I have noticed something strange lately

Arlene1963 wrote: ↑

Sun Dec 16, 2018 10:47 am

In your situation, I'd be tempted to have an at home sleep study to figure out if something has changed.
You mention that you're planning to get the machine checked, if it's OK then why not have another study? If a sleep study indicates that there is no reason to continue then you at least have that reassurance and the choice is then an informed one whether to continue or not.

I'd be doing the happy dance if I had your chart. Only I would want to sleep for longer.

Actually I am getting a two night oximetry test done after the first of the year. My cardiologist ordered it last week, one night with the Cpap, one without. Don't get me wrong,....I would love to be a rare exception, and not have to use one of these things anymore, even though I don't hate it or anything.

Your idea of doing an at home test is a good one, and I may very well do that if the machine checks out, which I think it will. The only issue I see is if it says I have no problem anymore and I quit using, how would I know if I go in reverse again and start having issues? Keep in mind I am not one of those that felt any kind of wonderful improvements in my energy levels after starting Cpap, so I couldn't use that as a barometer per se. I guess I could always keep my main machine and use it for an occasional test, running a straight 4cm should I be cleared to stop treatment.

I think the order of action will be,....
1. Call AC Biomed this week and ask what they charge to do a checkup
2. Do my oximetry test after the first of the year.
3. Do a home sleep test, especially if the oximetry without cpap shows desats,

In the meantime I am putting my settings back on Apap with a 6 min/12 max EPR 2, and will continue to treat until i know otherwise. I just have no earthly idea how my situation could have changed, as I have never had a weight problem, and none of my meds have changed at all.

Just for the heck of it I searched out an old chart from when I first started and had my initial prescribed settings,....they said my AHI was 16 IIRC,...just over the mild level into moderate. My two sleep studies were done at a 'professional' sleep lab.

Keep us posted if you decide to have another sleep study.

I don't "hate" using my CPAP either but if I had a sleep study that showed I don't have OSA anymore AND my data was reflecting very little evidence of OSA night after night at the lowest pressure AND it made no difference to how I sleep and how I feel during the day, I'd stop using CPAP in a heartbeat.

However, in my case, if I don't use my CPAP for even part of the night I'm plagued with dreams, a racing heart, night sweats and feel like *&^&. Also, I'm one of those who experiences a lot of energy and feel so much better with CPAP, huge difference. Can't imagine not using it now. I feel very fortunate in this regard. (Interestingly, I had the same diagnostic AHI as yours, just on the cusp of moderate at 16.)

But I must confess I would rather NOT have OSA and if I was ever somehow inexplicably "cured" would be delighted.

Based on my own experience, I think what you're seeing may be normal. In my case, as I got my therapy dialed in, my OAI decreased to less than 1.0. However, for a while my CA remained somewhat high, around 2 or more. As I worked on sleep hygiene, diet and other factors that might influence sleep, my CA decreased as well. For the past year or so my AHI is less than 1.0 with an OAI near zero. I don't see any reason one's "treated" OAI can not be at or near zero. But that wouldn't mean CPAP is no longer needed, it just means the therapy is optimal and is producing the desired result (preventing OA's).

Jay Aitchsee wrote: ↑

Sun Dec 16, 2018 1:30 pm

Based on my own experience, I think what you're seeing may be normal. In my case, as I got my therapy dialed in, my OAI decreased to less than 1.0. However, for a while my CA remained somewhat high, around 2 or more. As I worked on sleep hygiene, diet and other factors that might influence sleep, my CA decreased as well. For the past year or so my AHI is less than 1.0 with an OAI near zero. I don't see any reason one's "treated" OAI can not be at or near zero. But that wouldn't mean CPAP is no longer needed, it just means the therapy is optimal and is producing the desired result (preventing OA's).

Jay,
I never meant to imply that I thought a treated OA AHI of 0 was impossible, it just made me curious what happened so suddenly, and I wondered mainly if something was wrong with my machine and it's data. Keep in mind that the OAs disappeared while using 7/12 Apap, and I went down to a fixed 4 Cpap and still no OAs. As I said previously, my prescribed titrated pressure was a constant 8cm.

I guess I just expected at least a couple of OAs to appear when I cut my pressure to a fixed 4, and nada.

I have no idea what is actually going on here, that's why I am posting this for opinions, and I appreciate all the ideas I get.

Mark55 wrote: ↑

Sun Dec 16, 2018 9:40 am

Well, still no real answers I guess. Here is my short chart from last night, as I retired quite late. For some reason that one of the experts can probably explain, my pressure graph disappeared from this chart, so I moved up the mask pressure section even though it's not important per se.

