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TmjTerri
Unread post  Post subject: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Mon Aug 15, 2016 9:58 am
User avatar

Joined: Sat May 05, 2012 7:26 am
Posts: 22
PAP Mask: Mirage Softgel Petite
PAP Machine: ResMed Vpap Adapt S9 36007
Humidifier: ResMed H5i Heated Humidifier
Pressure Setting: 17/30 My paperwork also says Asv-Epap 10cm rate auto Min PS=4cm Max PS=15

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Hi! I have severe complex sleep apnea and am supposed to use a ASV machine but no matter what I do I cannot, cannot get used to it and so I just don't use it at all. Gasp! Trust me, I know how horrible that is for my health and I am so over feeling miserable so I am here in hopes of getting support to try again and actually be successful. I feel like crap like ALL of the time and I am so over it.
Here are all of my sleep reports and would like to see if anyone has any suggestions or advice on how I can actually be successful so that I can start feeling better. I am living a total nightmare right now.

BTW, I know that my last sleep studies were in 2011 but I have pretty much tried to pretend this away and ignored the fact that I have this..I know that it is stupid and very bad for my health. I'm truly hoping that I can start again but this time be successful with CPAP therapy. I'm hoping that is the case anyway. Thanks so much. I'm at my wits end! Seriously!

January 14th 1996

Procedure: The overnight polysomnogram was performed recording the EEG (6), EOG (2), chin and legs EMG (3), EKG, respiratory airflow, thoracic and abdominal effort and oximetry.

Summary: Sleep onset latency is prolonged, and once the patient is asleep, there are some arousals and awakenings due to spontaneous arousals. There was a fairly normal sleep efficiency of 91%, however there was decreased REM sleep of 6% with prolonged REM latency of 242 minutes, normal slow wave sleep of 28%. There are very infrequent respiratory apneas not associated with snoring and not associated with oxygen desaturation. The saturation was maintained above 94% to 96% SaO2. There was a combined apnea/hypopnea index of 12.5 events per hour and an apnea index of 8.3 events per hour. The electrocardiogram demonstrated a sinus rhythm of the usual rate of 80 beats per minute and no significant extrasystoles. There are no periodic movements of sleep or EEG abnormalities.

Interpretation: The overnight polysomnogram demonstrated mild central sleep apnea with no significant obstructive sleep apnea. No significant oxygen desaturation. Nasal CPAP therapy would not be recommended to control this respiratory disorder. The cause of the patient’s morning headaches are not clear, though medication effects or caffeine should be considered.


My 1st sleep study since this 1996 study and this was with my old sleep doctor. I desperately need to find a wonderful & helpful sleep doctor who can help me get healthy and happy! If that's even possible.

December 21st 2009

Sleep Parameters: Total study time was 372 minutes.; total sleep time was 280 min. Sleep efficiency was low at 75.4%. Sleep architecture was abnormal. Sleep onset occurred at 25 min.; REM onset occurred at 301 min. There was 1 episode of REM sleep lasting 12.5 min. The patient did not achieve stage N3 sleep. Sleep was fragmented due to intermittent arousals. There were a total of 7 arousals, 2 of which occurred spontaneously; 4 arousals were related to respiratory events. The arousal index was 1.7 events/hr. Snoring was noted. The patient slept in left and supine left-sided postures. Respiratory events occurred in all postures.

Cardio-Respiratory Parameters: Baseline oxygen saturation was 93%. Lowest recorded oxygen saturation was 81%. The patient spent a total of 214.6 min. below an oxygen saturation of 90%. Throughout the period of study, there were 27 hyponeas, 8 central, and 39 obstructive apneas. Mean duration of hyponeas was 31.1 sec. with some lasting 68.5 sec. Mean duration of central apnea was 17.4 sec. with some lasting 26 sec. Mean duration of obstructive apneas was 21.1 sec. with some lasting 40 seconds. Total Respiratory Index (RDI) was elevated at 15.8 events/hr. During REM sleep, the RDI was 38.4 events/hr. The apnea/hypopnea index (AHI) was 15.8 events/hr.

Cardiac Rhythm: There wee cyclic changes in heart rate. Heart rate was maintained in the 70s. No significant arrhythmias were noted.

