Help with cpap not helping

[jthom]

Hi guys this is my 1st time to upload images so i hope this works. my cpap seems not to be helping with daytime sleepiness anymore and just wanted your opinions on setting charts? [URL=http://s1383.photobucket.com/user/ ... .jpg[/img]][/url]

[VictorC]

Have you always had large clusters of centrals? They make up the majority of your apneas, and if that is not something you've had in the past then it could definitely account for your feeling tired. Also I saw that you had 22 large leak events, but didn't see them on the event plot.

[jthom]

They reduced my pressure from 8-12 about 2 weeks ago due to the centrals about 2weeks ago with no help.
yes the centrals have been ongoing for the last year i've had sleepy head and been monitoring.
ill try and post a detailed pic of leaks.

[aytikvjo]

If you are getting centrals at a relatively moderate pressure, you could ask your doctor about getting a bipap maybe.

[kaiasgram]

You've got a busy Flow Limit graph there -- partial airway obstruction can be disruptive to your sleep even when it doesn't 'escalate' into full apnea events. Your snore graph also has some periods of significant activity.

It's tricky when centrals start popping up because you need to find that sweet spot where the pressure is high enough to control obstructive stuff but also low enough to not be provoking centrals. Sounds like your doc is still trying to find that sweet spot. Bilevel is often the solution to this challenge.

[cnaumann]

Can't help but to notice the session runs over 11 hours. That is a long time in bed, doubly so if you are still not rested. Unfortunately, your AHI number alone may not 'justify' a bilevel or ASV machine. Have you done a sleep study or taken pulse oximetery data recently? I am curious as to the length of some of those CAs.

[jthom]

no i have not done a sleep study done since first titration. i'm trying to get my sleep doc to do another one by the end of year and my deduc restarts. as far as o2 i have not broke down to get a overnight one yet. as far as the 11 hours it was acually longer just start a new graph and 12 even though solid sleep.

[jthom]

Here's a few from last night not as many central's but still no energy [URL=http://s1383.photobucket.com/user/ ... .jpg[/img][/url][URL=http://s1383.photobucket.com/user/ ... .jpg[/img][/url]

[kaiasgram]

It appears that your pressure is bumping along the ceiling (the max pressure) most of the time, suggesting (to me) that it wants to go higher, which makes sense when I look at your Flow Limit graph. I realize that letting your pressure go higher could possibly allow centrals to start up again and I know your doctor lowered the pressure recently to try to reduce the centrals. There are a lot of folks on the forum who report that they do not feel great until their AHI is closer to 1 or 2 on a regular basis. So you may need more time to work all these bugs out before you start to feel significantly better.

When did you start using the machine? Sometimes centrals resolve after an initial adjustment period. Sometimes not, in which case you might still need to have a discussion with your doctor about whether a bilevel machine would allow you to get more effective elimination of obstructive and partial-obstructive events but still keep centrals at bay.

[palerider]

It appears that your pressure is bumping along the ceiling (the max pressure) most of the time, suggesting (to me) that it wants to go higher, which makes sense when I look at your Flow Limit graph.

the other part of that is that 5 is too low a pressure in this case, so there's FL, pressure goes up, things are ok for a bit, pressure goes back down, more FL, cycle repeats.

raise the min pressure and might not need to raise the max

[cnaumann]

If you are sleeping over 12 hours a day and suffering from sleepiness when awake, you may have medical conditions besides sleep apnea. I would not rule apnea out, it is easy to treat and your graphs show some weirdness, but you should discuss your hypersomnia with your doctor.

[Pugsy]

Do you take any meds (even OTC stuff)? If so, what are they...dose and when do you take them?

[digitalepiphany]

I had CAs when I first started on CPAP. It wasn't every night, but it was a majority of them. Some nights were really bad. It got up to 98.36 AHI at one point. The week before that, my AHI was 79.23 with a CA AHI of 60. They put me on BiPAP, and I haven't had a single CA since then. I'm still tired all the time, but at least my apnea is under control.

With that said, if you're experiencing clusters of CAs on a regular basis, I'd talk to your doc. A BiPAP may be just what you need. Of course, it could be something else altogether, but I think your doc should handle it.