Oscar Data from a couple nights and some issues I'm experiencing

Pugsy wrote: ↑

Tue Nov 24, 2020 8:23 pm

Miss Emerita wrote: ↑

Tue Nov 24, 2020 8:18 pm

But why not an ASV? Or do I have the wrong picture of its capabilities?

Because some doctors are idiots or they are afraid to prescribe ASV due to that flawed study some years back which caused such a panic among doctors (that congestive heart failure thing) and stuck people on the ST machine. You don't have the wrong picture at all. The ST isn't probably the best choice for someone with both central and obstructive apneas because it is a totally fixed pressure machine with a back up rate.

I hate ST machines for OSA and barely can stand them for central apnea alone because what it forces people to do might actually even cause some centrals....high PS with every breath no matter if a person needs it or not.

So what do I do about that/with that information? I doubt the neurologist that handles this wants to hear me come to him saying someone on the internet said that. Nothing towards you, obviously... just, you get what I mean. But if an ST machine isn't possibly the right machine, that concerns me. ALso the obstructive was most likely due to the weight I had gained (and have no almost completely lost).... so I would be that is much more reduced now. The central never goes away, from what I understand... as it is neurological? Right? Brain not telling my diaphragm to do its thing?

So how do I approach this? I was really hoping to avoid dropping another $2k on another damn sleep study... but is that what seems to make the most sense now that I have lost weight? And mention the ASV to the doctor as well?

boxofrain wrote: ↑

Tue Nov 24, 2020 5:29 pm

Have you considered that this may not be a sleep apnea problem but more of a mental health problem?
You said "a little depressed and a little anxious in your OP."
I am wondering if you are more than just a "little depressed."
The reason I ask is because I am going through something very similar to what you are going through so I am very in tune to this.
Just thinking out loud.

First off, love your username/picture! Dead head here!

Maybe I am more than a little depressed. I've been struggling a good bit overall... my issue there is this. I have dealt with depression in my life before and made it out the other side. It seemed like medicating was such a waste of my time. I couldn't seem to find a really decent psychiatrist to really workout what meds would work best for me. I live in a small town, so my GP was prescribing my SSRIs and I just hated the side effects... the complete lack of sex drive really put a strain on my romantic relationship plus various other uncomfortable side effects and I never really felt like it helped one bit. He tried a couple others but I can't remember which ones. I am not at all against meds for depression... I just dont' know how to find someone that can really help me work through the different meds to find one that really will help. Does that make sense? It's so expensive to see the doctor, then to get meds... I make just over the threshold for Obamacare but can't afford normal health insurance rates at how much i make lol So... I have no insurance.

That's where I'm at right now.

tirwander wrote: ↑

Wed Nov 25, 2020 1:10 pm

So what do I do about that/with that information?

I have been thinking about that and there's really nothing that I can think of short of starting over to see if you have OSA still being present since the weight loss and then at the same time see if central apneas are still an issue or not. We don't know what might be causing the centrals or how many you had to earn you that diagnosis.
So there's a lot we simply don't know. You know all that involves another sleep study and it needs to be done in a lab.

Short of that....if it were me...this is what I would do and I want you to know it's just my own personal thoughts.

I would change the machine to cpap mode and just do a minimal pressure and see if I still had some event flagging happening at a minimal but comfortable pressure. The only problem with doing this with the ST machine is that it doesn't distinguish between central apneas and obstructive apneas. It's just what these ResMed machines do even in cpap mode. If you have a truck load of events happen at a lower pressure then there's a good chance thy are obstructive but we can't totally rule out them being central apneas.

tirwander wrote: ↑

Wed Nov 25, 2020 1:14 pm

First off, love your username/picture! Dead head here!

Maybe I am more than a little depressed. I've been struggling a good bit overall... my issue there is this. I have dealt with depression in my life before and made it out the other side. It seemed like medicating was such a waste of my time. I couldn't seem to find a really decent psychiatrist to really workout what meds would work best for me. I live in a small town, so my GP was prescribing my SSRIs and I just hated the side effects... the complete lack of sex drive really put a strain on my romantic relationship plus various other uncomfortable side effects and I never really felt like it helped one bit. He tried a couple others but I can't remember which ones. I am not at all against meds for depression... I just dont' know how to find someone that can really help me work through the different meds to find one that really will help. Does that make sense? It's so expensive to see the doctor, then to get meds... I make just over the threshold for Obamacare but can't afford normal health insurance rates at how much i make lol So... I have no insurance.

That's where I'm at right now.

WOW so cool there is another Deadhead here. I am guessing there are more closet Deadheads that have yet to come out! Let's hear from more of you!!!
Anyway, tirwander, I HATE being on any meds. But I literally just started Lexapro (SSRI) so I am curious to see how it goes. I was on Celexa twenty years ago for less than a year when I went thru a divorce and it worked very well. Lexapro is supposed to be better. I am hopeful it will help my anxiety/depression because even though my CPAP tx is working very well, I still do not sleep nearly as well as I should. That's why I threw that out there. And you just admitted that maybe you are "more" than a little depressed. Do not ignore that! I am OK with the possibility of sexual side effects. I am 65, male and married. I am very active, have a good libido and my wife probably thinks I am too much!!! So if it calms me down a bit I'll be OK!

There are some incredible experts here. I am not one of them. Pugsy et al know SO MUCH. I would say they know more than most sleep docs on the workings of the CPAP machine and interpreting the data. But when I read your original post I just felt that your problem may not be so much with apnea, it may be more with depression. I would get it checked out and treated if that is whet it turns out to be. I may have missed it, but where are you located?