Impression: Moderate Sleep Apnea Syndrome (780.53)

*******My 2nd sleep study****

December 29th 2009

Sleep Parameters: Total study time was 411 min.; total sleep time was 374 min. Sleep efficiency was good at 91%. Sleep architecture was abnormal. Sleep onset was at 10.5 min.; REM onset occurred at 50 min. There was 1 episode of REM sleep lasting 15.5 min. The patient did not achieve stage N3 sleep. Sleep was fragmented due to intermittent arousals. There were a total of 23 arousals, 12 of which occurred spontaneously; 7 arousals were related to respiratory events and 4 arousals were associated with leg movements. The arousal index was 3.7 events/hr. Snoring was noted. The patient slept in the supine posture.

The study was initiated with CPAP at 6CM H2O and gradually increased to 12 CM H2O due to persistent respiratory events and snoring. Bi-Level ventilation was also initiated at 8/6 Cm H2O and gradually increased to 12/8 CM H2O. Baseline oxygen saturation was 95%. Lowest recorded oxygen saturation was 78%. The patient spent a total of 178.5 minutes below and oxygen saturation of 90%. Throughout the period of study, there were 60 hypopneas, 250 central, 1 mixed and 239 obstructive apneas. Mean duration of hypopneas was 18.6 seconds with some lasting 40 seconds. Mean duration of central apneas was 15 seconds with some lasting 33 seconds. Mean duration of obstructive apneas was 16.4 seconds with some lasting 37.5 seconds. Total respiratory disturbance index (RDI) was 88.2 events/hr. compared to 15.8 events/hr. during her baseline study. During REM sleep, the RDI was 69.7 events/hr. compared to an RDI of 38.4 events/hr/ during her baseline study. Due to the occurrence of frequent of central respiratory events, optimum pressure could not be determined. Cardiac Rhythm: There were cyclic changes in heart rate. Heart rate was maintained in the 60s and 70s. Mean heart rate was in the 70s. No significant arrhythmias were noted. Motor activity/Periodic Leg Movements: There were 7 PLMS episodes with an index of 15.4 events/hr.

Impression: Severe Complex Sleep Apnea
Periodic Limb Movement Disorder.

******My 3rd sleep study...

January 6th 2010

Results:

Sleep Parameters: Total study time was 350 min,; total sleep time was 298.5 min. Sleep efficiency was good at 85.3%. Sleep architecture was abnormal. Sleep onset occurred rapidly at 5 min. suggesting pathologic sleepiness; REM sleep did not occur. The patient did not achieve stage N3 sleep. Sleep was fragmented due to intermittent arousals. There were a total of 4 arousals, 2 of which occurred spontaneously; 2 arousals were related to respiratory events. The arousal index was .8 events/hr. Intermittent snoring was noted. The patient slept in the supine, supine left, supine right and upright postures.

Cardio-Respiratory Parameters: The study was intiated with bi-level ventilation at 8/4 cm H2O with a back-up rate of 10 b/pm and gradually increased to 30/25 cm H2O with a back-up rate of 10 b/pm due to persistent respiratory events and arousals. Baseline oxygen saturation was 91%. Throughout the period of study, there were 205 hypopneas, 174 central, 1 mixed and 62 obstructive apneas. Mean duration of central apneas was 15.1 sec. with some lasting 38 second. Mean duration of obstructive was 18.7 sec. with some lasting 38 sec. Total respiratory disturbance index (RDI) was 88.8 events/hr. compared to 15.8 events/hr. during her baseline study. Optimal pressure was not determined. Cardiac Rhythm: There were cyclic changes in heart rate. Heart rate was maintained in the 50s, 60s and 70s. Mean heart rate was in the 60s. No significant arrhythmias were noted. Motor Activity/Periodic Leg Movements (PLMS) No spontaneous leg movement activity was noted throughout the study.

Impression: Complex Sleep Apnea Syndrome

And then my doctor wrote that I had complex sleep apnea which is difficult to control with positive pressure therapy.

Then here is my last sleep study with my NEW sleep doctor tested on the ASV.

Diagnosis and Comment: 327.21 Primary Central Sleep Apnea, Severe

******Last sleep study...

December 20th 2011

Method of study” Complete polysomnography with a digital sleep system using the international 10-20 electrode placement for recording EEG (F3/M1, F4/M2, C3/M2, C4/M1, O1/M2, O2/M1), EOG, EMG, from chin, ECG, respiratory effort by inductance piethysmography, oximetry, body position, airflow (thermistry and nasal pressure), snoring sound, pulse rate and limb movement channels. The study was performed in a darkened room (low light video observation). The study was scored using the alternative AASM criteria for hypopneas. The attending physician below performed the epoch by epoch review of this study, formulated an interpretation (not 100% this is the word because my sleep study was faxed twice) of the study and directly participated in the preparation of this report.

