I was diagnosed with a rather severe OSA (AHI was over 120)..
I have since gotten a CPAP (Resmed S8 Elite) and a Switft nasal pillow mask.. I am prescribed for 12cm pressure... but my AHI won't go below 6-8/hr. I have tried everything from 11cm - 13cm and can't seem to find the sweetspot.. I have tried taping my mouth shut and have had nights with no detectable leaks whatsoever.
I am still suffering EDS and am getting very frustrated. I had hoped that this woudl be the solution to all my problems (grin)..
As I am sure I live in Southwestern Ontario so it's nearly impossible to find a family doctor.. I'm stuck going to the clinc for general inquiries and went directly to the sleep doctor for diagnosis and treatment.
With the cpap, my AI is pretty much zero.. (before it was 100+) and the hyponea is still 6+ (before it was only 15-20)
I'm not mouth breathing..,, and I am sleeping most of the night (6-7 hours)..
Should I be looking into things like Thyroid function? My OSA was undiagnosed for a very long time... Could it be possible that it may take a while before my body recovers from any damage caused by lack of sleep?
I have done searches and have not been able to find anything that gives me an idea... Perhaps did i not increase the pressure enough? during my sleep study, there were only a few Central apneas detected, nothing major.. I don't want to increase pressure TOO much as I'm perscribed 12cm which they read as 11-13cm.. and the swift seems to suck at higher pressure (leaks a bit around the seals on the mask..
Again, I hate to start a new thread, but I figure there are alot of very experienced people.. just hoping someone has some ideas for me to look into..
Joe
Need some advice on lowering my AHI..
Something else I don't know if it's related..
Since beginning CPAP therapy a few months ago, I have had consistent pain in my right leg at night.. I think it's nothing more than cramps in the thigh, but it may be causing false readings on the machine perhaps..
During my first sleep study, there were no PLM's.. I am considering asking for another sleep study with my own mask.. I had problems with their masks.. they leaked and I think I slept only a few hours ALL night.. they said my AHI went down to 70 instead of 120.. but my S8 Elite shows it is actually less than 10...
Are there instances where cpap can't eliminate apneas?
Since beginning CPAP therapy a few months ago, I have had consistent pain in my right leg at night.. I think it's nothing more than cramps in the thigh, but it may be causing false readings on the machine perhaps..
During my first sleep study, there were no PLM's.. I am considering asking for another sleep study with my own mask.. I had problems with their masks.. they leaked and I think I slept only a few hours ALL night.. they said my AHI went down to 70 instead of 120.. but my S8 Elite shows it is actually less than 10...
Are there instances where cpap can't eliminate apneas?
Yeah, an AHI of 30+ is still classified as severe sleep apnea. In fact the aim is to get that AHI number down below 5, which is often very doable unless you have issues like CSA going on as well.jvoisin wrote:they said my AHI went down to 70 instead of 120.. but my S8 Elite shows it is actually less than 10...
Yes, definitely. And that's not much cause for alarm. "Normal" people have apneas too, so the idea is to get as many eliminated as reasonably possible, and above all, keep oxygen in your system while you sleep.jvoisin wrote:Are there instances where cpap can't eliminate apneas?
I'm a programmer Jim, not a doctor!
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Guest
Anything below AHI=5 is considered normal. I range between 1.8 and 3.7 most nights, and I'm not having any problems. Untreated, I was over 70.
And remember, even if your AHI is above 5, it's not really super-serious if it's 6 or 7 or something, considering how comparatively HUGE it was when you were untreated. But definitely try to get it under 5. Perhaps try an APAP? It'd be able to kick up the pressure during the "tough events", but on the other hand, that pressure increase might wake or arouse (partially wake) you. And, I believe APAPs don't increase the pressure fast enough to deal with sudden-onset apneas anyway... they might rise to sufficient pressure only after the "tough apnea" was over.
The best advice is to talk to your sleep doc, though. Good luck!
