Help Needed Please

[Fizzy42]

Hi Ive been on CPAP since Oct 2013 been a bit of a bumpy ride, but I am 100% compliant. Im having a few problems at the moment well the last few months really. It looks to me on Sleepyhead that im getting some very long lasting Central Apneas lasting up to 2 mins? Is that possible? I also use Oxygen overnight as I desaturate 70% of the night. Im also getting some periodic breathing, long Hyponeas, reras. Im feeling rubbish, headaches, bad memory again, What to do? If someone would be kind enough plz to tell me how to post sleepyhead so I can show you the problems im having. Thanks for your help, Lynda

[Pugsy]

viewtopic/t103468/Need-help-with-screen-shots.html

https://sleep.tnet.com/reference/tips/imgur

see above links for instructions on how to post image of your reports as well as examples of what we like to see.

Do you have other health issues that cause the need for the added O2 during the night? Are you also on O2 during the day?

[Fizzy42]

Hi im being investigated for AF, have asthma, high BP. Not on oxygen through the day, doc said I have Complex Apnea? Im also overweight which im trying to do something about. Will try and post, Thanks

[Pugsy]

Your profile shows a machine that is not normally used when people have Complex Sleep Apnea...is your doctor trying the lessor approach first to see if things improve or did you choose the wrong machine?

Do you understand Complex SA? This video does a good job of explaining at keeping it simple
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

[Pugsy]

About your equipment choices...the humidifier you have chosen is a way old outdated discontinued humidifier and I doubt you are using it. Look at the picture....does yours look like that?

Also..let's figure out exactly which machine you are using. Turn the blower unit over and look on the bottom for a 3 digit number which may have DS, REF or P in front or behind it and tell us that number and we can tell you exactly which machine you are using and then tell you which humidifier you are likely using because the one you have chosen now won't work with any of the new machines.

Make sure no water is in the water chamber or remove the water chamber before turning the machine over to look for the model number.

[Fizzy42]

[Fizzy42]

Hi hope ive put these on ok? im not very good at posting lol. Any help wud be appreciated, thanks Lynda

[Fizzy42]

Wot machine do you think I shud be on with complex sa? That's what doc put in my diagnosis, thanks for helping

[Pugsy]

I don't see any evidence of Complex Sleep Apnea on these reports.
It's possible that you had it initially and it has gone away as your body got adjusted to cpap therapy (and that's a good thing) which can happen.

How often do you see the ugly clusters like you had on the Jan 15 report?

Can you redo the Jan 15 screen shot? Your AHI is cut off by the calendar (you can hide it) and the graphs below the events graph are zoomed in on a time frame that is at the very beginning of the night and isn't helpful at all.
Don't zoom in on anything.

You appear to be using a PR S1 60 series auto cpap...that's what SleepyHead says.
You have some incorrect choices in your equipment profile.
Machine should be....PR System One 60 Series CPAP Auto
and humidifier should be ...PR System One 60 Series heated tube humidifier with heated tube (even if you aren't currently using the optional heated tube at this time.

Have you had an overnight pulse oximetery test done while you are actually using your machine at night?
Was the 70% desat what you had during the diagnostic sleep study without cpap or was it from something else?

Can you show me an image of a night with Periodic Breathing....and zoom in on the PB green area so we can see the breaths?

[Fizzy42]

Hi Pugsy ur quite right lol id put the wrong humidifier down! My blower is 561P appreciate ur help, not scheduled to see sleep doc again until august, thanks

[Fizzy42]

Hi that's good that I might not have complex sa anymore, my doc came to that conclusion after id have an overnight pulse oximetry test which showed very bad desates. Being in the UK ur very lucky if you can have a proper overnight sleep study done, all ive ever had was the oximetry. The 70% desate was when I was using my cpap, which was set on 4-10! It was nearly suffocating me, he raised the pressure to 10-15 which did help enourmously, I cud breathe again! lol. I do get clusters quite often, either csa or oa, I also get a lot of reras. I can get my son to show the PB tom if that's ok? im useless on here lol, I do wonder tho with my hypopneas etc if Im on the right machine, I do feel I cud do with more help with my breathing. I didn't get any choice with my machine being NHS u get wot ur given, but hey ho, im lucky to have one. Thanks for looking, i'll get the PB done tom

[Pugsy]

I don't see the need for one of those high end machines that is normally prescribed for Complex Sleep Apnea because you aren't having the centrals (Clear Airway on SleepyHead) that is normally seen with Complex Sleep Apnea.

Have you had a recent overnight pulse oximetry done? Did you know you can buy your own and test your oxygen levels overnight yourself?

So you are in the UK? I know that they do things differently over there.

If you are seeing clusters of OAs...hyponeas...flow limitations or RERAs...usually just a little more minimum pressure will take care of it.
If you are seeing clusters of CAs/Centrals...we don't treat that with more pressure using the machine you are using now.

So far from the image you show here...it's mainly obstructive in nature and all I would do is maybe try 0.5 cm more minimum pressure because most of the time your pressure is doing a good job.
I suspect that maybe sleeping position or REM sleep is what is happening with the clusters of OAs and hyponeas.

I don't think that a different machine is needed at this time and I don't think it would help and for sure you wouldn't ever get NHS to swing for it if the bulk of your reports look like these...because they are anywhere near bad enough to warrant a different machine.

[Fizzy42]

Thanks Pugsy, very reassuring. I will get an Oximeter and keep an eye on my desats etc. Thank you for looking

[Pugsy]

Make sure you get a pulse ox that records all night and not one that just spot checks.
Available on EBay for roughly $50 to $100 US depending on how fancy you want to get...not all will record all night so make sure you know your models.
The CMS 50 D Plus and higher models will do the trick..see what's available here
http://www.coopermedical.com/overnight-pulse-ox