SnoreGraph displaying snore volume (?)
W-Avg: 0.00 0.00 0.00 0.00 0.44

[lilly747]

Yes , the machine is just set to default of 4-20, I started with EPR off but the air swallowing made it intolerable so I turned it on at 3 and now down to 2.

Your doctor should have his/her head put in a vice, and squeezed........

Wulfman and palerider will be able to help you....hang in there...but those centrals need to go, setting up in a chair won't help.

[Wulfman...]

Let me try again.........
If you had a sleep study, how is it you're using an APAP machine with wide open settings?
Usually sleep studies are supposed to find an optimal pressure setting.
Did you get a prescription with a pressure setting written on it?


Den

.

[sue60]

I did have a first sleep study and then a titration study. Both studies only mentioned OSA with 17 events per hour. The titration study said pressure was initiated at 10 and then increased to 15 where the events went to 0 per hour. Again, centrals were never mentioned. I was also using a Simplus mask those nights. My sleep doc never set a prescribed pressure, she said the auto machine would take care of it. I had to show her I was having centrals on the last visit and all she recommended was changing masks and come back in 6 weeks. I have a feeling that if I had not said anything and showed her the graphs ; she would have said all was great and come back in 6 months

This is all new to me and if not for reading posts on this site would I even know that I should be concerned. I thank you all especially the creator of sleepyhead and for all on this site who care to respond to folks like myself that are so new to it all. Does anyone think I should I start adjusting the pressure settings or have another sleep study?

[Julie]

You need to get a copy of the sleep study from your MD - not just the summary - and it's yours by law. Once you get it, can you cover personal info and post it the same way you did the graphs so we can take a look? It's also important to know e.g. if the 'centrals' are in fact happening all night, or just a few when you're falling asleep and then on awakening (those would be normal), or what's actually going on, and what you did show from SH is incomplete (take a look at samples others have posted - but do leave out the calendar on the top left).

[Wulfman...]

I did have a first sleep study and then a titration study. Both studies only mentioned OSA with 17 events per hour. The titration study said pressure was initiated at 10 and then increased to 15 where the events went to 0 per hour. Again, centrals were never mentioned. I was also using a Simplus mask those nights. My sleep doc never set a prescribed pressure, she said the auto machine would take care of it. I had to show her I was having centrals on the last visit and all she recommended was changing masks and come back in 6 weeks. I have a feeling that if I had not said anything and showed her the graphs ; she would have said all was great and come back in 6 months

This is all new to me and if not for reading posts on this site would I even know that I should be concerned. I thank you all especially the creator of sleepyhead and for all on this site who care to respond to folks like myself that are so new to it all. Does anyone think I should I start adjusting the pressure settings or have another sleep study?

You're also another one of those lucky souls to have a clueless doctor. (I think that's three tonight)
In many cases, a wide-open pressure range is a recipe for disaster. The minimum pressure should be set to where it prevents most all of the events.......at least in the category of "Obstructive". Centrals are somewhat of a different ballgame.

You might try a straight pressure of 15 for a few nights and see how good or bad that looks.
It's hard to tell if these "centrals" are the real thing or not.

That's about all I can suggest at the moment.

Do you know how to get into your machine settings to change things?


Den

.

[palerider]

I reordered the graphs as asked I hope- and zoomed in on 1:00 to 1:05

please use the f12, take screenshot button, instead of cropping out the important left panel.

and could you give us 1:00-1:15?

have you seen a cardiologist lately?

[palerider]

It's hard to tell if these "centrals" are the real thing or not.

as opposed to?

[sue60]

I do know how to go in, are you suggesting it go from auto to cpap? Or could I set it auto 10->15, would that be comparable? The ramp is also on for auto.
Thanks again, I know I need to try something different-