And remember, even if your AHI is above 5, it's not really super-serious if it's 6 or 7 or something, considering how comparatively HUGE it was when you were untreated. But definitely try to get it under 5. Perhaps try an APAP? It'd be able to kick up the pressure during the "tough events", but on the other hand, that pressure increase might wake or arouse (partially wake) you. And, I believe APAPs don't increase the pressure fast enough to deal with sudden-onset apneas anyway... they might rise to sufficient pressure only after the "tough apnea" was over.
The best advice is to talk to your sleep doc, though. Good luck!
Thanks,
Should be interesting, there is only one sleep doc in the area and he handles 3 cities in the area.. (about 400k people total or so)..
Took me 3 months to get my first sleep study and 4 months to get my results from that study.. then booked the CPAP study 3 months after that.. I will place a call and see what they say..
I am mostly concerned with the continued tiredness during the daytime..
Thanks for the feedback..
Should be interesting, there is only one sleep doc in the area and he handles 3 cities in the area.. (about 400k people total or so)..
Took me 3 months to get my first sleep study and 4 months to get my results from that study.. then booked the CPAP study 3 months after that.. I will place a call and see what they say..
I am mostly concerned with the continued tiredness during the daytime..
Thanks for the feedback..
you need to see your GP about the leg pain, that can interrupt your sleep just as well as other muscle-skeletal pains can.
How does your lower back feel? Leg pain can sometimes be sciatica nerve pain in which the root cause is the lower lumbar. Sometimes after going on cpap you can develop a back ache because you don't roll over and sleep in other positions like you may have once did due to wearing of the mask.
There can be many causes of the leg pains or if they are like cramps they can be from an adverse side effect from hypertension medication like DiovanHCT, or a blood clot or blocked artery can also cause severe leg pains. Your GP can check that out fairly easy by taking an ankle brachial index test to diagnose the problem. This is just a blood pressure cuff test but they take it in several places on the leg and ankle and compare to other side etc.
How does your lower back feel? Leg pain can sometimes be sciatica nerve pain in which the root cause is the lower lumbar. Sometimes after going on cpap you can develop a back ache because you don't roll over and sleep in other positions like you may have once did due to wearing of the mask.
There can be many causes of the leg pains or if they are like cramps they can be from an adverse side effect from hypertension medication like DiovanHCT, or a blood clot or blocked artery can also cause severe leg pains. Your GP can check that out fairly easy by taking an ankle brachial index test to diagnose the problem. This is just a blood pressure cuff test but they take it in several places on the leg and ankle and compare to other side etc.
someday science will catch up to what I'm saying...
I have been taping my mouth shut for a while now. I still have the same nearly zero leak as always. My AHI is still 8+ most nights. I am still extremely tired during the day even when I manage to get 10 hours of sleep.. I find that I am sleeping all night now except when it's too darn hot.
I have tried several pressure changes.. I find that if I lower it to 8 I can't sleep.. 10 cm is fine and I have the same AHI though.. lots of nights my AI is less than .5 but the Hyponeas are always around 7 or more..
I captured a couple of the screens.. will attach them...
Here is the Summary for the last month and a bit..
Also, here are a couple of nights.. both show that there are nearly no leaks..
I am thinking of going back to the doctor as I can't continue being this tired during the days. I would like to avoid having to ask for Alertec, but honestly, when I had the temporary scrip for that, it's the only time I was truely doing well during the day as far as being alert... I hate taking *any* medication.. I don't even like take pain killers... the thought of taking pills doesn't really sit well with me... but will do whatever I have to to get this fixed.. I *can't* go on like this.. Am getting so frustrated and depressed about all this.. I was so hoping that this would fix all the daytime tiredness issues...
I have tried several pressure changes.. I find that if I lower it to 8 I can't sleep.. 10 cm is fine and I have the same AHI though.. lots of nights my AI is less than .5 but the Hyponeas are always around 7 or more..
I captured a couple of the screens.. will attach them...
Here is the Summary for the last month and a bit..
Also, here are a couple of nights.. both show that there are nearly no leaks..
