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[Sludge]

OK, so clearly there are tons of desaturations.
They used the automatic scoring button but I haven't the slightest idea how they set it up to miss all the desats.
With no desats they couldn't have scored the hypopneas, but did anyway.
The OSA diagnosis is clearly absurd. But you need to get that changed to get the ASV.
Of interest is the lack of heart rate response to the apneas and desats.
With abdominal and thoracic belts they can score centrals effectively.
I have befuddlement as to why there are no breaks in the CSA during the periods where REM should be (you generally don't chain central in REM)(but you can have "normal" centrals).

[EMTunit31]

kaiasgram,
There is no way I was laying down. I do some serious choking and gasping if I do. Scares my husband to death. Me too for that matter. It's super hard to get back to breathing right. The sound I make is hideous. I would rather set up or be slightly reclined.
Desats? can you explain that to me. I don't understand what it is.

[EMTunit31]

Wow Sludge,
That sounds pretty intense but I don't understand all of it. Break it down for me?

[Sludge]

Desats? can you explain that to me. I don't understand what it is.

Sure:



Each time the oxygen line drops 4%, that is a desaturation. They take like 20-60 seconds each (dropping down, then coming back up). There are so many that what should have been a pencil thin straight line is now a thick jagged bar. And some of those desats are like 20%.

[EMTunit31]

Link to Interpretation

http://s249.photobucket.com/user/emtuni ... 4.jpg.html

[Sludge]

There is no way I was laying down. I do some serious choking and gasping if I do.

Even when you're awake?

[Sludge]

Link to Interpretation

http://s249.photobucket.com/user/emtuni ... 4.jpg.html

Boiler plate and worthless.

[Sludge]

Break it down for me?

First of all, we need to get the study properly scored and interpreted. Everything is suspect (all the centrals could have been improperly scored and they are actually all obstructive)(that would explain the existence of events in REM)(assuming there was REM).

Let's start with:

Do you think you slept all night?

[kaiasgram]

Thanks D.

[EMTunit31]

Hmmm, Sludge. To be honest I really don't know because I don't lay down. I wouldn't think so though.

[EMTunit31]

Ok. I'm going to get a LOT of backlash for this but sometimes I have to take the mask off in order to sleep without being woke up from the pressure being 20 and causing leaks. I have tried to reset it and it only goes back up to 20 usually within minutes. That spells NO rest. I finish the night without help (sometimes). Sometimes I just fall asleep a few hours after waking up. I simply cant stay awake.

[kaiasgram]

Ok. I'm going to get a LOT of backlash for this but sometimes I have to take the mask off in order to sleep without being woke up from the pressure being 20 and causing leaks. I have tried to reset it and it only goes back up to 20 usually within minutes. That spells NO rest. I finish the night without help (sometimes). Sometimes I just fall asleep a few hours after waking up. I simply cant stay awake.

Your case is complicated and your report is baffling and I don't think we're in any sort of position to judge you. Heck, at this point we don't even know if you're on the correct machine for your apnea.

Even if it turns out that you don't end up needing the ASV machine that Pugsy mentioned earlier (for central apnea), 20 is a very high pressure and most people who need that high pressure are either prescribed, or end up switching to, a bilevel machine for easier breathing (your current machine is not a bilevel).

So hang in there. I'm so glad you found this forum -- I can't believe what you've been up against, from the weird Resmart machine to the bizarre sleep study report...
And the doctor who signed off on your report is a neurologist... ?

[Sludge]

... it only goes back up to 20 usually within minutes.

Because it appears to be chasing centrals, and probably makes things worse as it does.

RESmart (or REStoopid) software appears to be very rudimentary:



You may be able to salvage some of this if you get the home study rescored, correct the desaturations and hypopneas, confirm wheather they are central or obstructive apneas and then get the correct diagnosis on the prescription (as long as "obstructive apnea" is on the prescription you won't get an ASV). Then take the REStoopid and throw it out. Central apnea detection is the standard of care nowadays and that thing does not appear to show any indication that it has that technology, and if we had something that did we'd at least be in a better position than we are in now.

If it turns out the apneas are central then you need ASV (or BiPAP S/T minimum) from a brand name manufacturer whose software offers complete disclosure.

[EMTunit31]

Yes, Sludge. He is listed as a University Neurology and Sleep Medicine.

[Sludge]

Do you want the RESmart software, or can you upload the files on the SD card so we can look at them?

Here's the crux of the issue here. An obstructive apnea occurs when you sleep, and is caused by a relaxation of the upper airway so you choke and gasp when you lie down. Your comments suggest that you do this. The treatment is just add a little CPAP pressure to splint the airway open and happily ever after.

An obstructed airway (new official term) is when your airway collapses even when awake. Your comments about being unable to lie down suggest that this could be occurring. Or, this feeling could occur with compression of the diaphragm. What else did the stroke affect? What is your current weight?

A central apnea is when you stop breathing completely for 10-60 seconds. The cause is usually exaggerated breathing for 10-60 seconds, and then stopping completely cause your breathing needs have been met (for a while, anyway). Not only does CPAP fail to treat this (simply adding pressure to somebody not breathing only results in a person sitting there with a mask on their face not breathing. A foil hat would work just as well) it will make thing worse because the periods when you do breathe become more exaggerated, so the resulting central apneas are longer and more frequent. Further, since you machine thinks they are obstructive apneas, it continues to add more pressure, and things get even more worster. So the treatment for central apnea is to get a machine that forces in breaths when you're having these events and not breathing. You don't need pressure, you need breaths. Hence, BiPAP S/T or ASV.

I think the ball will start rolling if you call you guy and say "I had 387 central central central central apneas on my sleep study but you gave me a diagnosis of obstructive apnea. What's up with that? And I read on the internet (they always love to hear that) that the WORST thing you can do with somebody who has central apnea is put them on a wide open APAP (that does not have central apnea identification technology). Now the thing skyrockets to 20 every night for no good reason. Why'd you do that to me?'"

Any guff and just hand him the link to this thread and tell him he's about to get famous.