HELP-Still having 17.7 OA on new Auto

[OutaSync]

I'm still new to this and my doctor told me not to "micro-manage", just let the machine do it's job. But here's the thing. He switched me to an auto from a straight last week and I don't get my card read until nest week. I didn't tell him that I have the software because he didn't seem happy that I was recording my numbers from the LCD screen. I have clusters of apneas and it looks as though the auto starts to raise the pressure and then There is a NR and it goes back down. The apneas contiue for 15 minutes to half an hour after the NR.
Here are my stats from last night:

90% 12
NR: 0.6
FL 1.9
OA: 17.7
H: 1.8
VS: 2.4
OH Events at pressure
6: 3.4
7: 11.9
8: 19.3
9: 19.5
10: 17.9
11: 35.6
12: 32.00
13: 22.2
14: 30.0
15: 8.6
The pressure only went up to 16 for one minute and that is what my sleep study prescription was for. Any ideas as to why the APAP is not stopping the apneas?

[Wulfman...]

What are your pressure settings in your Auto......min?....max?
From your description, I'm going to "guess" that it's set at 4 - 20.
If your bottom pressure is set too low, it can't stop the events that need a higher pressure.
The machine can't do its job if it's not configured correctly.

Den

[OutaSync]

It is set from 6-20 and the doctor doesn't want me to fiddle with it.

[Wulfman...]

Maybe your problem is at the other end of the pressure scale. (unfortunately, I had a brain lapse and didn't look at the significant increase in your events as the pressure increased....sorry)

Do you have a copy of your sleep study? Did they note any central apneas?
According to the data that you posted here, a pressure of 6 is your best pressure. Seems to be a long way off from your prescribed pressure of 16.

If you're not willing to change your machine, I would advise showing this data to the doctor. Do you have an Encore Pro report with all of this in it?
I think I'd take my chances of his "wrath" for monitoring my own therapy rather than having nights with those kind of numbers.

Den

[Wulfman...]

After all, he's SUPPOSED to be working for YOU. The money that's paying him is coming from your insurance provider whom (I presume) you pay premiums to.

Den

[OutaSync]

I do have a copy of my sleep study and it does not show any centrals. One night-only three hours. By the time I get them to read my card, this week's data will not be on the card, so I will have to show it to him. When I was on the straight CPAP I tried lowering my pressure and as it went down the QHIs seemed to go up. At a pressure of 10 it got up to 44. That is whent the Dr. told me that I should be at 19 but he didn't think I could tolerate that pressure so he set it at 16. If I only need a 6, why do I keep having apneas for a full hour, one right after the other ? I think the times that I am not having them I am awake.

[Wulfman...]

If you think you're up to handling the pressure, you could try to set your machine for a range of 15 - 20 and see what that data looks like......

If Centrals aren't an issue and he thought you should be at 19, that seems to be the only suggestion that I can come up with at the moment.

IF you do decide to try that and IF that much pressure brings down your numbers, your doctor should prescribe a Bi-PAP for you.

Den

[OutaSync]

Do "NR"s in the middle of the block of apneas indicate centrals? Is that why the auto will not go any higher? It thinks I'm having centrals. I'm willing to try anything. I just need the right direction!
My Dr. did mention that the next step might be biPAP. But don't I need to find out what pressure works first?

[Wulfman...]

Do "NR"s in the middle of the block of apneas indicate centrals? Is that why the auto will not go any higher? It thinks I'm having centrals. I'm willing to try anything. I just need the right direction!
My Dr. did mention that the next step might be biPAP. But don't I need to find out what pressure works first?

The only true way to determine Centrals is in a sleep study. These machines interpret these events from air flow. From what I know (more specifically have "read") the NR's COULD indicate Centrals.....but that's just a "possibility".

Another qualifier would be the "quality" of your previous sleep study. If it was flawed, then the rest of this is just GUESSING.

Den

.

[Wulfman...]

Do you know if you have GERD?
There have been many, many discussions about that on this forum. There's also a "silent" version (you may not know if you have it). Anyway, it can cause "clusters" of events to appear on the reports.
There are other things related to the vocal cords (I believe it's called VCD) that can mess up one's therapy, too.

Den


.

[OutaSync]

I have spent hours each day reading these posts. I think I'm addicted to it. So, yes, I've heard of GERD, but don't know if I have it. I've been following ROOSTER's story and some others from years back. Never thought that any of this would happen to me. I'll do some more research on GERD.

Thanks for your help. Let me know if you, or anybody else, comes up with an idea before I go back to the Dr.

[Wulfman...]

Bev,

One other question.
Do you save your Encore Pro reports to .pdf files?

Den

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[OutaSync]

I just got the software installed a couple of days ago and don't know how to save it to .pdf. If I figure out how to do that, how would one go about posting it here?

BTW, I'm at work so if I "disappear" it's because "boss over shoulder"

[Wulfman...]

I understand.

Please check your Private Messages (PMs).

Den

[OutaSync]

My sleep doctor finally called me back this morning. He wants me to go in for another sleep study tomorrow night. (First one was only 6 weeks ago) He is going to try me on a BiPAP and see if that brings the numbers down. If not, he suggests going to a ENT to see if surgery would help. Yikes! I guess there is no easy fix for me.