Can someone please help me

[Pugsy]

On the bad night the pressure really doesn't vary much except for the period of time from 1:30 to 2:30.
Up until around 2:00 AM centrals were random when the pressure was around 10.
The bulk of the centrals start around 5:30 AM when the pressure was back down to around 10.
Odd that for several hours with a pressure of 10 the centrals were very random and then later they come along by the truckload.

My first suspect is the awake/semi awake breathing irregularities getting flagged by mistake...the poor sleep being secondary to the pain, etc.
The centrals don't really follow the pattern that we normally see when pressure is the cause of the centrals.
Usually the centrals are present at all times of the night in large numbers and not for just a portion of the night.

If you are so certain it is the pressure...change it back to 8 cm and see what happens.
My money is on poor sleep from the back pain issues but I could be wrong.

[Pesser]

On the bad night the pressure really doesn't vary much except for the period of time from 1:30 to 2:30.
Up until around 2:00 AM centrals were random when the pressure was around 10.
The bulk of the centrals start around 5:30 AM when the pressure was back down to around 10.
Odd that for several hours with a pressure of 10 the centrals were very random and then later they come along by the truckload.

My first suspect is the awake/semi awake breathing irregularities getting flagged by mistake...the poor sleep being secondary to the pain, etc.
The centrals don't really follow the pattern that we normally see when pressure is the cause of the centrals.
Usually the centrals are present at all times of the night in large numbers and not for just a portion of the night.

If you are so certain it is the pressure...change it back to 8 cm and see what happens.
My money is on poor sleep from the back pain issues but I could be wrong.

He is using an APAP? Why isn't the pressure going up after 5:30?

[Pugsy]

He is using an APAP? Why isn't the pressure going up after 5:30?

Because APAPs can't/won't respond to centrals with more pressure. It's part of the algorithm for apaps...they only respond to obstructive in nature apnea events....not centrals at all.

[archangle]

6. Septoplasty should be considered. His turbinates may need re-sectioned.

Where did you come up with the idea that septoplasty is needed? I saw nothing indicating this.

[archangle]

IT's just that the average is high. If we could keep that down consistantly. Says average is 6.5 AHI. He was sick. I am trying to download this sleepy head thing.

Please put your equipment in your profile, so it shows up in your signature line like mine does. There's a link in my signature line at the bottom of this post about how to do this.

Other than the numbers, is he having problems? While we like to keep AHI lower than 5, it's not a magic number, and it's not necessarily all that accurate. If he's not having other problems, don't worry too much if it's 10 or so for a while.

If you share a copy of his SD card, we could look at his data in more detail. I see nothing terribly worrying about the data you've posted so far, but seeing the full data from the SD card would give more info to anyone looking at it.

Send me a private message if you share his SD card. Click the little PM symbol below my name to the left. I don't always notice when someone posts to a thread I've posted in.

[stardust123]

I don't know how to put up the entire SD card. Can I send you some more screen shots? I can send summary. I don't know, we put the pressure setting at 9 and set it to go up to 20. Let's see what happens. I can always put it back. I am pretty anxious about this because nobody really explains anything at the doctor. I am feeling better about it. when he had obstruction it went up to 20 several times.

I am an extremely light sleeper and I hear everything all night. He does that holding breath thing in the morning most of the time. I hear him at night and he sounds fine. He says he's hurting the most in the morning. He went to doctor for back issue but they mostly didn't do anything. PT helped a little.
Mostly he feels good. He's not sleepy. He's not falling asleep inappropriately.

I was worried about the average because the doctor said it should be under 5. It was 5.8 last night.

When we first married. I was like HOLY CRAP he snores like a buzzsaw! I noticed 20 years ago that he fell asleep at the drop of a hat. I told his doctor but I was ignored. After suffering from insomnia for a few months, I got used to the snoring and fell asleep myself.(that was fun as a new bride NOT!) He would also grab me and shake me awake, sit bolt upright and startle awake all the time. I sent him to doctor again, they said he was fine. Finally, he had a jaw problem from birth, and we had that fixed. His jaw was pushed out. They call that a Hapsburg jaw. That's when all hell broke loose 2 years ago and he fell asleep in a swimming pool. fixing his jaw must have worsened his sleep apnea. That is when he was diagnosed. This is embarrassing but he was having ED 2 years ago, which wasn't like him. That seems much better For those that don't know, sleep apnea causes ED.

[Julie]

Go back through the directions from Palerider re posting shots... one step at a time, when you are not so anxious or rushed. Do every step, slowly, and if you get stuck someplace, come and ask about that specific step only, and hold the personal stuff which seems to be the focus of all of your notes. Try to focus for now just on getting the info up so we can see it.

[palerider]

I don't know how to put up the entire SD card. Can I send you some more screen shots? I can send summary.

Summary is worthless. it's like flying over a state and looking at it when you need to be looking at one branch on one tree to figure out what to do to make the tree better.

you 'put up the entire sd card' by sticking it in the computer, archiving the entire card to a file, then uploading that file to an account you create on dropbox. then share the link from dropbox so other people can download it, and look at the data in detail.

