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rickyjoe
Unread post  Post subject: wildly differing PSG results  |  Posted: Tue Nov 27, 2018 5:59 pm

Joined: Tue Nov 27, 2018 5:47 pm
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Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
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in January 2018 I had my initial PSG, AHI was 9.5, I got an oral appliance and used it several months, blood pressure dropped from 140/110 to 120/87 (averages) and BP cut meds down from four types to two. Lost the day time sleepyness and wild dreams. (came back nights I didn’t use it).

I did a follow up study in October at a different lab with the appliance in, AHI now 36.5 with 202 RERA’s for night ...doc wants to titratate for CPAP!!

thoughts?


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Pugsy
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Tue Nov 27, 2018 6:06 pm
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Joined: Wed Aug 02, 2017 8:01 pm
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PAP Mask: Bleep/DreamPort nasal mask
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Too bad they didn't do the first part of the night without the appliance and the second half with the appliance.


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rickyjoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Tue Nov 27, 2018 6:50 pm

Joined: Tue Nov 27, 2018 5:47 pm
Posts: 14
Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
PAP Machine: Dreamstation Auto SV
Humidifier: dreamstation attached
Pressure Setting: EPAP min 9; EPAP max 15; Ipap max 25; Ipap min 9; PS max 15; PS min 0

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good thought, maybe i can talk them into it on titration night


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rickyjoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Wed Nov 28, 2018 1:13 pm

Joined: Tue Nov 27, 2018 5:47 pm
Posts: 14
Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
PAP Machine: Dreamstation Auto SV
Humidifier: dreamstation attached
Pressure Setting: EPAP min 9; EPAP max 15; Ipap max 25; Ipap min 9; PS max 15; PS min 0

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One of the things that really puzzles me is that nothings changed with me physically in between PSG‘s. I have a BMI of 22.1 and I am fit, walking 3 miles a day briskly. I could understand the change if I had put on weight or gotten out of shape. But none of that happened. Do people typically see this type of swing between tests and labs?


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diamaunt
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Wed Nov 28, 2018 8:59 pm
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Sleep Apnea, it's not just for old fat men anymore! You can play too!

1) false negatives (seem to) happen all the time, false positives are exceedingly rare (as far as I can tell).

2) Sleep varies from hour to hour, and night to night.

Figure the worse numbers are more accurate.

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How to format your charts


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TheLankyLefty
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Wed Nov 28, 2018 11:45 pm
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rickyjoe wrote:
One of the things that really puzzles me is that nothings changed with me physically in between PSG‘s. I have a BMI of 22.1 and I am fit, walking 3 miles a day briskly. I could understand the change if I had put on weight or gotten out of shape. But none of that happened. Do people typically see this type of swing between tests and labs?
If you can compare the two tests it's likely a huge change in body position during the night or the amount of REM during the night....or a combination of the two.

Some labs have REALLY lame reports that don't break down the report into stages and body position, but if they do then that is where you'd find the reason.

If there is a hypnogram then you can use that as well. It shows trend data of body position, SPO2, staging, and tagged events (similar to sleepyhead zoomed out all the way....but with greater detail). Feel free to post if you have copies of the reports.

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rickyjoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Fri Nov 30, 2018 10:52 am

Joined: Tue Nov 27, 2018 5:47 pm
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Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
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Pressure Setting: EPAP min 9; EPAP max 15; Ipap max 25; Ipap min 9; PS max 15; PS min 0

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Thanks, I do have copies, and I will post them as soon as I figure out how to do it. The first is a hospital lab and the second is privately owned. We used the privately owned one to test for REM disorder (negative fortunately) as the hospital one didn’t have video capability.


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rickyjoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Sun Dec 09, 2018 7:52 pm

Joined: Tue Nov 27, 2018 5:47 pm
Posts: 14
Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
PAP Machine: Dreamstation Auto SV
Humidifier: dreamstation attached
Pressure Setting: EPAP min 9; EPAP max 15; Ipap max 25; Ipap min 9; PS max 15; PS min 0

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OK, had my titration Study night before last. Took an Ambien and drifted off to sleep very quickly. After 49 minutes sleep on the clock I woke up, and stayed awake until the lights came on at 5:30. I had several conversations with sleep tech, we worked on mask… But I really do not think it was the problem. I was wearing a circadian elan And really found it quite comfortable.

