2/25 data(first night) and 3/4 data and 3/5 data

Hey,

I don't have a machine yet. But did receive my diagnosis this past Wednesday. I have mixed apnea. They listed me with an AHI of 116... which is very concerning after reading reports on this site, showing 30's as severe. Guess that puts me off the charts. My oxygen desaturation averaged 88% with lowest desaturation being 78% The report shows I had a reduced sleep efficiency of 83.7% Guess they weren't lying when the called back to schedule my follow up and told me my apnea was pretty sever.

This is all new to me, previously the only knowledge of sleep apnea I had was from my wife, she was diagnosed with it in Colorado, but after moving to North Carolina, had a sleep study performed and was told she did not have sleep apnea. Guess this might have been affected by the change in altitude.

So when I had went for the study I was not surprised to learn that I had OSA, but the CSA portion did come as a shock. I have a titration scheduled for tomorrow and hope that they can find something that works.

I want to say thanks for this site, I stumbled upon it by accident. First resource I found that has been helpful and not targeted towards a medical professional in the field.

So nice to meet everyone, and here's to sweet dreams for us all,

Mike

Nooblakahn wrote:Hey,

I don't have a machine yet. But did receive my diagnosis this past Wednesday. I have mixed apnea. They listed me with an AHI of 116... which is very concerning after reading reports on this site, showing 30's as severe. Guess that puts me off the charts. My oxygen desaturation averaged 88% with lowest desaturation being 78% The report shows I had a reduced sleep efficiency of 83.7% Guess they weren't lying when the called back to schedule my follow up and told me my apnea was pretty sever.

This is all new to me, previously the only knowledge of sleep apnea I had was from my wife, she was diagnosed with it in Colorado, but after moving to North Carolina, had a sleep study performed and was told she did not have sleep apnea. Guess this might have been affected by the change in altitude.

So when I had went for the study I was not surprised to learn that I had OSA, but the CSA portion did come as a shock. I have a titration scheduled for tomorrow and hope that they can find something that works.

I want to say thanks for this site, I stumbled upon it by accident. First resource I found that has been helpful and not targeted towards a medical professional in the field.

So nice to meet everyone, and here's to sweet dreams for us all,

Mike

Mike, Welcome to the board. I have severe OSA as well, though my AHI was "only" 63, almost half of yours. Despite that, my O2 desaturation was 61% which was the most alarming to me. It was so ridiculous, I laughed when the doctor told me...

I'm glad this board is available and so helpful. I doubt I would have been successful without it, honestly. Its a Godsend.

Welcome.
Your wife's change of diagnosis may be due to differences in test conditions.
Altitude would not be a factor; but a provider may. I was given a clean bill of health by an HMO-
sleep test, and suffered for years before I got a REAL sleep test, and got my machine.

chunkyfrog wrote:Welcome.
Your wife's change of diagnosis may be due to differences in test conditions.
Altitude would not be a factor; but a provider may. I was given a clean bill of health by an HMO-
sleep test, and suffered for years before I got a REAL sleep test, and got my machine.

I had read somewhere that high altitudes could effect sleep apnea. But looking again that was for CSA, not OSA per this link http://www.mayoclinic.com/health/centra ... ea/DS00995. Not sure why she was diagnosed with a clean bill of health then. The place she went to sells machines, so if they were to intentionally misdiagnose, I would think they would say someone who doesn't have it does, to sell them a machine. Not saying they would do that... just in either scenario, that would seem more likely. I also wouldn't have went there if I didn't think they were on the up and up, since I did go to the same clinic. Guess it could have been a weight loss thing, as that factors into OSA. Not sure.

Thanks for the warm welcomes.

[quote="Nooblakahn"I have mixed apnea. They listed me with an AHI of 116... which is very concerning after reading reports on this site, showing 30's as severe. Guess that puts me off the charts. My oxygen desaturation averaged 88% with lowest desaturation being 78% The report shows I had a reduced sleep efficiency of 83.7%[/quote]

Mike,

As a person who likes numbers, I thought I'd comment on a few of these. AHI of 116 is pretty high. Since there are 60 minutes in an hour, that means waking up about every 30 seconds. It is pretty hard to wake up more often than that. A number below 5 is the target once you get on a treatment.

Oxygen desats of 78% are concerning, but not as bad as what the 116 AHI would suggest. I have seen folks here with numbers down in the 40% range where you wonder how they were even alive. I dropped into the 60% range with an AHI of just over 100. Anything below 92% is concerning, and below 88% should be treated.

The sleep efficiency number isn't too bad considering you only slept 30 seconds at a time. The more interesting numbers are how much deep sleep you had, and if you reached REM sleep.