I am thinking of going back to the doctor as I can't continue being this tired during the days. I would like to avoid having to ask for Alertec, but honestly, when I had the temporary scrip for that, it's the only time I was truely doing well during the day as far as being alert... I hate taking *any* medication.. I don't even like take pain killers... the thought of taking pills doesn't really sit well with me... but will do whatever I have to to get this fixed.. I *can't* go on like this.. Am getting so frustrated and depressed about all this.. I was so hoping that this would fix all the daytime tiredness issues...
Your charts are very similar to mine except my 95 percent pressure on apap is around 13-14. My AHI averages between 5 and 6 with the AI about 1.2. I wouldn't be upset with your numbers at all. The AI by all accounts is more important to get down than the HI so in that respect you are doing better than me. I would consider your treatment a resounding success so far...plus you get a lot more sleep than I do.
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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI, APAP
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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI, APAP
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my opinion looking at your reports, you need to look at the empty green boxes in the leak chart for "Max" leak.
See how those empty boxes go to the right, fill in those boxes with solid "avg" leak and you have a bunch of "Maximum" leak.
What does Max leak mean? Well it is the maximum or most leak seen during the night. Maximum leak is basically short-term or periods of leak, like what is seen if you have bouts of mouth breathing.
But you mention you are using a swift and get leaks with the pillows, so it can be coming from there as well. You may try tape or chin strap or other method you prefer then compare another report to how far to the right those empty green boxes go for a comparison.
Your average leak is excellent, cannot get much better than a 0.1L/s.
But your AHI is not really that bad. In fact, looking at your report I'd say you are effectively treated for OSA. You will always have a higher HI with that machine. It will be high because that machine "calculates" those HI's out. It doesn't respond to them, it only responds to:
-Flow Limitations
-Vibratory Snores
-Apnea
See Hypopnea (HI) on that list above? It is supposed to address those when they are at the FL state. But are those HI's possibly central-hypopnea? you don't know that. If you tried 10cm and it was no worse for wear as it relates to AHI, maybe you should try 9.5cm or 9.0cm? What have you got to lose but good sleep. I would even consider trying 8.5cm if I were you. The worst that could happen is you would be even more tired.
But I don't see enough residual OSA remaining to cause the EDS you speak of. While reducing that Max leak is a good idea I would start asking your doctors about non-OSA related sleep arousals/disorders possibly seen on your first diagnostic PSG.
As mentioned above, muscle-skeletal pains, medications you may be taking for other disorders like hypertension can also destroy your sleep architecture and leave you with the EDS not just OSA.
See how those empty boxes go to the right, fill in those boxes with solid "avg" leak and you have a bunch of "Maximum" leak.
What does Max leak mean? Well it is the maximum or most leak seen during the night. Maximum leak is basically short-term or periods of leak, like what is seen if you have bouts of mouth breathing.
But you mention you are using a swift and get leaks with the pillows, so it can be coming from there as well. You may try tape or chin strap or other method you prefer then compare another report to how far to the right those empty green boxes go for a comparison.
Your average leak is excellent, cannot get much better than a 0.1L/s.
But your AHI is not really that bad. In fact, looking at your report I'd say you are effectively treated for OSA. You will always have a higher HI with that machine. It will be high because that machine "calculates" those HI's out. It doesn't respond to them, it only responds to:
-Flow Limitations
-Vibratory Snores
-Apnea
See Hypopnea (HI) on that list above? It is supposed to address those when they are at the FL state. But are those HI's possibly central-hypopnea? you don't know that. If you tried 10cm and it was no worse for wear as it relates to AHI, maybe you should try 9.5cm or 9.0cm? What have you got to lose but good sleep. I would even consider trying 8.5cm if I were you. The worst that could happen is you would be even more tired.
But I don't see enough residual OSA remaining to cause the EDS you speak of. While reducing that Max leak is a good idea I would start asking your doctors about non-OSA related sleep arousals/disorders possibly seen on your first diagnostic PSG.