The tech tried CPAP at all different levels to see if I could get to sleep; when that did not work we tried bi-level. at Pressure below six I felt air starved but was comfortable between six and 14 . I really did not have too much trouble breathing against pressure, thank you Lanky lefty for the advice to just relax and let my body exhale on it’s own. Although I have to admit when we got up to 14 cm with EPR on 3 CPAP that was a challenge! I did notice That I would leak out my mouth at higher pressures. Even when I was awake I would bubble right along! A couple times I had almost drifted off and was awakened by it.

I did notice also that by morning I had a lot of excess air In my stomach when I got up, that was not much fun.

I am not sure where we go from here, the tech mentioned auto CPAP; and bilevel CPAP as potential options to discuss with the doctor.

Anybody else have ideas?


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rickyjoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Wed Dec 26, 2018 10:03 pm

Joined: Tue Nov 27, 2018 5:47 pm
Posts: 14
Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
PAP Machine: Dreamstation Auto SV
Humidifier: dreamstation attached
Pressure Setting: EPAP min 9; EPAP max 15; Ipap max 25; Ipap min 9; PS max 15; PS min 0

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I just got my titration PSG of Dec. 7th back AHI 37 with emergent central’s on cpap. (guess i slept more than I thought). Doc ordered echo cardiogram, just did a stress test 6 months ago with normal result but...OK let’s do it.

does this sound familiar to anyone? I’m not sure what to think about it.

Not. what I expected since central’s were low on other two PSD’s


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mbushnoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Fri Dec 28, 2018 4:21 am

Joined: Sat Aug 11, 2018 12:15 am
Posts: 32

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rickyjoe wrote:
OK, had my titration Study night before last. Took an Ambien and drifted off to sleep very quickly. After 49 minutes sleep on the clock I woke up, and stayed awake until the lights came on at 5:30. I had several conversations with sleep tech, we worked on mask… But I really do not think it was the problem. I was wearing a circadian elan And really found it quite comfortable.

The tech tried CPAP at all different levels to see if I could get to sleep; when that did not work we tried bi-level. at Pressure below six I felt air starved but was comfortable between six and 14 . I really did not have too much trouble breathing against pressure, thank you Lanky lefty for the advice to just relax and let my body exhale on it’s own. Although I have to admit when we got up to 14 cm with EPR on 3 CPAP that was a challenge! I did notice That I would leak out my mouth at higher pressures. Even when I was awake I would bubble right along! A couple times I had almost drifted off and was awakened by it.

I did notice also that by morning I had a lot of excess air In my stomach when I got up, that was not much fun.

I am not sure where we go from here, the tech mentioned auto CPAP; and bilevel CPAP as potential options to discuss with the doctor.

Anybody else have ideas?


Aerophagia is one of very few common side effects of CPAP, but it generally happens more at high pressures. I do find it a little unusual that they kept bumping you even when you weren't sleeping. Typically I will do this with patients to the extent that they feel like they are getting enough air, and by patient request in certain cases, but usually we try to only bump you while you are asleep and only if we have seen events that indicate that you need a higher pressure.


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rickyjoe
Unread post  Post subject: Re: wildly differing PSG results  |  Posted: Sat Dec 29, 2018 12:18 pm

Joined: Tue Nov 27, 2018 5:47 pm
Posts: 14
Location: middle midwest
PAP Mask: Circadence Elan cloth nasal mask
PAP Machine: Dreamstation Auto SV
Humidifier: dreamstation attached
Pressure Setting: EPAP min 9; EPAP max 15; Ipap max 25; Ipap min 9; PS max 15; PS min 0

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apparently the OA’s were gone at 10cm on CPAP but centrals emerged, doc is going to explore auto service after my echo cardiogram. I don’t have heart failure (just had a stress test a few months ago) so I’m puzzled.


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