Do I quit? Am confused on what to do now....in the UK

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
MeleeMK2
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Joined: Wed May 21, 2025 8:41 am

Do I quit? Am confused on what to do now....in the UK

Post by MeleeMK2 » Wed May 21, 2025 8:50 am

First time posting here :) Sorry if the post is a bit messed up
For context, am 18 in the UK and sleeps always been a pain.... Thank you to anyone who does end up reading this :D

While back i was really having issues bad enough to take it into my own hands without talking to dr first (heard how bad wait times are). I had for near certainty what the issue was due to every link to it, including other health issues also linking. Few months ago was able to try a cpap and instantly could tell with proof i had issues at night. Showing just under 5 ahi gradually going down, with it going to pretty high pressures and when being told about oscar could see for certain theres an issue. Was concerned enough to go to doctors and gp agreed to get referred for a test. Dont know if it changed results or not but couple weeks before the test i was using the machine as it helped enough to stick with it, especially helping with eduation atm. Carried on using it with help from the start with settings and whats going on but was nearly constantly told i need bilevel, even people here including Sleeprider (thank you). I did end up jailbreaking the machine to have bipap and asv, and it made a huge difference compared to cpap though didnt give it long enough for symptoms to change before the next issue came up.

Couple weeks ago i got the results back from the test (at home test) and came back mild 7ahi... RDI was not recorded. Dont know how accurate it is or if using cpap for the month before made a difference, seems much lower than i was expecting and was told to expect but Nhs only treats 15< so not really up to me. Though was still told they wanted me to use a cpap and got fitted and given one at an appointment? Due to previously using cpap it wasnt an adjustment at all. Settings of 4-20 no epr, not great at all obviously but can deal with it, ahi was around 2 but everything zoomed in looked like a total mess, which they cant see or bother looking at as ahi <5 is cured to them. Had a phone call appoinment to check in and asked about it rising to much higher pressures than i was told "mask fit at 10 should be fine as i rarely see people go above 11", ive been averaging around 11+ and going much higher, I know why but i wanted them to know theres an issue. Only positive thing i can say about this clinic, she said i may have upper airway resistance where she then said about possibly being referred to an ent. She said to stick with it and am getting good scores so am doing well. Have been to gp and referal is happening. I have issues with nose anyway so need to see them but at night i mouthbreathe so believe FL's are not linked to it. The clinic seemed like a mess and each doctor i saw except for the phone call didnt seem helpful or like they wanted to help.

Less than a week after the phone call was then told to come into an appointment where i was told they think i dont have an issue and are dismissing me... And because im nervous asf about this stuff i pretty much just kept on agreeing and not saying much. This was a week ago now

Am now really stuck on what to do... Do i try get retested? Do i carry on with it? Do i even have a problem? Do i quit?

REALLY in need of good sleep atm, have huge exams for the next month and being told i dont have an issue has only just added to my worries/stress atm. Am i doing the right thing. Maybe i should quit as according to a test i dont have an issue and dk how much more stress i can handle atm.

Am currently using asv mode due to being advised to with help, will send some screenshots of oscar from nights on cpap and asv. Bipap helped aswell but was told to try asv as overall did the biggest difference.
Some screenshots zoomed in from more recent last few nights on cpap machine - https://imgur.com/a/flow-rate-Hp6OnPn
SleepHQ on cpap https://sleephq.com/public/teams/share_ ... _id=ebaOaa
Just want to know if this is an actual SBD issue. Idk what to do anymore
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ChicagoGranny
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Re: Do I quit? Am confused on what to do now....in the UK

Post by ChicagoGranny » Wed May 21, 2025 3:36 pm

MeleeMK2 wrote:
Wed May 21, 2025 8:50 am
SleepHQ on cpap
The flow limitations are high. Personally, I would turn the EPR to 3 for one night and look at SleepHQ again the next day. (Many on this forum will say make the EPR changes in steps of one unit. Your choice.)
"It's not the number of breaths we take, it's the number of moments that take our breath away."

Cuando cuentes cuentos, cuenta cuántas cuentos cuentas.

MeleeMK2
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Re: Do I quit? Am confused on what to do now....in the UK

Post by MeleeMK2 » Wed May 21, 2025 4:18 pm

The flow limitations is the main reason I was told by many to switch to bilevel/asv. I had tried up to max pressure epr 3 with it still staying there, less but still an issue. My main reason for the post though was how much do I actually need it though, do I have an issue. Would flow limitations be seen in someone without a sbd? NHS seemed to say I have no issues and just let me go so am kind of stressed on what to do

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ChicagoGranny
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Re: Do I quit? Am confused on what to do now....in the UK

Post by ChicagoGranny » Wed May 21, 2025 4:36 pm

MeleeMK2 wrote:
Wed May 21, 2025 4:18 pm
My main reason for the post though was how much do I actually need it though, do I have an issue.
I would change your question to, "Will I benefit from treatment?"

Given your original post, I would say you benefit from some type of noninvasive treatment ---->
MeleeMK2 wrote:
Wed May 21, 2025 8:50 am
I did end up jailbreaking the machine to have bipap and asv, and it made a huge difference compared to cpap ...
-------------------------------------------------------------------------------------------------
MeleeMK2 wrote:
Wed May 21, 2025 4:18 pm
Would flow limitations be seen in someone without a sbd?

Yes, depending on how severe it is.

