Second sleep study results 90 m of water LOL

[jacobsbd]

Did the first sleep study, Put on CPAP 3/4 of the way through. Second study many days later. Just got the results of the studies in my email.

Looks like they will do a third study or put me on an APAP machine. They suggested that I be given a hypnotic next time.

"Unsuccessful titration study with persistent obstructive and central events at the highest pressures evaluated of CPAP 90 m water. Lower pressures resulted in persistent obstructive hypopneas with desaturations into the lower 90s."

90 meters of water! Would have exploded with that pressure LOL. (probably should have said 9 cm as that is what the graphs said.)

Second study had 413 minutes in bed with only 1 (one) minute of REM. 4.5 minutes of REM in first study. First study had some time not on my back and I felt like I slept some. Second test was all on my back and I did not really feel like I was asleep except for maybe a couple of minutes. Had lots of PLM in first study none in the second.

Looks like they ramped the pressure up to stop the obstuctives and started getting centrals. Almost all the desaturations on the second night happened while I was awake. I had a light cough at times. In otherwords, I was awake for a few minutes and then had a low O2 number, not the low O2 waking me up.

I told them in advance that I do not sleep well on my back and that I sleep from 3 AM to 9 AM. Usually do not sleep much the first night in a new place. So they told me to go to sleep at 10 PM and 9PM.

I may put most of the sleep studies up on one of my websites with a link here if needed.

The question I now have is: If the pressure must be increased so much to stop the obstuctives that it starts to cause centrals what is done about that?

Thanks

[avi123]

I would do what "they" say without criticizing "them" b/c I and you know almost nothing about "it"

[Pugsy]

I would start researching Centrals and also the other types of machines. Some of the members here do use a different machine because they also have Centrals. I am sure they will chime in. Maybe change your topic to something to include the central and regular OSA to get their attention.

I believe that to qualify for these special machines some hurdles have to be crossed. They can explain it better than me so I won't even try.

[avi123]

I would start researching Centrals and also the other types of machines. Some of the members here do use a different machine because they also have Centrals. I am sure they will chime in. Maybe change your topic to something to include the central and regular OSA to get their attention.

I believe that to qualify for these special machines some hurdles have to be crossed. They can explain it better than me so I won't even try.

Reply:

Pugsy, after reading about CENTRALS in this report I decided to get an S9 Elite (CPAP only) and not the S9 AutoSet because the Autoset suppose to detect CENTRALS and act upon this info. If it misses to calculate correctly then it continues to push the regular pressure air or even at higher pressures (running away) even if it is harmful. IMO, the Central Sleep Apnea Detector (CSAD) has yet to prove itself over time.

Link:

(Read the INTRODUCTION here)

http://www.resmed.com/us/assets/documen ... -paper.pdf

[rested gal]

I may put most of the sleep studies up on one of my websites with a link here if needed.

That would probably be helpful.

The question I now have is: If the pressure must be increased so much to stop the obstuctives that it starts to cause centrals what is done about that?

Sometimes it just takes time for the body to become acclimated to the pressure. It may be that after you use CPAP for awhile (days, weeks) at the prescribed 9 cm H20 the centrals could subside on their own. I'd try that first before I started worrying about centrals having shown up in such a rocky night of sleep as you had at the study.

90 meters of water! Would have exploded with that pressure LOL. (probably should have said 9 cm as that is what the graphs said.)

heheh. Yeah. A rather unfortunate typo, that one.

A trial on autopap at home for a month would probably be a good idea, if the doctor will order it.

If it were me, I'd want to use the autopap in CPAP mode at 9 cm H20 for the first week of the trial, however...to get a good long baseline look at how things go while using a single pressure night after night for awhile. One week at CPAP 9 cm pressure would give the body quite a few nights to become acclimated to using CPAP at just one pressure. It would give time to work out any mask issues (mask leaks, uncomfortable mask, wrong size, etc.) After having a week or two to get most of the usual new-to-CPAP issues sorted out, I'd want to switch to autotitrating mode at this range: 7 - 15

One of the first things I'd absolutely want to check during the first two or three days of using CPAP would be the "leak rate." A high leak rate when not using a Full Face mask can be an indication of mouth breathing...therapy air escaping out the mouth instead of being contained where it's needed to keep the airway open.

Every autopap gives AHI and leak info, except the one called the ResMed Escape Auto. I don't think it can show "leak" data. Don't let them give you an "Escape" Auto. In the ResMed line, you'd want the ResMed S9 Autoset.

Without having software to get the most detailed look at the machine data, the ResMed S9 Autoset would give the most helpful info in the machine window display itself. So, that's the machine I'd want for an autopap trial at home.

Good luck, Jacob. Let us know how it goes!