Still no OAs, and only one 11 second central. The only thing I see different is the fact my flow limit graph looks more active than normal. I assume this means the 4cm is just barely succeeding in holding my airway open, but it IS doing it?

The only other thing I can think to do would be to have it checked out at the local Cpap repair place. Let me know what you think.

On the other hand,....maybe I AM cured! JK

You're still having a fairly active flow limitation graph, and if you'd had the machine in auto mode, it would have raised pressure for a while there...

This means, you're still having sleep disordered breathing, even if it's not showing up as apneas or hypopneas.

PR,
I zoomed in on my flow rate graph in the area where the flow limit is kind of 'iffy', and it definitely shows a change in the normal breathing wave. I'm assuming without the 4cm,....maybe even 3cm, but with nothing at all, I would be showing OAs of both types. Of course that's pretty much what you're saying I think.

I just wish I could figure out what has changed to enable 4cm or less to hold open my airway, when 8cm wasn't doing it in that chart a few responses back, last year. Oh well, one can't always get answers for everything that happens in life.

I will be looking forward to my oximetry testing, and very likely may still do a home based test just to see what happens in my own home and bed. I also still might call the repair folks and see what they charge to give a machine the once over just in case there is something quirky there,......I don't really think there is though.

Thanks again to everyone.

I think your machine is probably OK. Your charts appear normal, though I haven't really studied them. If I were you, I'd be happy with the result but I understand your curiosity. I'd be looking at factors other than the treatment--environmental, physiological, etc. I know my sleep varies with the seasons, but I don't know why. Cooler temps, no AC, different bedding, time changes, differerent exercise patterns, are some of the possibilities. How about you? Do you see a similar trend in last year's results around this time?

You didn't change masks or bed pillows, did you?

Jay Aitchsee wrote: ↑

Sun Dec 16, 2018 6:45 pm

I think your machine is probably OK. Your charts appear normal, though I haven't really studied them. If I were you, I'd be happy with the result but I understand your curiosity. I'd be looking at factors other than the treatment--environmental, physiological, etc. I know my sleep varies with the seasons, but I don't know why. Cooler temps, no AC, different bedding, time changes, different exercise patterns, are some of the possibilities. How about you? Do you see a similar trend in last year's results around this time?

You didn't change masks or bed pillows, did you?

That's the weird thing Jay,...nothing has changed, nothing at all. I have weighed within a narrow range since my early twenties. With the business I'm in, I really don't need much additional exercise, and I have been doing the same thing for 26 years now, longer if you include when I worked for others. Same bed, and type of pillow as this time last year also.

I DID get a new mask (AF P10), but that was only a week or so ago, and I have only used it a couple of times to date. I think it's the 'aliens' like Pugsy said!

Mark55 wrote: ↑

Sun Dec 16, 2018 8:04 pm

Jay Aitchsee wrote: ↑

Sun Dec 16, 2018 6:45 pm

I think your machine is probably OK. Your charts appear normal, though I haven't really studied them. If I were you, I'd be happy with the result but I understand your curiosity. I'd be looking at factors other than the treatment--environmental, physiological, etc. I know my sleep varies with the seasons, but I don't know why. Cooler temps, no AC, different bedding, time changes, different exercise patterns, are some of the possibilities. How about you? Do you see a similar trend in last year's results around this time?

You didn't change masks or bed pillows, did you?

That's the weird thing Jay,...nothing has changed, nothing at all. I have weighed within a narrow range since my early twenties. With the business I'm in, I really don't need much additional exercise, and I have been doing the same thing for 26 years now, longer if you include when I worked for others. Same bed, and type of pillow as this time last year also.

I DID get a new mask (AF P10), but that was only a week or so ago, and I have only used it a couple of times to date. I think it's the 'aliens' like Pugsy said!

The biggest variable in cpap therapy is that thing attached to the mask...

While you may not think anything has changed in you, there are so very many variables...

If you wish to switch to plain-old CPAP, you don't need to change the machine. You can use the one you have in plain CPAP mode.

palerider wrote: ↑

Sun Dec 16, 2018 9:55 pm

The biggest variable in cpap therapy is that thing attached to the mask...

While you may not think anything has changed in you, there are so very many variables...

I believe you are correct, as my 2 or 3 OAs, and a hypop or two a night have returned as strangely as they left.

I called Accurate Biomed last week though, and found out they charge 85 bucks to go over the whole machine and make sure everything is working according to spec. If nothing else I know where to take it if this keeps happening. For now,...I'm just leaving things be.