I was worried about the average because the doctor said it should be under 5. It was 5.8 last night.

if you don't see people like pugsy, here, expressing concern, then chill out.

saying "oh noes, the number is over 5, what shall I do???" is like being on that flight again.. as with so many things, the devil is in the details. WHY is it over 5, is it really a problem, what IS the problem... etc.

that's why more detail is needed.

[stardust123]

Okay, here's what I am going to do. I am going to turn the starting pressure down a notch and see what happens. If I continue to be concerned I will load the whole SD CARD.

Thanks for helping. I really appreciate. Here's what some of you don't understand. Here's what a lot of doctors DON"T understand. The personal stuff matters. That's all clues to the problem. I bet you cash money a lot of the men that see their doctor with ED really have undiagnosed sleep problems. The doctors look at their computer not a human. Sleep apnea is treating a person, not a line on a graph. I am sorry if it makes people uncomfortable, but it does matter. If the doctor got to know the patient as a person, a lot of misdiagnosis would be avoided. THIS PROBLEM COULD HAVE BEEN FIXED 22 YEARS AGO, if people would listen to the person details instead of instantly dismissing things.

The symptoms were all there, but the medical people were too busy looking at a number on a blood test, a line on a graph, or a number in a chart.

[Pugsy]

When you evaluate the results with the slightly lower starting pressure make sure that you quiz your husband about wake ups during the night and if he ends up doing a lot of tossing and turning.
Ask him that if he wakes up and doesn't go right back to sleep for some reason...to reach over and push the on/off button twice...once to turn off and immediately again to turn it back on.
This will show up in the therapy graph lines and that way if we see a bunch of centrals either just before or right after that break in therapy we will know for sure that he was awake at that time.

If he finds that he is having prolonged time awake either at the beginning, middle or end of the night....have him push that button several times during the time frame where he knows he was awake.
That way we will know he was awake and at least any events flagged during that time we know won't count.

I once worked with a guy whose AHI was around 20 and it was 80 % centrals....come to find out he was spending a lot of time awake (bad case of insomnia) with mask and machine on. What we did was do the on/off thing for the time he was awake and he quit laying there for an hour awake....and his AHI dropped to a nice respectable 2.0...the bulk of his AHI was awake breathing flags which don't count.

[palerider]

Here's what some of you don't understand. Here's what a lot of doctors DON"T understand. The personal stuff matters

here's what YOU don't understand... whether or not your hubby can get it up really has nothing at all to do with the efficacy of his cpap treatment, which is what we're trying improve here.

perhaps it'd be better if he made an account and we could get the info straight from the horses mouth, as it were, instead of being filtered with your perceptions of what personal details are impotent.

what *matters* is the information that the seasoned veterans of the forum here *ask for*. there's a *reason* we ask for it, we've helped hundreds of people improve their therapy... it's all in the 102811 topics on the board, if one wanted to look for it.

[Lucyhere]

Thanks for helping. I really appreciate. Here's what some of you don't understand. Here's what a lot of doctors DON"T understand. The personal stuff matters. That's all clues to the problem. I bet you cash money a lot of the men that see their doctor with ED really have undiagnosed sleep problems. The doctors look at their computer not a human. Sleep apnea is treating a person, not a line on a graph. I am sorry if it makes people uncomfortable, but it does matter. If the doctor got to know the patient as a person, a lot of misdiagnosis would be avoided. THIS PROBLEM COULD HAVE BEEN FIXED 22 YEARS AGO, if people would listen to the person details instead of instantly dismissing things.

The symptoms were all there, but the medical people were too busy looking at a number on a blood test, a line on a graph, or a number in a chart.

Hi stardust - of course the personal stuff matters. It matters a lot! That's why being an advocate for your own health is so crucial. That means unfortunately, going from doctor to doctor until you find one that gets it. I believe you mentioned Kaiser... if I'm correct, you can change doctors as many times as you wish.

Thing is... people here aren't doctors so aren't really interested in the personal stuff. They want to see graphs, know pressure numbers, etc., and will advise you accordingly. I hope you find those special doctors; they are not easy to find.

[archangle]

I don't know how to put up the entire SD card.

There's a link in the post you're replying to.

If you share a copy of his SD card,

Click the link there or go to:

http://www.apneaboard.com/wiki/index.ph ... _your_data

[Roman Hokie]

Has he always had the full face mask?

If this has changed, but the machine hasn't been set for the change, the flow rate and pressure may be different than what he needs now (i.e. if he started with a nasal mask or pillows, that may not be enough pressure for the full face).

I realize I'm grasping at straws here...

[palerider]

(i.e. if he started with a nasal mask or pillows, that may not be enough pressure for the full face).

I realize I'm grasping at straws here...

you have it backwards... nasal masks, and even more so pillows, require *MORE* pressure at the machine, to compensate for the smaller holes, and thus more restrictive interface.

this is handled automatically by setting the mask type appropriately.

the same as a smaller hose requires more at machine pressure than a larger one, because it's more restrictive to the flow.