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Yes, well denial is also a powerful thing. My FIL, who uses CPAP, falls asleep within a minute and a half of sitting on the couch. If asked, he says he is not sleepy and only falls asleep if there's nothing stimulating occurring. He fails to acknowledge that normal people don't fall asleep within a minute of sitting down, even if all they have to do is gaze at a bare wall.

secret agent girl wrote:Raw data files
I don’t know whether I could get these. I’m not even sure how to or from where I could get them…

Just ask the sleep lab to "Burn CD" from the Data Management Module. Given the severe sleep fragmentation, it may be useful to check that all the respiratory events were in fact, really respiratory events and not artifact due to sleep disturbance. If so, then your obstructive index could be low enough to be "mild".

That said, virtually all of the events appear to have concomitant desaturations (albeit the "4B" Rule), so there's strong likelihood that they are truly respiratory events.

That said, the possibility that they have a central flavor is strong. Observe the appearance of central phenomena with introduction of pressure (mixed apneas) and the total absence of events in REM (although there is lateral position and fairly high pressure). Perhaps there is CompSAS underfoot:

secret agent girl wrote:Latest Doctor Appointment

• agrees the mask is not an issue, and that my numbers are great.
• was quite satisfied with my compliance.

I guess that leaves out dial wingin' as a potential solution.

Can you post the summary graphs for the period, including hours of use?

NotMuffy wrote: Perhaps there is CompSAS underfoot

I agree---especially if the central component of CompSAS is episodic or variable. However, central instability induced from excessive wake/sleep/wake/sleep transitions might be another explanation. I can offer my own wake/sleep/wake/sleep central-breathing controller skew as an example:
viewtopic.php?f=1&t=58711&p=552766&#p552606

Secret agent girl might experience that same wake-to-sleep transitional phenomenon:

secret agent girl wrote: she kept the pressure at 5 for about 2 hours during which I was unable to fall asleep.

If so, treating pain and also stabilizing sleep might be a good treatment strategy here.

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-SWS wrote:...central instability induced from excessive wake/sleep/wake/sleep transitions might be another explanation.

Absolutely, and the point of the "Should Mild OSA Be Treated" articles. It was not clear if the 70 hypopneas were the total or the AHI, central in nature, overscored events and besides she feels so much worse on CPAP. Consequently, a treatment consideration would have been to stop treatment ("Doctor, it hurts when I do this." "Don't do that.")

However, there are the 116 desaturations on Diagnostic, so now that's not such a good idea.

-SWS wrote:If so, treating pain and also stabilizing sleep might be a good treatment strategy here.

Also a great idea, but I would question taking a sleep medication during the next titration. If the physician on the one hand is saying "Pressure is good, events are controlled, compliance is good...", then what's the point of taking a sleep medication? The new working diagnosis is sleep disruption, so why mask the sleep disruption?

OTOH, if sleep becomes completely stabilized, then short-, intermediate-, or even long-term use of a sleep-aid should be considered.

secret agent girl wrote:-SWS, what type of things might "stabilizing sleep" include?

Drugs. If respiratory events are completely controlled on CPAP, then ASV would not be clinically indicated.

That said, you might want to keep the idea of a bilevel something-or-other on the table in case sleep disruption is compounded by PAP therapy. I mean, I'm kinda looking at this in a very basic fashion:

Used to sleep good.

Started CPAP.

Now sleep bad.

BTW, is your physician willing to try a little bilevel during the next titration?

Also, can you upload an S9 file somewhere?

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secret agent girl wrote:I edited a previous post on this page to add the summary charts/data from my S8's smart card. I can add some random nights detail, if you'd like.

Sorry, I thought you had an S9 since you just (relatively) got your machine. Those files have waveforms.

The date on the file is askew. Why be that? Is that from last year?

NotMuffy wrote:Sorry, I thought you had an S9 since you just (relatively) got your machine.

NM, looks like you missed the release by a few months. Oh well....

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Muffburger wrote:

secret agent girl wrote:The Rescan is showing use from December 2009 and January 2010.

Right. Do you have current data?

Cause what needs to be looked at is sleep itself. That "good sleep hygiene" stuff:



which includes same time to bed and awake every day. Overall, not too bad back then. Few days that could use some work. Although those last few are certainly ek.

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