Inconsistent CPAP results

cboyce, what's the story with the results from 7/14/2011 with apneas of 40, hypopneas of 121 and no REM sleep. Have you followed on the CPAP pressure recommendation of 8 cm?


The hi rate of hypopneas could indicate:

The doc wrote [with lots of grammar mistakes]:Should the patient continue to have complex apnea as, consideration should be made for an adaptive servo ventilation ASV! titration
study.

To Roby Sue: I have added the word UNDERLYING to medical condition to satisfy your correction.

Did you have a chance to check this about your new BLOG in which you render medical advice?

http://online.wsj.com/article/SB124287328648142113.html

Bloggers, Beware: What You Write Can Get You Sued

avi123 wrote:cboyce, what's the story with the results from 7/14/2011 with apneas of 40, hypopneas of 121 and no REM sleep. Have you followed on the CPAP pressure recommendation of 8 cm?

The hi rate of hypopneas could indicate:

The doc wrote [with lots of grammar mistakes]:Should the patient continue to have complex apnea as, consideration should be made for an adaptive servo ventilation ASV! titration
study.

I did try a minimum CPAP pressure of 8cm, but I think I was having the same sleep pattern problems then. I've been slowly raising the minimum pressure, but so far I'm at 6cm. I have an upcoming appointment with my neurologist in a couple weeks, so I'll also talk to him about getting a follow-up study with ASV. Thanks for spotting that!

I'm not sure if it's my computer or what, but when I pulled up the results, some lines were overwritten making some of it not readable. Of course that would be on the lines about limb movements. Can you tell me what they read?

kteague wrote:I'm not sure if it's my computer or what, but when I pulled up the results, some lines were overwritten making some of it not readable. Of course that would be on the lines about limb movements. Can you tell me what they read?

I think the fax service I used to receive a copy of the report might have mucked it up a bit. I've put a screen capture of the summary for 5/17/2011 up here (username/password are both "cpap") Part 1,Part 2. (it looks like the fax cut off the bottom of the summary). The leg movement is on the second page, but I'm not sure how to interpret it.

Is this helpful?
Link:
http://sonic.net/cboyce/cpap_priv/summa ... 011_p2.png

Now that I'm trying to get my sleep schedule to a regular time again, I'm reminded of the problem I had in the past. If I don't go to bed until I'm tired enough to go to sleep, I'm exhausted early the next day, but by evening I always get a second wind. So, even if I'm dead tired during the day, when the evening rolls around I'm awake. Has anyone else experienced a similar problem?

*edit*
Just to add some more information, I don't eat after 5pm, and I only (occasionally) have coffee in the morning.

I have the same exact problem. I have been exhausted all day today, did not sleep well at all last night. I am presently waiting for my Respiratory Therapist to come with a new mask for me to try out. Mine seems to leak when I need it most, when the air pressure rises for an OA, which is usually in the middle of the night... Even if I am exhausted all day, just like I am today,by this evening I will get a second wind and be good to go, may not be able to fall asleep tonight.. It's a vicious cycle.

cboyce wrote:Now that I'm trying to get my sleep schedule to a regular time again, I'm reminded of the problem I had in the past. If I don't go to bed until I'm tired enough to go to sleep, I'm exhausted early the next day, but by evening I always get a second wind. So, even if I'm dead tired during the day, when the evening rolls around I'm awake. Has anyone else experienced a similar problem?

When you say you are exhausted "early in the day" how early is early?

But at any rate, it's a common problem---particularly for those of us with insomnia. But unfortunately the only way to deal with too many wake ups at night is by trying to not give in and nap early in the day or trying to force ourselves to go to bed when we are not particularly sleepy. Your sleep will start to feel subjectively better when your sleep efficiency improves to where it is consistently close to 85-90% or above. And remember:

sleep efficiency = (total time asleep)/(time in bed)

And also remember that the need for an afternoon siesta/nap is not uncommon even for folks with perfectly normal sleep---ie no apnea, no PLMD, no insomnia, etc.

Would anyone be willing to tell me if there's anything significant in the lines about limb movements? The links require a login.

kteague wrote:Would anyone be willing to tell me if there's anything significant in the lines about limb movements? The links require a login.

Login ID is cpap
Password is cpap

I looked.. near as I can tell I saw leg jerks at 9 during first part of study and titration part 0

robysue wrote:When you say you are exhausted "early in the day" how early is early?

If I don't get enough restful sleep, I'll feel tired after being up for 4-6 hours. This will usually mean around noon, I feel like I'm about to crash. Then my "tiredness" will fluctuate a bit for the next few hours, and usually around 4-6pm I'm feeling awake again. I'm continuing to try to enforce a set sleep schedule though, I realize that it's not something that's going to be fixed in a few days.

On another note, I do have an upcoming (on the 22nd I think) appointment with my neurologist. He's the one I've been seeing about my OSA (and the headaches/tiredness that led us to discover I had OSA). I see him semi-regularly, every 1-2 months. Is there anything specific that I should mention/ask for in the upcoming appointment? A previous sleep study had suggested that I get a special type of CPAP machine if I continue to have complex (CPAP induced) apneas, but I'm not sure if I can determine that is happening from the data in SleepHeady/EncoreViewer. Thanks again to everyone for all the help and support!