Is This Normal?

Hi all. I am a newbie. Have been using CPAP for three weeks and really have not had too many problems. I was diagnosed by VA and they are a little weak in the support area. I will see my sleep doctor after 6 months unless I am having problems. The first week, I was averaging 8 or 9 AHI, but am now down to about 4 or 5 which is in the target range. However, my apneas are not OA's. I mostly have CA's and Hypopneas. I hate the title of this post, because there is never a normal, but it at least leads to my question. I am attaching three screen shots showing two different days data. Is this a normal pattern, or is it something I should try to see my sleep doctor about. I am on a fixed pressure of 9. I was titrated at 11, but I could not tolerate that pressure, so I adjusted the pressure to 9 and I am comfortable. As I mentioned, my OA's are almost always 1 or less on average.
My concern is the fact that the CA's and Hypopneas seem to occur as a group, and my breathing pattern seems a bit funny during that timeframe.
Any comments would be appreciated. I am sleeping better and seem to sleep more soundly with the CPAP.
Thanks!
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I'm not familiar enough with complex apnea to be able to tell you that's what it is, but I will say this: I had tons of CAs after going on CPAP. I'm also going to the VA. My first follow-up was after 3 months. That's when they reviewed my data and determined I needed a BiPAP (or bilevel device). I've since been put on a S9 VPAP ST. I haven't had a CA since. I've also attached some screenshots of my data from when I was using straight CPAP.

If I were you, I'd be calling your sleep tech and explaining what's going on with the CAs. They can generally work you in appointment-wise for something like this. Of course, I could be wrong, but I've been down the CA road before, so thought I'd give you my $0.02.

Also, whichever software is "supposed" to be used with a PR system, make sure you download it and look at your data in that before calling your sleep tech. I've been using SleepyHead from day 1. When I would tell my sleep tech what was going on, he kept pointing out that he couldn't be sure the software I was using was reliable. I've since also been using ResScan, and told him I've been using it. Now, when I speak with him about my data, he doesn't even question it.

As far as my screenshots are concerened:
The first one is really bad. The second one is closer to what a "normal" night on CPAP was for me.
I thought I'd also point out that my diagnosed AHI was 49.3 (or maybe 49.6, close either way). So, for me to have an AHI of 88.3, there was definitely something wrong. If you experience any nights with an AHI above what you were diagnosed with, make sure to point that out when you call.

Hope this helps.

dav6406 wrote:I mostly have CA's and Hypopneas. ... I was titrated at 11, but I could not tolerate that pressure, so I adjusted the pressure to 9 and I am comfortable. As I mentioned, my OA's are almost always 1 or less on average.

Well, the pressure reduction likely explains the Hypopneas. Hypopnea is a 50% or greater reduction in airflow caused by a partial collapse of the airway - an "almost" Obstructive Apnea (though they are still bad, since you are getting at least 50% less air and that is enough to cause blood oxygen desaturation and arousal). Reducing the pressure has likely allowed the partial collapse of the airway creating the H events, but you haven't reduced it enough for many of those to progress to full fledged OAs.

Someone new to CPAP having CA events isn't that strange, but I don't normally see them concentrated that tightly. That concentration of CAs is unusual in most sleep reports I see here. Other people who know more about the presentation of complex apnea symptoms will need to address that part for you.

How many of those ugly CA clusters do you see a night?
With the one shown above...I think I see a break in therapy right after it. Were you awake a long time before turning the machine off or did you wake up then restart the machine pretty soon afterward?

Thanks for the responses. I usually have one or two of these clusters per night. According to the data, they usually last about an hour or so and then I wake up. When I wake up I do not lay in bed awake, I turn the machine off go to the bathroom and return to bed. Takes about two or three minutes. Then I turn the machine on, ramp up and am asleep before the ramp is complete.

Concerning the VA tech, I have know idea who my tech is. They did a one night study with me, with half the night without clap and then half night with clap. Then the doctor called two weeks later and said he was writing a rx for a clap and a DME would call. A week later the DME called and I went to them to fit a mask and they gave me the CPAP.

What software is supposed to be used with this machine? Is there a free version I can try?

Thanks

I think you have the wrong machine showing in your profile....You picked a model that doesn't show any data...so I think you need to change it to
PR System One 60 Series Pro CPAPxxxxx that would be model 460 which SleepyHead says you are using.

You can also use Respironics Encore software and I can help you out with it...but send me a private message telling me what operating system is on your computer so I can point you to the what works best. It's free. Shows the same data as SleepyHead just visually it is presented differently.

No rush as I am going out the door just for for a doctor appointment.

It looks like you might have a little bit of Complex Sleep Apnea going on...hard to say for sure.
It isn't taking up a huge part of the night though so just watch it for now...it's possible it will reduce further as you adjust more to cpap therapy.
Sometimes it does go away with just some time...for now just keep an eye on things.