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Pmatt
Unread post  Post subject: Please help with these results?  |  Posted: Thu Jun 13, 2019 5:34 am

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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New at this...Can someone help me understand these results.
Thank you.


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Pugsy
Unread post  Post subject: Re: Please help with these results?  |  Posted: Thu Jun 13, 2019 6:44 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1326
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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What part are you needing help understand?
I work best by answering questions.

Your AHI is too AHI....but more than half of the AHI is clear airway/central apneas. Simply increasing the pressure is unlikely to have much impact on the centrals.

First thing I would suggest doing if this was my report....turn off EPR and don't use it if at all possible....and if you can't just turn it off...at least reduce it to the setting of 1.

Sometimes in a very small percentage of people using EPR actually causes centrals...so first idea is to turn EPR off and see if the centrals reduce.
Also turning EPR off will effectively increase the baseline pressure a bit and that might help reduce the number of OAs and hyponeas.

Couple of questions....
Are you taking any medications? If so, what?
And how is your sleep quality??? Waking often or sleeping soundly?


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Pmatt
Unread post  Post subject: Re: Please help me understand these results?  |  Posted: Thu Jun 13, 2019 8:32 am

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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Sorry.. why the swing from one day to the next on AHI?
No, not taking medication other then vitamins.
the sleep apnea was discovered due to severe headaches.
feeling tired/exhausted every day and headaches everyday.
Used the cpap for one month and half went from a regular cpap to auto cpap, auto cpap since june11, pressure is set from 10 to 16.
I dont know what EPR is yet but I will google it and figure it out how to turn it off. Thank you so much I hope that will help to see better numbers.

Update: I did figure it out and did set the EPR to 1


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Pugsy
Unread post  Post subject: Re: Please help with these results?  |  Posted: Thu Jun 13, 2019 11:18 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1326
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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The bulk of your AHI is composed of central apneas both nights.
As to why the dramatic change in centrals...dunno...something changed in your respiration that caused more instability in the gas exchanges causing centrals to happen.

Centrals are when the brain just doesn't tell the body to breathe.
Hold your breath for 10 seconds...the airway is open but no air is moving...that's essentially what a central apnea is. A few centrals here and there is normal and no big deal but you are having more than a few and when you have them they are happening in dense clusters back to back.

The drive to breathe is a function of the level of carbon dioxide in the blood stream. For some reason the carbon dioxide levels in your blood stream aren't building up high enough for the brain to say "CO2O is high, time to breathe". When you are using cpap there is too much CO2O being lost out the mask venting and the level of carbon dioxide just doesn't get up high enough. Why some parts of the night and not others? Dunno.

You may end up needing a different type of machine but there are a couple of things that can be tried in an effort to bring down those centrals that don't involve a different (and very pricey) machine.

One thing is for sure...more pressure isn't the answer.
Won't do a thing for the centrals unless you were sleeping poorly and those are all false positive awake flagged centrals and the awake times were caused by OAs or hyponeas which I doubt.
You didn't say if you were having a gazillion wake ups...so I assume you aren't having a lot of wake ups during the night????


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Pmatt
Unread post  Post subject: Re: Please help with these results?  |  Posted: Thu Jun 13, 2019 12:43 pm

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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Just a few wake ups not very many..
I have adjusted the EPR … hopefully this will help some, this is the first time central apnea was over 5 and I did notice they are clustered and back to back … usually in the morning hours between 4 and 5 am
Today I will be getting a new mask the dream ware full face, this should help with less leaks.
Thank you so much for your help.


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Pmatt
Unread post  Post subject: Re: Please help with these results?  |  Posted: Fri Jun 14, 2019 11:50 am

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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Hello Pugsy,
just wanted to let you know, changes to EPR and new mask seems to have done the trick, for now anyway.
Please see the attached data results.
Hopefully this will keep up.
Thank you so much again.


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Pugsy
Unread post  Post subject: Re: Please help with these results?  |  Posted: Fri Jun 14, 2019 12:46 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1326
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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You may want to open that maximum pressure setting up to 20 cm.
You are hitting your 16 cm max and still having some clustering of OAs.
Machine wants to go higher and better prevent those OAs but it can't.


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Pmatt
Unread post  Post subject: Re: Please help with these results?  |  Posted: Fri Jun 14, 2019 4:45 pm

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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Got it, I will do that.. thank you


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Pmatt
Unread post  Post subject: Re: Please help with these results?  |  Posted: Mon Jun 17, 2019 12:38 pm

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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Hello Pugsy, few days of normal range AHI.
Attached is the latest Oscar detail from last night,
is there anything else I can do to get better AHI results??
Thank you


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screenshot-20190617-060448.png
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Pugsy
Unread post  Post subject: Re: Please help with these results?  |  Posted: Mon Jun 17, 2019 1:42 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1326
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

Offline
You might try a little more minimum pressure and see if that brings the OAs and hyponeas down a bit.
I would just try 1 cm more if it were me...for a week...and see if things are trending downward.
I never make changes based on one night of results unless those results are horrible....we don't sleep the same each night and the AHI will vary as sleep varies.
I might see AHI 0.80 one night and the next night it be 2.80....but I have more nights closer to that 1.0 than I do the higher AHI nights.


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Pmatt
Unread post  Post subject: Re: Please help with these results?  |  Posted: Mon Jun 17, 2019 5:01 pm

Joined: Thu Jun 13, 2019 4:14 am
Posts: 7
PAP Mask: air fit F30 and Dream ware full face
PAP Machine: Resmed 10 auto
Pressure Setting: 10 to 16

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Thank you so much, you have been a life saver.
I will give it a try and see.


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