As mentioned above, muscle-skeletal pains, medications you may be taking for other disorders like hypertension can also destroy your sleep architecture and leave you with the EDS not just OSA.
someday science will catch up to what I'm saying...
Thanks snoredog.
I have finally found a doctor accepting patients.. It's a couple of cities over but at least I can get in there. Hopefully he can look into things that the sleep doc can't.. Takes months to get in to see the sleep doctor.. he works one day a week.. after my sleep test he said my AHI was down to 70 (from 120) and to try the machine for a year and we will see how it is then.... How he could send me away with an AHI of 70 is quite frustrating.. and there are no other doctors to go to..
they didn't record any CI's on my sleep study, but I read somewhere that pressure can actually cause them.. any truth to that or is that info incorrect?
I appreciate all the information I am able to get.. Wish the doctors were as helpful..
I have finally found a doctor accepting patients.. It's a couple of cities over but at least I can get in there. Hopefully he can look into things that the sleep doc can't.. Takes months to get in to see the sleep doctor.. he works one day a week.. after my sleep test he said my AHI was down to 70 (from 120) and to try the machine for a year and we will see how it is then.... How he could send me away with an AHI of 70 is quite frustrating.. and there are no other doctors to go to..
they didn't record any CI's on my sleep study, but I read somewhere that pressure can actually cause them.. any truth to that or is that info incorrect?
I appreciate all the information I am able to get.. Wish the doctors were as helpful..
[quote="track"]Your charts are very similar to mine except my 95 percent pressure on apap is around 13-14. My AHI averages between 5 and 6 with the AI about 1.2. I wouldn't be upset with your numbers at all. The AI by all accounts is more important to get down than the HI so in that respect you are doing better than me. I would consider your treatment a resounding success so far...plus you get a lot more sleep than I do.
Last edited by jvoisin on Sun Jun 03, 2007 10:57 pm, edited 1 time in total.
regarding the leaks.. I don't think they are the cause at all.. the max is the max leak detected.. IE if I take the mask off briefly and then put it back on quick before the machine shuts off, that would be a max leak..
Here is the other page for last night... (June 2)
I am pretty certain that i am not having issues with leaks.. I will tape my mouth shut again tonight and make sure the mask is tighter.. (results in a sore nose tomorrow, but will definately make it not leak..
thanks again..
(only saturday nights do I get the ability to sleep 10 hours.. is wierd seeing it say 10.04h!)
[quote="Snoredog"]my opinion looking at your reports, you need to look at the empty green boxes in the leak chart for "Max" leak.
See how those empty boxes go to the right, fill in those boxes with solid "avg" leak and you have a bunch of "Maximum" leak.
What does Max leak mean? Well it is the maximum or most leak seen during the night. Maximum leak is basically short-term or periods of leak, like what is seen if you have bouts of mouth breathing.
But you mention you are using a swift and get leaks with the pillows, so it can be coming from there as well. You may try tape or chin strap or other method you prefer then compare another report to how far to the right those empty green boxes go for a comparison.
Your average leak is excellent, cannot get much better than a 0.1L/s.
Here is the other page for last night... (June 2)
I am pretty certain that i am not having issues with leaks.. I will tape my mouth shut again tonight and make sure the mask is tighter.. (results in a sore nose tomorrow, but will definately make it not leak..
thanks again..
(only saturday nights do I get the ability to sleep 10 hours.. is wierd seeing it say 10.04h!)
[quote="Snoredog"]my opinion looking at your reports, you need to look at the empty green boxes in the leak chart for "Max" leak.
See how those empty boxes go to the right, fill in those boxes with solid "avg" leak and you have a bunch of "Maximum" leak.
What does Max leak mean? Well it is the maximum or most leak seen during the night. Maximum leak is basically short-term or periods of leak, like what is seen if you have bouts of mouth breathing.
But you mention you are using a swift and get leaks with the pillows, so it can be coming from there as well. You may try tape or chin strap or other method you prefer then compare another report to how far to the right those empty green boxes go for a comparison.
Your average leak is excellent, cannot get much better than a 0.1L/s.