Please help cpap friends

[Sadman]

I don't have the machine anymore but a awaiting a new one with full face mask. Also looking into a mouth one to maybe pull my tongue forward. My sleep doctor did once say that my throat had a narrow air passage.

And my Air portal, which tracks all my sleeping progress, showed no red flags. At least not any leaks...Thanks everyone.

[Julie]

Everyone with obstructive apnea has a narrow throat ... that's the whole point of Cpap!

[CarpeNoctum]

Sadman,
You had asked earlier if anyone had brain fog along with sleep apnea. That's a fairly generic phrase, but I suspect most folks either before cpap or before success at cpap have some loss of mental alertness. Loss of sleep and loss of rem certainly will do that.

There was a member named sickwithapnea whose main symptom seemed to be brain fog. But he was commonly assumed to be a troll.

One thing you mentioned is your PO2 level (from a finger oximeter) was 90%. That's actually kind of low. A young healthy person should be close to 100%. If you can't maintain 88%...then adding oxygen is considered. (just to put yours in perspective) I have some serious lung issues from trauma and can maintain 95%.

Do you have some sort of respiratory issues? Do you live high up in the mountains? I'm just trying to think of something that fits in with your scenario.

Took me over 6 months to get cpap working for me and often it takes longer. So persist with cpap and troubleshoot when problems occur.
CN

[palerider]

One thing you mentioned is your PO2 level (from a finger oximeter) was 90%. That's actually kind of low. A young healthy person should be close to 100%.

1) SpO2

2) No, a "young healthy person's" SpO2 should NOT be close to 100% WHILE ASLEEP.

[Sadman]

Sadman,
You had asked earlier if anyone had brain fog along with sleep apnea. That's a fairly generic phrase, but I suspect most folks either before cpap or before success at cpap have some loss of mental alertness. Loss of sleep and loss of rem certainly will do that.

There was a member named sickwithapnea whose main symptom seemed to be brain fog. But he was commonly assumed to be a troll.

One thing you mentioned is your PO2 level (from a finger oximeter) was 90%. That's actually kind of low. A young healthy person should be close to 100%. If you can't maintain 88%...then adding oxygen is considered. (just to put yours in perspective) I have some serious lung issues from trauma and can maintain 95%.

Do you have some sort of respiratory issues? Do you live high up in the mountains? I'm just trying to think of something that fits in with your scenario.

Took me over 6 months to get cpap working for me and often it takes longer. So persist with cpap and troubleshoot when problems occur.
CN

I live in LA, and before that the east coast. No respiratory issue that I know of? Being tired is NOT one of my complaints. Hmmmm.

[Sadman]

Thanks everyone. Attached are the results of my sleep study done with a nasal mask, and one month's compliance data.

Is it still worth trying the machine again? The sleep doctor says my 90 percent oxygen level is not my issue--it's the snoring arousals--11 per hour. She said the mask should have helped that but it didn't.

Also, has anyone here treated periodic limb movements?

[Sadman]

IMG_9168.jpg (74.25 KiB) Viewed 947 times

[Sadman]

Bump, thanks for helping me y'all.

[Julie]

Still haven't filled out your equipment so we don't really know what you use when... hard to advise or come to conclusions. Plus those pgs are hard to read (Sleepyhead really does a great job).

[Friendly]

This might be easier to read:

]Impression:
1. CPAP setting of 6cmH2O effectively improved sleep disordered breathing during REM sleep and in the lateral position and stabilized oxygen saturation at 97%.

2. The patient slept 2.7 hours out of a total 7.1 hours bedtime monitored, yielding reduced sleep efficiency of 38%.
Latency to sleep onset was 34.5 minutes, which was prolonged.

3. EKG, EEG, and EMG were normal.


Diagnosis:

Axis I: Obstrctive sleep apnea (adult) (G47.33)
Axis II: CPAP Titration study, 95811


Recommendation:

1) Suggest a CPAP setting of 6-9 cm H2O
2) The patient preference was ResMed Mirage FX- standard nasal mask.
3) The UCLA Sleep Disorders Center offers mask-fitting consultations and positive pressure acclimation (PAP Nap) studies. Orders may be placed through CareConnect or faxed to the sleep center at (310) 267-1062
4) The patient should be advised not to drive when sleepy.
5) The patient should avoid long acting sedatives and alcohol close to bedtime.



The patient was referred for sleep testing only. Patient should return to the referring physician for follow up and management including prescribing Nasal CPAP for home use. For formal consultations with sleep specialist, please call 310-825-2631.

