Mysterious Sleep Apnea or UARS. Unsolved. Please HELP

Here is the 4th picuter
Done without any CPAP/ Dental device or anything: just normal sleep recorded.

Actually your machine will do some limited data but OSCAR can't see it to report it because the files it needs to report the limited data aren't ever written to the SD card.

You have a couple of ways of seeing more data...
On the LCD sleep report you can see AHI and leak and pressure used...it's a generic AHI (apneas and hyponeas) and if it is low...we know the machine is at least preventing most apnea events.
If the AHI is high we don't know what kind of events are being flagged...this is unfortunate when this happens because some events need more pressure but some events more pressure can actually cause some types of apnea events.
To see this data on the sleep report you have to change a setting in the clinical setup menu area called "Essentials"...the default setting is "on" but if you change it to "Plus" you get more data than hours of use.

There is a software that will show what little data your machine does record....ResScan put out by ResMed. Unfortunately it is a PITA to use and it's Windows only.
If your computer is Windows OS and you want to try it send me a Private Message and I will send you a link to download it. I can't make the link public.

2 nights at a setting and guessing...not nearly enough time at a setting to give it a chance to see if it's going to help or not.
Especially if the hours of sleep are short and if you are sleeping at all without mask on.

Are any of those pulse ox reports where the O2 drops below 90 while you were using the cpap machine? If so, which one and what pressure were you using when you did it?
ResScan would give a record of the date and pressure used.

Hello Pugsy,
Thanks a lot for your reply.

To see this data on the sleep report you have to change a setting in the clinical setup menu area called "Essentials"...the default setting is "on" but if you change it to "Plus" you get more data than hours of use.

I have now changed it and will start to record on this setting from to-night.

There is a software that will show what little data your machine does record....ResScan put out by ResMed. Unfortunately it is a PITA to use and it's Windows only.
If your computer is Windows OS and you want to try it send me a Private Message and I will send you a link to download it.

I do have Win OS. I will make a Private message to you.

2 nights at a setting and guessing...

How many days should I stay in a single pressure setting? I can start to do a trial from tonight. Keeping a record of every night oxygen and pressure+time used in CPAP. and compare after some time to see if there is any pattern.
By the way, should I rent an auto cpap and try. A trial in the above-mentioned way would take a long time.

Are any of those pulse ox reports where the O2 drops below 90 while you were using the CPAP machine? If so, which ones and what pressure were you using when you did it?

All of them were done without any CPAP/ Dental device or anything. These are just normal sleep recorded.

Hello Pugsy,
I tried to send you a private message. Not sure why my message got stuck in my outbox. It is not listed in the sent items section. So not sure if you received it or not.

shossain3 wrote: ↑

Sun Feb 14, 2021 9:34 pm

Hello Pugsy,
I tried to send you a private message. Not sure why my message got stuck in my outbox. It is not listed in the sent items section. So not sure if you received it or not.

a private message stays in the outbox until the recipient reads it.

odd, but that's how the forum works.

zonker wrote: ↑

Sun Feb 14, 2021 10:51 pm

a private message stays in the outbox until the recipient reads it.

odd, but that's how the forum works.

Not that odd once we understand what it means. It's the same on a lot of forums...even Jason's forum.

Dear Zonker, Pugsy, Miss Emerita,
As I mentioned I do not have an auto-CPAP and neither have a pressure recommendation from the titration study. (The last one was done before 3 of my surgeries. +13cmH2O that time) so should I go ahead and take a home sleep study and get a prescription from them for auto-CPAP. I saw Lofta.com offers a package for 189$ where they do a home sleep test with watchpat and then provide a prescription. With that, I can buy/ rent CPAP. My insurance will not cover it.
If sleep apnea gets detected and I can get a prescription I will initially rent for two months. if works I am happy to buy a machine bypassing my insuence.

Another thing is: I successfully installed the rescan and scanned the data. Though it does not show detailed event detection as OSCAR does for other models of CPAP but it shows daily usage hours, leaks, and AHI. My previous data was once accidentally erased due to a computer virus issue. Anyway, that won't be much of use as they were done before some of the surgeries. I will start recording from tonight and will try to see if any particular pressure can make the AHI less. However, this will be a lengthy process given that I often can not tolerate CPAP regardless of the pressure settings. So, I have to discard those nights. So let me know if it is a good idea to buy a sleep study from lofta and bypass this lengthy trial and error method.

One more question is: what do you guys think about the last two oximetry recordings? Are they indicate some breathing disorder ?.

Thanks in advance

shossain3 wrote: ↑

Tue Feb 16, 2021 10:46 pm

Dear Zonker, Pugsy, Miss Emerita,
As I mentioned I do not have an auto-CPAP and neither have a pressure recommendation from the titration study. (The last one was done before 3 of my surgeries. +13cmH2O that time) so should I go ahead and take a home sleep study and get a prescription from them for auto-CPAP. I saw Lofta.com offers a package for 189$ where they do a home sleep test with watchpat and then provide a prescription. With that, I can buy/ rent CPAP. My insurance will not cover it.
If sleep apnea gets detected and I can get a prescription I will initially rent for two months. if works I am happy to buy a machine bypassing my insuence.

i see nothing wrong with your plan. while it wasn't watchpat, i myself did a home sleep study. it certainly served it's purpose in that it got me a prescription, which got me a machine, which led to here on the forum where folk helped me get things dialed in.

just as an alternative, you may want to consider buying a used machine from forum member lsat. he seems to have them on hand quite a bit of the time. while *I* haven't purchased from him, those who have seem to be very happy with the experience and machine. if you buy from lsat, you won't even need a prescription.

mind you, i'm not urging you to do the second one. whatever works for you. the main thing, of course, is to get your sleep apnea well treated. how you get there is down to you.

good luck!