Central events are often a lot more tricky to treat. The garden variety CPAP or APAP machine can actually make the centrals worse. The issue is that pressure can cause more centrals, but pressure is what you need to treat the OSA. In your follow-up study, the RT will be trying to find a pressure that is high enough to treat the OSA, but still low enough to prevent more centrals. That often isn't possible. The next attempt would be a BiPAP machine that runs at 2 different levels, one for exhale that is lower than the pressure that causes centrals, and a higher pressure on inhale to provide the pressure to treat the OSA events. If that doesn't work, then there are ASV machine that have a lot smarter algorithms.

One of these solutions is bound to work, but it might mean a few different attempts. In my case, had 3 studies. The first was to diagnose the OSA, the second was to try CPAP (which failed), and the third was for BiPAP (which was successful).

-john-

Thanks john for the info. Yeah. Im a numbers guy too. But alot of these numbers here don't mean a whole lot to me yet. Pre titration I did have some r sleep but no n3 sleep. With titration I had rem and a lot more n3. Im at work and don't have the report with me to give the actual numbers.

Hopefully I can find out more tomorrow morning after my titration tonight... but im sure it will be Wednesday at the earliest that I hear anything. Yeah. I've seen some oxygen desaturations lower than mine since coming on here.

Oh yeah. Im in the same boat as you. Cpap did not work for me. I had centrals occur as low as 4cm. They already had me on bpap during this titration. But didn't get it set exactly how I need it. They plan to set me up on bpap st with a back up rate of 12 bpm ... so sounds like asv bipap for me.

Another thing I hoped someone can answer is it effiicacy data that we want for sleepy head? Do all bipap machines offer this? Im understanding that some only show hours used etc.

Nooblakahn wrote:Another thing I hoped someone can answer is it effiicacy data that we want for sleepy head? Do all bipap machines offer this? Im understanding that some only show hours used etc.

I am pretty sure that all the new technology bipaps that offer back up rates for centrals offer full data.
The 2 main players are Respironics and ResMed.
I don't think you will have to worry about getting a brick bilevel machine with a back up rate...To my knowledge even the plain bilevel machines all offer full data.
Respironics used to have a BiPap Plus (in the M series) that was a brick but I haven't seen a Plus model in the PR System One line and besides..it doesn't do backup rates anyway. Backup rates for people with centrals are on the high end machines and all the new models have full data available.

SleepyHead has had some trouble with some of the models of these high end machines...works well with some and not at all with others (both Respironics and ResMed) but that's not a huge problem because there is always EncoreBasic or ResScan that you can use.

So am I correct in assuming if they want to titrate with a backup relate of 12 bpm it will be one of those machine types? Also what ls the st in bipap st?

Thanks again for the help.

Also... what is bpm in this case... can't be beats per minute here right?

Nooblakahn wrote:So am I correct in assuming if they want to titrate with a backup relate of 12 bpm it will be one of those machine types? Also what ls the st in bipap st?

Thanks again for the help.

Also... what is bpm in this case... can't be beats per minute here right?

S/T = Spontaneous/Timed. Meaning, you are to breathe on your own, but if you don't breathe when you should, the machine will give you a breath.

bpm -- Breaths per Minute. The S/T will work based on this setting.

My machine runs in S/T mode (with other settings that aren't important here). My bpm is set to 7. The machine wants me to breathe at least 7 times per minute (and this is slow). If I don't, it gives me a breath.

I breathe very slowly so anything higher than 7, for me, pushes air on me too quickly and I can't handle it. The average person will have a bpm of 10-12.

When you said you had centrals even with pressure of 4 cm that tells me that you most likely will be getting one of the bilevel machines that acts like a ventilator... ASV type of machine. I don't understand all the difference between all the ASV types/models of machines and/or which one works better in a certain situation but that is what the titration study is for...to figure out which one works best for you.
ASV Adapto Servo ventilation

I use a bilevel machine but I call it a plain bilevel machine....it doesn't do the fancy stuff...doesn't try to make me breathe or anything like that. It's unlikely that you would get a machine like mine. Might be same brand but a much higher end model.

Thanks madalot. You helped me with this in chat earlier.. but it still didn't click. That still sounds like asv to me... but im bot sire on the differences.

Yeah. Asv is what it sounds like im in for I agree...

Here at the sleep lab for my titration. Just checked in, not hooked up yet. Wish me luck!

Good luck...have fun....sleep well...don't let the bed bugs bite.

Nice. I asked my sleep technician if he ever found lice in anyones hair when he was putting the leads in... "not yet."

Sleep study last night went. Don't have my results yet. Technician said he didn't know if I would have to come back fir another study or not... which im taking as code that I probably do. Will update one I get the results of the study/ get to talk to the dr.