First night on CPAP with some interesting results....

[cpap626]

I was recently diagnosed with mild SA with an ahi of 8. I resisted it for awhile and finally broke down and bought a resmed escape s9. I sleep with an o2 meter on and and an alarm goes off every time my o2 goes below 90 percent, so I can be actively monitoring my o2 levels. I have a severally deviated septom and usually when I lie down my 02 is around 95 then goes sometimes to the low 90's.

So last night I was using a full face mask (resmed f20) and started the cpap out at 6 cm. According to the formula on here with my bmi, neck size, and ahi, my pressure should be at 5.25 cm of pressure. I just have to say one thing....OMG it was awesome, I could finally breath quickly and take a deep breath through my nose. I remember before my septom was messed up 15 years ago I would wake up and take a deep breath when I awoke! I finally had that feeling again and it was incredible! I smiled so hard my ff mask seal broke lol!

After about 30 minutes while laying on my side, just when i was forgetting the mask was on and I was drifting off to sleep....my 02 sensor went off and my 02 was falling from 95 to about 86. I was still breathing fine and hearing my breaths I think the cpap machine really helps me breath deeper. I changed the pressure to 7 cm, I was almost asleep and still taking deep breaths and noticed my alarm went off again (at this point i am more annoyed at my alarm than my mask). I check my 02 monitor and its falling from 90 to about 86 (which it has never been that low before. I bumped the pressure up to 8 cm. I feel an increase in pressure and I am getting more air than my little nose has received in a long time. It was feeling really good as my body is barley doing any work to breath. My alarm goes off yet again and my 02 goes back down to about 86.

During the treatment I was on my side and my exhaust ports were not blocked. After 4 hours on the cpap, I was more afraid it was hurting my 02 levels more than helping. I went to sleep without it and my 02 level never went below 90. Here are two charts, the first one is with the cpap on, at 6cm, 7cm and 8cm. The second chart shows me without the cpap on with better 02 results.

What could be causing this? Do I need more air pressure? Or maybe this isnt SA its more of me not getting enough o2 through my deviated septum? This form has really helped, I would not have even tried it without your support.

Just to sum up the 02 report:
Results of 02 with cpap set at 6cm for 30 mins, 7 cm for 30 mins, then 8 cm for 2 hours.

o2 score 6.6 (lowest ever)
02 drops over 4 percent: 39
average 02: 97 percent
lowest 02: 86 percent
02 time under 90 percent: 260 seconds
Recording time: 2 h 58m

Here are the 02 results of me NOT wearing the cpap:

o2 score 9.9 (out of 10)
02 drops over 4 percent: 2
average 02: 95 percent
lowest 02: 90 percent
02 time under 90 percent: 0 seconds
Recording time: 5h 10 min

Screenshot_20180331-080325_O2 Vibe.jpg (457.6 KiB) Viewed 915 times

Screenshot_20180331-080242_O2 Vibe.jpg (430.01 KiB) Viewed 915 times

[songhust]

if you compare,

with cpap, and when O2 is good, your heart rate is stable and slow.
without cpap, your heart rate variation is bigger, suggesting you might have apea episode.

the fact that your O2 dropped a lot suggest that: after a good few hours CPAP treatment, your body feels it does not need so much O2 anymore (your body used to apea all the years and got trained to it ) and your nerve system might just quit breathing ( central now ).

I had very similar experience before, and after using S9 for a few months, I complete stopped central and went back to my autoset10 APAP.

[Mogy]

Hi cpap626,
Without data from the CPAP we would only be speculating.
As songhust has mentioned it may be Treatment-emergent CSA. Some of us don't do well at the beginning of CPAP treatment. Our OSA becomes CSA with the additional pressure.
Fortunately, the centrals subside once you get used to the pressure, for most people. It is also known as Complex Sleep Apnea.
As I said above, this is just a guess.

[cpap626]

Thanks for your insights, I just purchased a better machine that will show data so I will post the sleepyhead results when I get the new machine (I am super excited about getting the data). I thought it was very odd that my 02 levels went down more in the twilight stages as I was going to bed. As opposed to my 02 levels without the cpap which are not terrible. Last night I tried the same thing I had it set to 8cm, and towards the end I felt starved for air. Songsaw was right, when I am not on the cpap, my 02 is better but my heart does spike up more at times. I dont know what is worse, having my heart spike up or getting low 02? Pugsy was very kind and we think it may be centrals as others have posted. Here are last nights results which showed the same type of results:

o2 score 7.3
02 drops over 4 percent: 39
average 02: 96 percent
lowest 02: 87 percent
02 time under 90 percent: 124 seconds
Recording time: 2 h 47m

Here are the 02 results of me NOT wearing the cpap:

o2 score 9.9 (out of 10)
02 drops over 4 percent: 2
average 02: 96 percent
lowest 02: 91 percent
02 time under 90 percent: 0 seconds
Recording time: 6h 36 min

Screenshot_20180401-093031_O2 Vibe.jpg (445.46 KiB) Viewed 787 times

[D.H.]

Is it possible to lower the alarm threshold to 85%? That way, you won't be awakened by minor deficiencies.

[cpap626]

yup, I can lower the alarm. I thought that anything under 90 was really bad and I didn't want to starve my body too much of 02. My biggest fear is the machine is causing the onset of central SA and it could get worse really messing my 02 level during sleep. Hopefully in the next few days I will have the sleepy head info everyone can look at:) This board is great! Thanks everyone again for their help!

[lucas7bm]

yup, I can lower the alarm. I thought that anything under 90 was really bad and I didn't want to starve my body too much of 02. My biggest fear is the machine is causing the onset of central SA and it could get worse really messing my 02 level during sleep. Hopefully in the next few days I will have the sleepy head info everyone can look at:) This board is great! Thanks everyone again for their help!

I'm not a doc, but in my last visit on mine I asked him about the O2 level improvement on my second exam (with CPAP) and asked about the levels. He said that from 87 (first exam - without CPAP) to above 90 was really an improvement, but that things start to get dangerous when the O2 levels are under 80, or so. Actually, I believe he said under 70, but probably considering only immediate risks, not the long term ones.

Considering that you probably has sleep apnea for a while, lowering the alarm to 85 as D.H. mentioned shouldn't be too risky for one or two nights. But nonetheless, use SleepyHead to get more detailed data and soon, with dedication, you'll be solving your problem and getting optimal treatment!

[Mogy]

I agree that lowering the alarm would not be something I would do.
When I first found out that I had Complex Sleep Apnea I limited the time that I used my APAP. Much like what you are doing with the half night on, half night off.
Generally I just did one sleep cycle with the machine, then the rest of the night without. After about 5 weeks the central events were much lower and I started using my machine more.