Numbers check and analysis

[Tielman]

I've been having issues with the quality of my sleep for a while. When I started CPAP in January, everything started getting better, my AHIs were decreasing, I was feeling better. Then March ran around, and my AHI almost doubled. While many folks would love to have a 3.16 average for the month, it was murder for me. Fatigue and daily tiredness. It hasn't gotten much better since March despite all the changes I've tried.

I've been through the grinder at work, one of my colleagues retired and I inherited much of his work (some of it was sent off to the Dept I was merged back in with). Mind you, prior to this the two of us were doing the work of 2-3 persons EACH, about the same in some areas of another similar 5 person department (we have the stats to back it up to). I also have been dealing with some anxiety and depressive issues trying to work those out. To give you an idea, for about the last 10 years I probably had no more than 5 "good" days a year. I don't know how much of my anxiety and depression are tied to my severe sleep apnea numbers (I had a sleep efficiency of 48%, and an AHI of 73, and an O2 level of 78% prior to treatment).

I have tracked the following numbers:
9 Mo Average: 2.74 AHI, 1.52 CA, .44 OA, .78 H
January: 2.45 AHI, 1.28 CA, .45 OA, .73 H
February: 1.86 AHI, .93 CA, .25 OA, .70 H
March: 3.16 AHI, 1.44 CA, .63 OA, 1.10 H
April: 2.81 AHI, 1.52 CA, .35 OA, 1.04 H
May: 2.88 AHI, 1.55 CA, .45 OA, .88 H
June: 2.63 AHI, 1.63 CA, .35 OA, .65 H
July 2.02 AHI, 1.22 CA, .30 OA, .50 H
August 3.17 AHI, 1.86 CA, .58 OA, .74 H
September 3.57 AHI, 2.27 CA, .56 OA, .74 H

I've tried a number of things to improve my sleeping, including:
- No caffeine after 2 pm
- No food after 8 pm (2 hours prior to bed time)
- Using Tums (Antacid)
- Sleeping on an incline ( 9" Foam wedge)
- Changing medicine times from morning to bedtime
- Going to bed at the same time

I've tried a number of things to improve my CPAP including:
- Ensuring flat (or near) leak lines, w/ no large leaks (except 1-2 days for 9-10 months)
- Mouth taping to ensure no leakage
- Titrated to 11 cm
- Adjusted up to the following: 11.5, 12, 12.5, 13, and 15 (the latter upon advice from a sleep lab)

What's been bothering me is two things:
1) My CA numbers are always above 1, and my periodic breathing is always around 3.5-4%
2) I can feel LOUSY even with a high 3 and low 4

During my "good months", my CA and Periodic breathing are at their lowest ( 1.0 and 3.3 %) versus my "worst months" where my CA and periodic breathing are higher (2.2 and 5.2%).

I only feel good when both the AHI, AND the CA / Periodic Breathing numbers are low. The sleep doctors are convinced that I do NOT have central apneas and complex sleep-apnea. I've dropped back to the 11 titrated pressure, and had the best day ever on Sunday, so there's hope, but usually it's only been lasting 1-3 days.

This is my question: How do I keep the CA and Periodic Breathing numbers low??

[ZQuest]

Hello



How many hours of sleep do you get a night on averaged? Are you keeping track of that also?


Phil

[Tielman]

Hello



How many hours of sleep do you get a night on averaged? Are you keeping track of that also?


Phil

It is not consistent, however it is at least 7-7.5, and up to 10-12 hours

[cwied]

I only feel good when both the AHI, AND the CA / Periodic Breathing numbers are low. The sleep doctors are convinced that I do NOT have central apneas and complex sleep-apnea. I've dropped back to the 11 titrated pressure, and had the best day ever on Sunday, so there's hope, but usually it's only been lasting 1-3 days.

This is my question: How do I keep the CA and Periodic Breathing numbers low??

Central Apneas don't involve obstruction, so I'm surprised that higher pressures were recommended to you to try to reduce them. In fact, I've seen some references to higher pressures causing CAs.

Did you have any central apneas reported during your sleep study? Did the sleep doctors tell you you weren't having central apneas, or that you didn't have CSAS? I wonder if they just meant that there weren't enough to call it a syndrome.

I've only been on CPAP for a week, but I'm also seeing central apneas. During my sleep study, I had no apneas of any kind reported (central or obstructive). With my CPAP at home I have a central apnea index of around .8. I suspect that the CPAP is changing my breathing enough that I hyperventilate and then just stop breathing for a bit after that. I think the only main way to get these down is to get used to the CPAP. I also find that with EPR (equivalent to C-Flex on your machine) turned off I do better. My pressure is only 7, though, so you might not be as comfortable with that option.