diagnosing a friend

[mhorowit]

I was discussing SA with a friend and he mentioned that he to was having "brain fog" and some of my former symptoms. I lent him my AutoCPAP for a night to see if he could adapt to it and if anything I recorded would be of use.
He adapted well and I read the card, which showed an AHI of 3.7 with an OA of 2.1.
Now, the machine is recording the residual obstruction i.e. that which it could not control.
There is no substitute for a doctor, but what did this one-night session and reading tell us? - Mike

[ozij]

Did you note the pressure?
Unless the 90th percentile pressure remained at 4, the results tell you that you fried had enough obstructive events to drive the pressure up, and that they were reasonable resolved by the machine.

O.

[mhorowit]

Did you note the pressure?
Unless the 90th percentile pressure remained at 4, the results tell you that you fried had enough obstructive events to drive the pressure up, and that they were reasonable resolved by the machine.

O.

I'm sorry, I'm not CPAP savvy enough to understand that on the first go-around. The average 90% CPAP was 9.0 and the Average CPAP Pressure was 6.9

I set the lower pressure on my machine to either 4 or 5 (don't recall). Because the pressures remain high and there is no Large Leaks, does that mean the machine is sensing and resolving some, but not all the obstructions and stays high in preparation for resolving still others? - Mike

[ozij]

Yes, you understand that correctly.
That pressure result combined with the AHI means your friend needed far more than ambient pressure (normal room pressure) for him to breathe properly during the night.
The machine identified obstructions in his breathing during the night, and when it identified them - or their precursors - it brought the pressure up, and did indeed remain at that higher pressure for a while.

The APAP would not have raised pressure if you friend did not have some kind of breathing problem, and one of the reasons he still had residual events is that most APAP's for most people go up in response to an event, back down when breathing has bee stable for a while, back up if necessary, and so on. Their ability to preempt events is limited.

The "90%" pressure means you friend needed a pressure of 9.0 or less for 90% of the night. He may even have gone higher for 5% of the time.

You test is an excellent indicator that your friend may benefit from CPAP therapy -- he really should get a sleep study ASAP -- even ask for a loaner APAP till the study since he seems to be doing so well on it.

[Goofproof]

To get a better idea of whether someone need XPAP, the machine needs to be set to the lowest pressure one is comfortable using, usually 5 CM, and even that low a pressure in some people could pre-empt some events from happening. But it would give you a better idea of how your needs are. Personally, I couldn't stand anything under 8 CM, as I am use to 15 CM as my normal pressure. Recording your friends breathing sounds could be useful, and maybe using a recording O2 monitor too. Jim