Increase in AHI; OSCAR says CA and Cheyne-Stokes

[lindsayschach]

The doctor said my averages over the last 90 are good enough that she didn't want to change anything, except she did lower the max pressure from 16 to 14. She said if my average CA or AHI get to 15-20, she'll do something -- BiPAP, probably. Oh, and I'm welcome to get another sleep study.

I'd like to try to run my CPAP at 7, like someone suggested. I'll try that tonight.

Thanks for all the input, insight, and advice!


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[Miss Emerita]

Lindsay, your doctor's response is not acceptable. Your AHI should be under 5, ditto your CA index. And the pattern of your CA clusters is suggestive of Cheyne-Stokes breathing, which absolutely requires investigation. Your doctor's insistence on looking at a 90-day average, rather than a recent trend, doesn't make sense to me.

If your revised settings somehow give you great results, then ... great! But otherwise, please ask your primary care physician to refer you to a cardiologist and/or a pulmonologist.

In the meanwhile, I recommend that you get a recording oximeter. Look on the home page of Oscar for some oximeters that are compatible with Oscar. It's important to see what's happening to your O2 levels, especially during those prolonged periods of CA. And the data could be helpful as you press for further and better medical care.

Keep us posted, would you?

[lindsayschach]

Thanks for your post. I felt that way, too - they’d rather use the 90 day average which has very little real information. I’ll talk to my PCP.

I like the idea of an oximeter - that was also suggested by a friend who is a respiratory therapist. I’ll check them out.

Thanks everyone!

Lindsay

[lindsayschach]

Sorry, I can’t find the list of oximeter compatible with OSCAR. Can you please point me in the right direction?

Thanks,

Lindsay

[Pugsy]

https://www.apneaboard.com/wiki/index.p ... _Oximeters

Pulse Oximeters

List of OSCAR compatible oximeters:
ResMed

Proprietary module for the S9 and S10 models.
AS11 utilizes the Nonin 3150BLE - Supported

Contec brand

Contec CMS-50D+, CMS-50-E, CMS-50E, CMS-50EA
Contec CMS-50F, CMS-50H, CMS-50I (v3.7 firmware or later)
Pulox PO-200/300/400/500

Wellue/Viatom brand

Viatom/Wellue SleepU
Viatom/Wellue O2Ring
Viatom/Wellue Check Me O2 Max
Viatom/Wellue Oxylink (see note below)
Facelake FL330
Lookee O2 Ring (by Wellue)

[lindsayschach]

Thanks!

[lindsayschach]

Here's my screenshot from last night. CPAP set to 7, EPR off, plus a zoomed-in screenshot of a couple of CA apneas.

Feedback most appreciated.

ZOOM.png (855.13 KiB) Viewed 8640 times

OSCAR Screenshot.png (849.99 KiB) Viewed 8640 times

[Miss Emerita]

What a remarkable improvement! I'm very glad to see it.

With EPR off, your flow limitations have increased, but in your place I'd continue for now to do without EPR.

I hope someone with expertise will give you advice based on the zoomed-in snippet. You're having some periodic breathing, which isn't in itself worrisome, but I'm uncertain whether there's still any chance that the type of PB we're seeing is Cheyne-Stokes.

Could you post another night after a few days, again showing the whole night plus a snippet from CA territory?

Oh, and you might turn off the ramp unless you really need it to fall asleep. A pressure of 4 is generally too low for an adult.

[lindsayschach]

Thank you. I did turn off the ramp. I will keep these settings, then repost in a few days.

Lindsay

[Respirator99]

That's a huge improvement, and I hope it is sustainable, not just a one-off. So please let us know how it goes over a period of time. Even though you have some periodic breathing, it's not prolonged enough to be a worry.

The main question now is whether you can feel any difference? Do you feel more rested and invigorated?

[lindsayschach]

Can somebody please explain to me why I loweeed the pressure to 7 and what the results might mean?

Thanks,

Lindsay

[Miss Emerita]

Higher CPAP pressures can induce CAs in some people. CPAP pressure can lead you to blow off more CO2 than you'd normally do when you exhale. With less CO2 in your blood, there can be a delay in the "breathe-now" neuro-chemical signalling that controls your breathing during sleep. Sometimes this will result in a series of CA events. You delay inhalation, then you inhale more deeply to make up for the delay, then the deeper breathing washes out CO2, and so on.

[ozij]

I'm a 74 YO female who has been using a CPAP for about 10 years, successfully. But recently, my AHI has increased significantly.

This a happened at a minimum of 10, maximum of 16.

And then you lowered to 7 - suggestion by respirator 99 - and the difference is tremendous.

Which raises the question: What else happened the changed your pressure needs?
Who, or what put you on 10/16? When was that last changed? Did your CA index creep up gradually? Happen overnight, and go away overnight?

Have you lost weight recently? Changed any kind of medication?

[lindsayschach]

Hey, y'all. Here's the latest OSCAR report. I got an appt with a pulmonologist/sleep doctor later this month. Does is make sense to go to him or just stick with what I have now?

For some reason, I can't get my screenshot to attach. Can anyone help?

Thanks,

Lindsay

[lindsayschach]

Hey, y'all. Here's the latest OSCAR report. I got an appt with a pulmonologist/sleep doctor later this month. Does is make sense to go to him or just stick with what I have now?

For some reason, I can't get my screenshot to attach. Can anyone help?

Thanks,

Lindsay