SLEEP STUDY WRONG?You make the call!

[grandpap]

A recent sleep study titrated me at 12cm and the sleep doc was kind enough to perscribe me a cpap data capable machine.He wanted to have it set at a straight cpap of 12cm because he thinks that the auto setting would just end up "chasing" events. I have been tracking my therapy on Encore Viewer and have noticed that my AHIs are not dropping and Vs is pretty solid bar all night with a setting of 12.
I decided to change to auto and made my max number 20cm and my min 12.Right away my graphs showed a rise of pressure up to an average of 16.8 and a 90% of 20cm .I have been pushing the min pressure up slowly and am at 16 now with a steady average at almost 18cm but still hitting a 90% of 20. My vs is nonexistent,fl is like a .3 but apneas are about 5 and hyps are 2.5.The real problem now is nrs are showing 2-3 times a night,usually when the pressure is falling off of max.Even though I am sleeping, my leak numbers look OK and all numbers are dropping, I don't feel good,I have headaches, feel sleepy and very little energy.My question is am I chasing the wrong pressure or was the sleep study wrong.Should I stop at 17cm min with a 20 max and see what the numbers do.If it takes me to 20,I may have to see the sleep doc and ask for a machine with higher pressure.My data is in an album form and starts with the straight cm of 12 and goes to apap 16-20http://s950.photobucket.com/albums/ad35 ... slideshow&. I have another appointment with the doc in a week. What do you think your conversation with him would be like if you were in my shoes.

[cinco777]

Are you sleeping on your back at anytime during the night as some of us have Positional Sleep Apnea and have many times more Apneas & Hypopneas when "back sleeping"? If you are sleeping on your back, train yourself to sleep on your sides (or stomach using the Falcon position).

Additionally since I am also a mouth breather, I would recommend that you try a FF mask for a week or so and see if your leak rates start to flatten and your sleep #s start to trend lower. I started with Nasal pillows and could not get my leaks under control even with mouth taping, etc. Switched to a FF mask after two weeks and am getting a restful sleep and good numbers.

I'm glad to see that you do not experience Non-Responsive Apneas (centrals).

Good luck in getting this straightened out.

[rjjayrt]

What was your AHI on 12cm. Possible central apneas with increased pressure. If your not sure of settings you need to consult with someone on heres whos willing to work with you or consult your sleep doc. I;m sure others on here would be interested with helping as am I but you need to provide all the numbers.

[Julie]

The higher your pressure, the more likely it is that you're mouth breathing, so do at least try taping for a few nights and see how you feel, then look into a FF mask if it makes sense.

[Wulfman]

I thought we tried to cover some of those issues in THIS thread:

viewtopic/t47139/viewtopic.php?f=1&t=47 ... 08#p424208


Den

[mdintx]

Looking at your graphs, it's hard not to take notice of the jagged nature of your leak line. Your OA's seem coincide with the jagged leak line. I wonder what your AHI would look like with a smooth and low leak line.

[grandpap]

Wulfman,you are right but you were the only one who truly gave an opinion.I am hoping to create some interest and receive some input.The rest are questions so I reposted,forgive me.
Yes I have a sleep doc
I have several different pillows and am trying different ones every week
I sleep on all sides
I use both ff and nasal pillows,numbers and jagged lines of leak are about the same.
If you look at my 12cm cpap you will see my ahis are high,they will sometimes go as high as 30 without large leaks.I would say not to focus on the leak numbers.
Nrs could be an anomaly because the timing is so short but I'm not sure.
I am beginning to think that I may have some complex osa sleep disorder and wanted to see if anyone else sees that. I'm chasing numbers to the limit and still not seeing significant improvement.I think that even if I could acheive flat line leaks,I would still see barely acceptable numbers.

[Pugsy]

I am beginning to think that I may have some complex osa sleep disorder and wanted to see if anyone else sees that. I'm chasing numbers to the limit and still not seeing significant improvement.I think that even if I could acheive flat line leaks,I would still see barely acceptable numbers.

I went back to your other thread and re-read things. I finally was able to see your other reports. I could not the first time. I will share my thoughts here.

Having the UPPP makes treating with cpap a whole lot more problematic for some people. This I have read often but we don't often see it or really know for sure if that is what you are facing all by itself. So all we can really do with these reports is "suppose".

I didn't see any comments about any recent sleep studies but I may have missed them. Has anyone ever mentioned centrals or complex sleep apnea??? Are they known as a certainty or are we "supposing" that some of those OAs are centrals?

Whatever they are and whatever is going on I agree with you that I don't think having a "perfect" leak rate is going to fix that mess. Some of your reports don't show much of a leak yet you are still woefully under treated.
If centrals are a known certainty then for sure you need a different machine and to be honest even if not a known certainty I would think a different type of machine is called for. BiPap or maybe SV if centrals are a known certainty......

Has there been a recent titration study? My apologies if you mentioned it somewhere but I have been on the forum more limited time lately and I don't see every thread. If this were me, I would be talking to doctor about a Bipap sleep study titration with the thoughts of making sure I knew for sure if any of those events were central and if so thinking along the specific needs for treating complex sleep apnea.... The past UPPP probably factors into things but you gotta find out exactly what is going on to have any hope of getting effective therapy.

[grandpap]

Pugsy,thanks for the reply.I did have a sleep study and they did not say anything about CAs or complex issues just a 12cm straight cpap.I find it quite puzzling that the study could be this far off