I've been terribly wrong (got my report)

[turbosnore]

I got my report finally, and the impression about my state has been totally wrong.

I guess the reason for quick start of treatment were not so much due to the central
apnea events but hypoventilation.

A+H 36,0 / h
supine A+H 58,5 / h
Non-supine A+H 20,0 / h

(What is "supine"?)

Apnea 55,6 %
Obstructive 51,5 %
Central 1,4 %
Mixed 2,7 %
Hypopnea 44,4 %

Flattening statistics: 58,8% breaths below threshold
(What does this mean? Too shallow breathing?)

Can anyone decipher?
More info needed?

I got a 8-page paper and for now I have nothing in electrical form.

[ozij]

Supine mean lying on your back - and you are having more obstructions when you're on your back than when you're on your side.
Since you report was written by a Finnish lab I think you should ask them what the terminology means - for instance, what they mean by "flattening" and what is the thershold that you are below for more than half the night.

I think you'll find a pretty low blood oxygenation level somewhere in those 8 pages - and that, more than any other number will explain why treatment was started so fast.

Blood oxygen should not go beneath 90% - they give you supplemental oxygen in the hospital if you are at less than 90%.

O.

[turbosnore]

The report was created by Somnologica SW (Embla).

Do these say anything?

Avg. Oxygen Saturation 94,1 %
Lowest Oxygen Saturation 81,0 %
Average Desaturation 5,9 %
Saturation < 90 % 8,7 minutes 1,8 %

[congahands]

Yep, that's what ozij was referring to. That 8.7 minutes with Saturation less than 90% is not a good thing.

[TerryB]

Turbosnore,
Remember that as a layman I don't know crap about medical subjects, BUT, it seems that the only thing changed is to remove your original emphasis on centrals.
You do have obstructive apnea and you have more problem when on your back than on your side(s) which is quite normal in the group.
So, relax, we're right back to fighting the mouth breathing/leaking.

Since the centrals are mentioned and I don't have any reference for a rating of the frequency of occurrence, you need to be cautious about raising pressure.

Get busy on preventing mouth leaking.

Regards,
TerryB

[Julie]

And do remember that hypopneas usually outnumber apneas by a lot, so don't worry too much about that, it's normal.

[ozij]

Get busy on preventing mouth leaking.

Very good idea.

And I would not make an issue of those central apnea at this point. People with obtructive apnea are often aroused out sleep, because of an obsturction, and pant to catch up on the oxygen they've missed during that obstruction. And then after panting, they stop breathing - a central apnea.
Look at this video (it takes long to load) to understand Sleep Disordered Breathing. http://www.resmed.com/en-us/clinicians/ ... 40x380.swf

O.

[turbosnore]

This morning my nasal mask was changed to full face mask. I hope that takes care of the mouth leaking.
If that does not help, they (at the clinic) promised to change my constant pressure device to auto adjusting device
with pressure limits 9-13 cm (now 12 cm). Do you think that would be the right thing to do next if 3 weeks do not show
any progress?

By the info shown in the earlier postings, what do you think of my severity levels?

[ozij]

Do you think that would be the right thing to do next if 3 weeks do not show any progress?

I think that would be very right indeed. The reason being that you seem to have far more apneas when supine (severe) than when on your side (moderate) so one can assume you may need different pressures on you back and on your side. An automatic machine can let you sleep at lower pressures as long as you don't need them and will then bring pressure up when you turn from your side to your back.

O.

[FoxNewsFan]

Get busy on preventing mouth leaking.

Very good idea.

And I would not make an issue of those central apnea at this point. People with obtructive apnea are often aroused out sleep, because of an obsturction, and pant to catch up on the oxygen they've missed during that obstruction. And then after panting, they stop breathing - a central apnea.
Look at this video (it takes long to load) to understand Sleep Disordered Breathing. http://www.resmed.com/en-us/clinicians/ ... 40x380.swf

O.

Thank you, thank you, thank you for that video. It was very educational. They should require everyone, diagnosed with sleep apnea, to watch it. I'm going to e-mail it to my brother in Derby, Kansas who is in denial.

Is there anything else on the Clinicians menu worth watching?

Ed

[TerryB]

Turbosnore,
Don't be too hung up on your sleep study figures. Remember that the results show how you are affected by the disordered breathing while without the treatment of XPAP. Concentrate on getting the therapy working for you. Based only on my own experiences and what I have read here along the way:
1. A properly set Continuous Positive Airway Pressure (CPAP) machine can prevent obstructive events and give you the best ventilation during remaining hyponeas.
2. Some people are more comfortable with the exhalation pressure relief provided by many machines.
3. Some people are more comfortable with the Auto-Titrating Positive Airway Pressure (APAP) because it runs at a lower pressure until an apnea causes it to ramp up to break the apnea. Some people find the pressure excursions disturbing. I am one of those so I self titrate if I feel I might need more pressure, but operate on a fixed pressure most of the time.

Just some more information to digest.

Regards,
TerryB

[turbosnore]

Ok, first night behind wit a full face mask.
I removed the mask a few times, but after some minutes (don't remember why) I put it back and continued seeping.
I couln't have continued with the nasal mask so quite an enhancement.
Also, my mouth still dryed, but my throat was OK - remarkable change.
I guess my throat got sore partly because I needed to force my throat to keep air not escaping
into my mouth and out. Even awake, every now and then a bubble broke through my throat to my mouth.

Another thing arose, With 12cm pressure, my wife told me that I did snore a few times with my mask on,
and I didn't wake up any less tired. Is it usual? Could the pressure needed be different with FFM than with nasal mask?

Next step is probably getting a humidifier, but then what?
Which, do you think, would be better for me? APAP or BiPAP? Or sthold I stick with CPAP?
I mean, I have hypoventilation too? Could a BiPAP lure me to breathe deeper?

[ozij]

Get a standalone humidifier, it will supply more humidity and will work with any machine you will eventually have.

http://www.fphcare.co.nz/osa/hc150.asp

O.

[TerryB]

Turbosnore,
An important piece of information is that a snore is only a noise you make which may or may not disturb your wife. It is a precursor to apnea but is not an apnea event. If you do not proceed into an apnea and stop breathing then you have not lowered the oxygen levels.

As I said above, you may find the bipap change useful, but maybe not. Don't worry about not feeling instant ly better. You need to have a considerable number of consistantly restful nights before you feel really rested in the morning. If the process is bothering you, you need to deal with those things like noises, vibrations, etc. which are disturbing you.

Good Luck,
TerryB

[billbolton]

1. A properly set Continuous Positive Airway Pressure (CPAP) machine can prevent obstructive events and give you the best ventilation during remaining hyponeas.

Minimize the occurance of obstructive events is a more appropriate description than prevent obstructive events.

For may users there are trade offs between various CPAP usage factors, and other SDB factors, which effect the "set up", and therefore whether obstructive events can be entirely eliminated.

Cheers,

Bill