I think I have Central Sleep Apnea, but doc gave Philips CPAP.

As the subject says, I think I have a more serious case of Central compared to Obstructive (I think). Judging from the self recorded night camera video of me stopping chest movement, sound from nose OSA, and jolting awake on SPO2 drop (matched live with the cam I think I am towards CSA.

When I was at the doctor, in 2018 it feels like she isn't concerned about answering my question, keep repeating what is written on the "report" and say mine is mild sleep apnea only, nothing to worry. But I felt brainless each day and too tired to focus.

Was prescribed a Philips Dreamstation CPAP. Felt that it was useless on 99% of the times. Should I be given a BiPAP instead based on the report? From how I see it, it's more of shallow breathing and central, 2nd page on sleep study says
72 Central, 53 Obstructive (my addon: due to sensitive nose in aircon hospital), 1 mixed apnea, and 66 Hyponeas

And here's the report from the sleep study from 2018: https://photos.app.goo.gl/5EobdYQYdhtpF9kC8

And the data from my Dreamstation CPAP from latest 2022 - 2018 (reverse timing on random dates): https://photos.app.goo.gl/qaa5u5VyCyU9hCyd8

so my question.
1) Should I be given a BiPAP instead based on the report?
2) A dentist who says he can treat me with myofunctional therapy, is trying to sell me a package. But online says it's more for OSA, limited efficiency for Central. Anyone tried this before?

Thank you for all the help....

turtle wrote: ↑

Fri Jul 01, 2022 2:39 am

so my question.
1) Should I be given a BiPAP instead based on the report?
2) A dentist who says he can treat me with myofunctional therapy, is trying to sell me a package. But online says it's more for OSA, limited efficiency for Central. Anyone tried this before?

1...No. Not proven to be needed at this time. You do need to do something a LOT different with your pressure settings though. Why are you using those settings? You need to use more pressure and deal with the OAs and hyponeas first (more pressure) and then if you have very many centrals then you worry about a different machine.
Roughly 75% of your AHI is obstructive in nature (those OAs and hyponeas..which BTW hyponeas are a lot more than just "shallow breathing") and the fix for those is more pressure.

2....No, it won't help with centrals and probably any help it does for obstructive stuff will be marginal.
Even if you did have central apnea issues ....oral devices can't do a damn thing about them. Centrals happen because the brain doesn't tell the body to breathe. Tell me how an oral device is going to affect the carbon dioxide levels in the blood which is what the brain monitors and sends the need to breathe signal for????

Pugsy wrote: ↑

Fri Jul 01, 2022 5:47 am

You do need to do something a LOT different ...

I'll say.

Check out sleep study:

137 spontaneous arousals.

0 desaturations.

Get out of SkyLab view in Oscar and look for TWA.

Rubicon wrote: ↑

Fri Jul 01, 2022 10:19 am

137 spontaneous arousals.

I didn't get that far but doesn't surprise me. In all honesty I just confirmed the presence of centrals.
Pretty much the definition of sleep quality train wreck isn't it? We go back to sleep quality in general being in the toilet and lets throw cpap at it because we all know that cpap/apap fixes everything....cough, cough.

Then lets tie its little hands so it can't even deal with the obstructive stuff while I worry about central apneas instead of fixing what can easily be fixed with the machine and then worry about anything left over.

So much is so wrong with all this thought pattern I just didn't have time or energy to go into it all.

I guess I need to go back and read the entire 4 yr old "mild OSA" sleep study report.... Later when I have more time. I pretty much wanted to just address the 2 questions at this point and I didn't read the entire sleep study because I could answer the questions without needing all that much from the sleep study itself.

I am wondering who in the hell came up with 4 to 4.5 range in auto mode in the first place?...and why? What was the thought process? This is why doctors don't want patients screwing around with settings and/or results.

Pugsy wrote: ↑

Fri Jul 01, 2022 10:34 am

4 to 4.5 range in auto mode

I just took a quick glance and probably saw what you saw. His nights are bad at that pressure range. Looking at a few charts where the max is 12.0, his AHIs are under 2.0.

ChicagoGranny wrote: ↑

Fri Jul 01, 2022 10:52 am

Pugsy wrote: ↑

Fri Jul 01, 2022 10:34 am

4 to 4.5 range in auto mode

I just took a quick glance and probably saw what you saw. His nights are bad at that pressure range. Looking at a few charts where the max is 12.0, his AHIs are under 2.0.

OMG a gazillion reports at a gazillion settings with a gazillion results. I have a headache.
May 19, 2019 was a very nice report...AHI less than 1.0 with settings 8.5 to 12 but 2 breaks in therapy (there were probably more because there are always more arousals) with a little bit of VS2 snores which is nothing.
For sure no evidence of central sleep apnea that the centrals couldn't be explained away as arousal related and with so many OAs at times the OAs could possibly be causing arousals which in turn will cause false positive centrals.

At any rate...doesn't change the answers to the 2 questions presented by OP and since I don't have a working crystal ball that is all I can offer at this time.

Thank you all for the reply and effort to review the shitload of data hahaha! <3 Shall summarize and reply.
- for the OA, I am thinking it's more like my nose have became sensitive from the increase air pumped through my nose. From what I heard, there's 3 area that can contribute to OA, I don't know the medical term for the area, but remember one to be at the nasal opening, soft palette (behind the nose?) 1 at the throat (tongue)...
- video recordings of myself and see my own's chest movement stopped and restarted most often in the supine position.
- When I start having nightmares, I wake up having my nose all blocked, or the pressure just go overboard and keep blasting at my blocked nose. Feels like the CPAP machine is untraining my body to want to breath after going back to it for the 4th night, and I can feel that I don't feel much like breathing when I am awake now.
Latest 4 days update from trying around different pressure: https://photos.app.goo.gl/kWLV3C4zsvfykxSL6

What I will do tonight.
- go for a short run.
- will change the settings to 8.5 - 12.
- Sleep on my sides.

Little tip - post Oscar settings without the calendar and do post according to directions re which graphs (and which not) plus the left hand side column beside the graphs. If you need help staying on your side vs back there are tricks to do that as well.

turtle wrote: ↑

Mon Jul 04, 2022 3:58 am

Latest 4 days update from trying around different pressure: https://photos.app.goo.gl/kWLV3C4zsvfykxSL6

Those charts aren't helpful except to show you are doing poorly. Please follow the instructions for posting the Daily Details screenshots.

turtle wrote: ↑

Fri Jul 01, 2022 2:39 am

\ I think I am towards CSA.

Whatever makes you think that? your most recent pics show a strong obstructive and insignificant amount of CSA.