Electronically signed by

Karen Lee, M.D.
Diplomate, American Academy of Sleep Medicine




The following data based on technologist observation – subject to physician interpretation


A. GENERAL PARAMETERS MEASURED

Left and Right EOG EKG
Chin EMG Anterior Tibialis EMG
Abdominal Movement Thoracic Chest Movement
C-Flow Oximetry
EEG (F4-M1, C4-M1, and O2-M1) Snore Sound
Body Position



B. SLEEP SCORING DATA

1. Lights Out: 10:49 PM
2. Lights On: 5:54 AM
3. Total sleep time: 160 minutes (2.7 hrs)
4. Total recording time: 425 minutes (7.1 hrs)
5. Sleep Efficiency Index: 38%
6. Wake time: 265 minutes (Normal is equal or less than 20 minutes)
Stage N1: 22 minutes (14% of total sleep time. Normal: 5-15%)
Stage N2: 105 minutes (66% of total sleep time. Normal: 45-80%)
Stage N3: 12 minutes (8% of total sleep time. Normal: 0-15%)
Stage R: 20 minutes (13% of total sleep time. Normal: 12-20%)


7. Latency to sleep onset: 34.5 minutes (normal 10-20 minutes)
8. Wake after sleep onset: 231.0 minutes (Normal is equal or less than 20 minutes)
9. Latency to REM onset: 41.5 minutes (Normal is equal or greater than 90 minutes)

C. AROUSAL EVENTS
1. Total number of arousals: 64
2. Arousal index: 24/hr (Normal is less than 10/hr)

D. CARDIAC SUMMARY
Heart Rate Summary
Average heart rate during sleep: 51 bpm. Highest during sleep: 64 bpm. Highest of awake: 62 bpm

Cardiac Events:

(None)

Other Arrhythmia: Tech did not observe any arrhythmias during the study.


E. MOVEMENT EVENTS

LMs Index
PLMS 37 14/hr
PLMS with Arousal 16 6/hr



F. RESPIRATORY EVENTS

Respiratory Rate: 12-14 breaths per minute

The patient did not have Cheyne-Stokes breathing. CPAP was utilized at pressures ranging from 5 to 8 cm H2O. During the study, ResMed Mirage FX standard nasal mask was used.

CPAP (cmH2O) 5-8
Position Supine, Lateral
Sleep State REM, NREM
Baseline O2 Level 96-97%
Supplemental O2 None LPM
Minimum O2 Saturation 92.0%
Recorded Sleep Time 2.7 Hours
Apnea-Hypopnea Index (AHI) 1/hr
Apnea Index (AI) 0.7/hr
Hypopnea Index (HI) 0.0/hr
AHI on supine position 1/hr
AHI during REM sleep 3/hr




Pressure CPAP 05 06 07 08
Time TRT 221.5m 132.0m 44.0m 28.0m
TST 68.5m 42.0m 43.0m 7.0m
Total Events 1 0 0 1
Obs. Apn. 0 0 0 0
Mixed Apn 0 0 0 0
Resp. Central Apn. 1 0 0 1
Obs Hyp. 0 0 0 0
Cen Hyp. 0 0 0 0
AHI 0.88 0.00 0.00 8.57
Supine AHI 0.88 0.00 N/A N/A
Side AHI 0.00 0.00 0.00 120.0

Apnea/Hypopneas Index (AHI): Number of apnea/hopopnea episides per hour of sleep (Normal less than 5).
Hypopnea definition (AASM Rule 1B): A decrease in the nasal pressure signal amplitude of 30% or greater, lasting 10- seconds, with a 4% or greater oxygen desaturation from baseline
Respiratory Disturbance Index (RDI): Number of apnea, hypopnea, and respiratory effort related arousal (RERA)episodes per hour of sleep.

G. OXIMETRY SUMMARY

Percent time and time in minutes for each oxygen saturation range during sleep:


Oxygen Saturation Range Sleep time in minutes Percent of total sleep time
89-100% 160 100%
81-88% 0 0%
71-80% 0 0%
61-70% 0 0%
Artifact 0 0%

[Friendly]

Equipment:
AirSense 10 AutoSet

Serial Number 23171718078
Mode: AutoSet
Min Pressure 6cm H20
Max Pressure 9cm H20
EPR Fulltime
EPR level 3
Response Standard

Pressure: cmH2O
Median 6.8 95th percentile 8.3
Leaks
Median 0.4 95th percentile 105
Events per hour
AI: 2.2 HI: 0.1
Apnea Index:
Central 1.2 Obstructive : 0.8

[LSAT]

If Sadman and Friendly are the same person he is causing confusion..............

[Friendly]

Not the same person.

[TexasLongHorns]

Did you check to see if your current settings were sufficient while on CPAP Therapy such as your AHI?

[Sadman]

Still haven't filled out your equipment so we don't really know what you use when... hard to advise or come to conclusions. Plus those pgs are hard to read (Sleepyhead really does a great job).

Resmed Airsense 10 with airfit p10 nosal pillows. That was the old gear before I quit and ordered a new machine.