What is my problem? Noobie needs settings advices

[Xantat]

Thanks alot for all the informations!

I'm trying to use the CPAP as much as I can handle it until my apt. I'll keep you updated of the next steps in July!

See you then!

[Xantat]

Hello,

I've seen my sleep doctor this morning.

We have decided to stop CPAP for now, wait 5 month and do a polysomnography to "start from scratch" again. I think it's the best option for me right now, as I feel like we have missed alot of informations with the polygraphy.

Thanks for all the tips.

I'll come back to keep updated of the next steps!

[ozij]

Thanks for the update.
Good luck!

[Xantat]

Hello,

Update: more than 2 years have passed, and I have done 3 new sleep studies in the mean time. The first one was polysonography, and showed no sleep apnea, which drove me crazy. After a year I decided to do another one, which came back positive, and 1 month ago I did a polygraphy with a physician (came back positive too) so he could prescribe me a new machine.

I'm now on an Airsense 11 with p30i, trying the APAP therapy again!

[Julie]

Good luck!

[Xantat]

Thank you!

It's been 7 days and it feels like a nightmare again. I feel 10x worse on APAP than without. And I know I will have to go through the same bullshit again with technicians and doctors: "you need time to get used to it", "it's maybe your body relaxing after years of bad sleep". But I just can't accept that it's normal to feel like a zombie. I feel desperate, and I hope I can find a solution this time or I'll just give up for good on treating my apneas and accept that I'll die earlier.

Here is the latest full night I've had if you are interested. I have changed my upper pressure to 12 as it seemed to be blocked at 10. I normally have around 20 ahi, with maily obstructive hypopneas, and none to low (max 3.9/h on a polygraphy) centra apneas.

Sorry for the bad mood.

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[ozij]

Hello,
The first one was polysonography, and showed no sleep apnea [...]
After a year I decided to do another one, which came back positive[...]
and 1 month ago I did a polygraphy with a physician (came back positive too) so he could prescribe me a new machine.

I'm now on an Airsense 11 with p30i, trying the APAP therapy again!

My edit and emphasis
Welcome back.

I don't understand the difference between polysomnography and "polygraphy with a physician". Why did nothing happen after the second test?
Did you have a test in which your response to different pressures was recorded? If you didn't, why not?

I also don't understand

I have changed my upper pressure to 12 as it seemed to be blocked at 10

What seemed blocked?
You upper pressure on the image you attached is 10.
What were the reasons for choosing the pressures and the APAP mode?

[Xantat]

Thank you!

Polysomnography = done at a clinic with more sensors like EEG.
Polygraphy = done at home, with less sensors.

The reason I did the last polygraphy was to (1) have a definitive diagnostic (4 positive tests and 1 negative) and (2) so my physician could prescribe me a machine or MAD. He needed a recent exam I think.

OSCAR shows that sometimes the pressure roofs at 10, so I though it meant that it wanted to go higher than that.
I guess the pressures are just a large guess to get a first trial during 2 weeks, and then decide what to keep and change with the technician. I feel like I really don't like APAP as (1) the pressure changes bother me and (2) the pressure goes to maximum right away as I'm still awake which seems counter-productive.

[Xantat]

Update: technician put me on CPAP mode pressure 8, EPR 2.

[zonker]

Update: technician put me on CPAP mode pressure 8, EPR 2.

and what are the results?

[Xantat]

Here it is, but it's only one night with 2h30 of recording. I'm having troubles keeping the mask all night long for now.

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[Miss Emerita]

I have some questions.

During your long break from CPAP, did you feel better?

What were your AHI and the break-down of events in your two most recent "positive" sleep tests? And did they note the amount of time, if any, that your O2 levels were 90 (0r 89) and lower? Finally, did they note periodic leg movements?

What is it about the mask (or the machine?) that makes you stop part-way through the night?

Finally, could you zoom in on your CAs to see whether they follow arousal breathing? Arousal breathing looks deeper and messier than nice, regular asleep breathing. See the example below; that's a short arousal with no CA.

Arousal 3.png (37.59 KiB) Viewed 11123 times

When you have a lot of CAs in a row, you may see arousal breathing kicking the sequence off, followed by waning and waxing, with CAs after some of the waxing.

[Xantat]

Thanks for your time!

During my long CPAP break I felt like before using it, that is better but not best. Without CPAP I feel at max 70% rested, with it 20-50%.

Here is the result from one of the last tests (PSG):

"- We performed a neurophysiological exploration of the sleep-wake cycle including:

- Polysomnography: Neurophysiological recording was performed on a CIDELEC Lxe according to AASM recommendations. It included analysis of the electroencephalogram (8 to 24 leads), electro-oculogram, surface relectromyography of the chin and anterior leg muscles, position sensor, electro-cardiogram, airflow analysis using a nasal pressure cannula and its tracheal, nocturnal oxyinetry, and measurement of thoracic and abdominal effort using a strap with a piezoelectric sensor. The tracing was analyzed by visual scoring by a sleep neurologist.

- Neurophysiological analysis: The night's sleep was characterized by a total sleep time of 7h40 min. Manual visual analysis documented a distribution of 57.4% in light slow-wave sleep, 31.3% in deep slow-wave sleep and 11.3% in REM sleep. The onset latency of REM sleep was 100 min. Analysis of sleep microstructure revealed 166 microarousals, an index of 22 per hour. This microfragmentation was secondary to the neurophysiological/respiratory disorder. Muscular analysis with a collection of the anterior hamstrings did not objectify periodic movements.

- Respiratory analysis: Analysis of respiratory parameters revealed 199 events corresponding to 50 apneas (12 obstructive, 30 central and 8 mixed) and 149 hypopneas. This gives an index of 26 per hour.Oximetry analysis revealed a mean oxygen saturation of 95% and a time spent below 90% of 0 minutes. The desaturation index was 20 per hour.

- Overall, we conclude from this global assessment to a sleep of 7h40 with sleep efficiency 98% fragmented 22/h on moderate OSA 26/h (30/h dorsal) by predominantly obstructive hypopnea, desaturation 20/h without periodic movement.

- This neurologist didn't write it but told me I had UARS"

Here is the result from the last test (polygraphy):

"Good-quality examination (analysis performed on nasal cannula pressure signal) in favor of moderate-stage obstructive sleep apnea hypopnea syndrome, with AHI of 18.1/H (11.3% obstructive apnea; mean duration = 16.8 sec, maximum = 34.4 sec, 70.6% hypopnea). Oxygen desaturation index 14.7/H with mean SpO2 94.7% (basal 97.0%, minimum 88.0%). Episodes of desaturation with 0.7 min of the recording (i.e. 0.1%) below 90%. Ronchopathy with a Snoring Index of 8.9/H. Confirmation of moderate OSAS."

I stop using the machine during the night because I wake up and have troubles falling back asleep. I would say it's mainly because I'm not used to the mask yet, it hurts a bit on the bridge between my 2 nostrils (p30i). Other than that, I know that if I push to keep the mask all night long I will feel like a zombie in the morning.

I have uploaded 3 zoom-ins so you can see:

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[Xantat]

I have seen my doctor, but he does not want to look at the raw data like in Oscar. He only uses the global indicators. I'll see him again in 1-2 months to see if I feel better.