An ENT could help by merely examining your airway and warning your other doctors of a high risk of SDB.
"It's not the number of breaths we take, it's the number of moments that take our breath away."

Cuando cuentes cuentos, cuenta cuántas cuentos cuentas.

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Pugsy
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Pugsy » Wed May 21, 2025 4:40 pm

Are you having much (if any) nasal congestion? If you are that could explain the increased flow limitations.
MeleeMK2 wrote:
Wed May 21, 2025 4:18 pm
Would flow limitations be seen in someone without a sbd?
Yeah...nasal congestion, deviated septum, or potentially some other nasal issue.
Nose issues are NOT SDB issues. They are just nose issues and need to be address in other traditional nose treating ways.

I am not so sure that you have UARS either.....you aren't showing any RERA flagging and you need to have RERAs to help diagnose an already hard diagnosis to make.

Adding EPR will often help reduce FLs as LONG AS THEY aren't caused by nasal congestion.
Conversely increasing the minimum pressure is another way (again as long as it's not nasal congestion related).

ASV probably not a good choice just for FLs....Like using an atomic bomb to swat a fly.

BTW.....general consensus is that prior to any sleep study (home or lab) that people who are already using cpap abstain for at least a week (preferably 2 weeks) to eliminate the risk of any hold over effect clouding the results.

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MeleeMK2
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Re: Do I quit? Am confused on what to do now....in the UK

Post by MeleeMK2 » Thu May 22, 2025 4:04 am

I do have nasal congestion and always have, am currently being referred to an ent due to it however i completely mouth breathe at night due to it, my nose gets nearly fully blocked and becomes impossible to solely breathe through them.
I dont know much about asv tbh, only been told to try use it as same as bilevel helped and have the option to try it so why not. Sadly seeing flow limitations on this aswell, not nearly as many but still definitely some so might just be something i cant fully get rid off
Have done my research and been told many times about uars and reras not being flagged doesnt mean much, still having tons from what i can see just not flagged. I was told to stop a few days before the test so had a couple nights off it
Well my ahi was just enough for mild so i guess theres a something there but was confused why so much is going on and cpap is showing messed up nights seeing if i do have an issue, even though shows mild was told i have no problem

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Nocibur
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Nocibur » Thu May 22, 2025 4:30 am

MeleeMK2 wrote:
Thu May 22, 2025 4:04 am
am currently being referred to an ent
Best idea. IMO the Fls are caused by soft palate interference (your entire expiratory waveform looks contaminated by that, don't think it's CB artifact). Don't see any PP. Anyway ENT guy will give you definitive answer and treatment options.

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Nocibur
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Nocibur » Thu May 22, 2025 4:32 am

MeleeMK2 wrote:
Wed May 21, 2025 4:18 pm
The flow limitations is the main reason I was told by many to switch to bilevel/asv.
I can't find a BiPAP/ASV night in SleepHQ.


MeleeMK2
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Re: Do I quit? Am confused on what to do now....in the UK

Post by MeleeMK2 » Thu May 22, 2025 4:47 am

Nocibur wrote:
Thu May 22, 2025 4:30 am
MeleeMK2 wrote:
Thu May 22, 2025 4:04 am
am currently being referred to an ent
Best idea. IMO the Fls are caused by soft palate interference (your entire expiratory waveform looks contaminated by that, don't think it's CB artifact). Don't see any PP. Anyway ENT guy will give you definitive answer and treatment options.
Have talked to someone from the uk who has dealt with uars for a while now trying to get it fixed (ended up going abroad) and apparently all they like to do is cut stuff until it fixes, made him worse off. so am hoping i dont have the same experience

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Nocibur
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Nocibur » Thu May 22, 2025 5:01 am

ASV gives you some nice waveforms:
melee.jpg
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melee1.jpg
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Nocibur
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Nocibur » Thu May 22, 2025 5:05 am

MeleeMK2 wrote:
Thu May 22, 2025 4:47 am

Have talked to someone from the uk who has dealt with uars for a while now trying to get it fixed (ended up going abroad) and apparently all they like to do is cut stuff until it fixes, made him worse off. so am hoping i dont have the same experience
You don't what he had.

You don't know what they did.

You don't know the qualifications of "they".

For that matter, could've been the "someone's" fault for pushing for surgeries that had little hope of success.

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Nocibur
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Nocibur » Thu May 22, 2025 5:10 am

BTW if your sleep staging device has any degree of accuracy your continuity is kinda FUed.

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Nocibur
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Re: Do I quit? Am confused on what to do now....in the UK

Post by Nocibur » Thu May 22, 2025 5:14 am

Although this one's a little weird. Doubt you got that much REM. These things can get confused REM vs Wake:
melee2.jpg
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MeleeMK2
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Re: Do I quit? Am confused on what to do now....in the UK

Post by MeleeMK2 » Thu May 22, 2025 5:18 am

Nocibur wrote:
Thu May 22, 2025 5:14 am
Although this one's a little weird. Doubt you got that much REM. These things can get confused REM vs Wake:

melee2.jpg
Yeah not a clue what happened there, think its a glitch. apple watch has never really been that accurate for me i think but is good to see a rough overview. Though its not fully accurate can still tell between a good night and bad night on it pretty easily
Last edited by MeleeMK2 on Thu May 22, 2025 6:14 am, edited 2 times in total.