Your O2 results have improved tremendously over the course of your surgeries. I'm not myself able to infer anything from the most recent report about sleep apnea, but I do know your O2 sats are consistently in a normal range now.

I would recommend that you hold off a little on the Lofta route, though that might in the end be a reasonable plan. It'll be helpful first to see what information you can get off the LED screen for a couple of night. And this gives me some pause:

"I will start recording from tonight and will try to see if any particular pressure can make the AHI less. However, this will be a lengthy process given that I often can not tolerate CPAP regardless of the pressure settings."

Why do you say you can't tolerate CPAP? Do you think you'll be able to tolerate it in the future?

Dear Zonker,
Thanks a lot for your reply and the information you provided.

just as an alternative, you may want to consider buying a used machine from forum member Lsat. he seems to have them on hand quite a bit of the time. while *I* haven't purchased from him, those who have seem to be very happy with the experience and machine. if you buy from Lsat, you won't even need a prescription.

I am right now planning to rent one first. As I have past experience of failure with CPAP (Auto fixed both) previously, before buying a machine, I would like to try a rented one 1st. Thanks for the info though, it would be needed if the experiment with rented auto-CPAP comes out positive. Let me know if you know anyone (in the forum) or a good website that rent an auto-machines at a reasonable price. I would message Isat asking if he rents machines or not.

Thanks in advance

shossain3 wrote: ↑

Mon Feb 22, 2021 7:07 pm

Dear Zonker,
Thanks a lot for your reply and the information you provided.

I am right now planning to rent one first.

you are most welcome. sorry, but i don't know of a cpap rental place.

perhaps someone will come along and inform the both of us.

Dear Miss Emerita,
Thanks a lot for your reply.

Your O2 results have improved tremendously over the course of your surgeries. I'm not myself able to infer anything from the most recent report about sleep apnea, but I do know your O2 sats are consistently in a normal range now.

Yes now the oxygen is better than before and mostly above 90 but one thing, I guess, is making a problem with my sleep, which is the continuous zigzag of the oxygen curve through-out the night. I guess this indicates breathing trouble in a relatively milder format. I have recorded overnight oxygen of healthy people who have no complaints of their sleep and it was very stable almost like a line at 96-97. However, I am not a medical professional, and as I said before, very astonishingly, the sophisticated sleep-lab equipments historically failed to detect any major sleep issue. More strangely, 2 times it happened that my lab/home sleep studies came below 5 (AHI+RDI). And after that, I had surgeries (done based on DISE) that made progress in my issues. Why did this happen? God knows. Some of my doctors explained that sleep-studies is not absolutely perfect and in my case, it is not just working properly. So they kinda depended on my symptoms and DISEs.

I would recommend that you hold off a little on the Lofta route, though that might in the end be a reasonable plan. It'll be helpful first to see what information you can get off the LED screen for a couple of nights. And this gives me some pause:

"I will start recording from tonight and will try to see if any particular pressure can make the AHI less. However, this will be a lengthy process given that I often can not tolerate CPAP regardless of the pressure settings."

Why do you say you can't tolerate CPAP? Do you think you'll be able to tolerate it in the future?

You pointed a very good point. Before my Sinus surgery (2019), I used to tolerate the machine but there were no benefits and no change in the oxygen curve. However, since the sinus surgery, it became hard to tolerate the machine. Anyway, I will jump to the current problems with the cpap.

Current issues:
1. Hard to start sleeping if the mask is on my mouth, especially if the pressure > 15. Even in the lower pressure, I would not be able to tolerate it once every four days.

2. Even if I manage to start sleep with a mask and CPAP after 2-3 hours I will wake up. And it is impossible to go to sleep second time with the mask on the face.

3. I tried the nasal mask which is easier to tolerate initially. but if the pressure is above 8 then as soon as I will start to sleep air will come to my mouth and will make my mouth inflate like a balloon- which will then make me awake. To prevent I had to tape my mouth and put a chin strap. It is hard to tolerate and sometimes painful. Also since the genioglossus advancement surgery, I have a screw in my chin. So, a chin strap will make very much pain and so that option has become invalid now.

Let me know if you have any suggestions to solve the above problems.

Have you tried combining CPAP with a CPAP mouthguard? I know a lot of people on this forum aren't the biggest fans of mouthguards but for my 'mild'/probably UARS sleeping issues it's helped a lot when combined with CPAP.
It's also worth entering your symptoms at https://fixmyfog.com and see what conditions it comes back with.

Got my lofta sleep test report today. Prescribed for APAP. I am planning to rent for one/ two months. If work then I will buy one.

Thanks for the update, Hossein. May I recommend that you use a ResMed Airsense 10 Autoset machine for your trial period? It has the capacity to provide true pressure support, which might be of some help with your frequent non-apnea respiratory-related disturbances.

Earlier, you explained the reasons for your discomfort with masks. I wonder whether you'd do well to try a nasal pillow mask with a soft cervical collar to help keep your jaw up. This might be more comfortable than a strap.

Also keep in mind that with a machine that is supported by the Oscar software, we can see in some detail what's going on and fine-tune your settings. It's possible you'd do OK with pressure settings that would be more comfortable for you. We won't know until we can see the data.

To get your machine's data into Oscar, you'll need a laptop or desktop computer for the software, an SD card in the machine, and a way to read the SD card, which can be an inexpensive plug-in if there isn't a slot in your computer.