Titration- Severe Complex Sleep Apnea. The patient was diagnosed with moderate sleep apnea with an AHI of 15.8 on a diagnostic polysomnogram on December 16th 2009. She was subsequently found to have complex sleep apnea on a CPAP titration study. She was retitrated with BiPAP 30/25 cm H2O with a back-up rate of 10 with persistent respiratory events with an AHI of 88.8 with 40% being central in nature. An ASV titration study was, therefore, performed with setting of minimum EEP=8 cm H2O, maximum EEP=18 cm H2O, minimum pressure support= 4 cm H2O, maximum pressure support = 15 cm H2O with a Respironics ComfortGel (petite) nasal mask and heated humidification. During the 437.5 spent at this pressure, the patient’s AHI was improved to 7.6 and oxygen saturation was maintained in the 89%. There was adequate REM supine time. The patient tolerated the ASV well and felt more rested after the study. Close clinical follow-up is necessary to assess patient tolerance, compliance and response to treatment. In addition, avoidance of sleep in the supine position, avoidance of alcohol and other sedatives, medical maximization of nasal airway patency (e.g. through use of antihistamines or nasal steroids as needed).

_________________
My equipment that I'm "supposed" to be using...

Mask: Mirage™ SoftGel Nasal CPAP Mask with Headgear

Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control

Additional Comments: Severe Complex Sleep Apnea & New Life Elite Oxygen Concentrator~Pressures 17/30..Contect CMS50F Pulse Oximeter


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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Mon Aug 15, 2016 3:58 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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you listed what the *humidifier* is, but not what actual cpap you have.

look on the back, is it a 36007 or a 36037, or something else?

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TmjTerri
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Wed Aug 17, 2016 9:39 pm
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Joined: Sat May 05, 2012 7:26 am
Posts: 22
PAP Mask: Mirage Softgel Petite
PAP Machine: ResMed Vpap Adapt S9 36007
Humidifier: ResMed H5i Heated Humidifier
Pressure Setting: 17/30 My paperwork also says Asv-Epap 10cm rate auto Min PS=4cm Max PS=15

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Omg you are so right! I didn't put my actual machine..Duh! So sorry about that. So I have ResMed S9 36007. I hope that is the proper info. Thanks so much!

_________________
TmjTerri
Diagnosis: Severe Complex Sleep Apnea
My Equipment:
ResMed Vpap Adapt S9 #36007
ResMed H5i Heated Humidifier
NewLife Elite/Intensity/QuietLife 5 Oxygen Concentrator
Respironics CPAP Nasal Mask with Headgear - ComfortGel Blue Size Petite
Pressures 17/30
My paperwork also says..
Asv-Epap 10cm rate
Auto Min PS=4cm Max PS=15cm
CMS50F Pulse Oximeter Recordable
CPAP Hose Lift v5


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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Wed Aug 17, 2016 10:10 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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indeed it is. there's two s9 vpap adapt, and the 36007 tells us which. it's a good machine.

there was a wall of text, and if there were any questions in there, I missed 'em.

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TmjTerri
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Wed Aug 17, 2016 10:41 pm
User avatar

Joined: Sat May 05, 2012 7:26 am
Posts: 22
PAP Mask: Mirage Softgel Petite
PAP Machine: ResMed Vpap Adapt S9 36007
Humidifier: ResMed H5i Heated Humidifier
Pressure Setting: 17/30 My paperwork also says Asv-Epap 10cm rate auto Min PS=4cm Max PS=15

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Thank you so much! I am struggling so bad as I haven't been able to get used to my machine.. I honestly find it impossible to keep it on let alone try and sleep with it. I also really need to find a new sleep doctor as I haven't seen any sleep doctor since 2011 which is absolutely horrible. You know how you get to that point of being sick and tired of always feeling sick and tired? Well that is me to a t! I never sleep more then 15-20 minutes and this is my regular normal. At this point I am ready to take my severe complex sleep apnea seriously. I've tried to live this past 6 years as if I wasn't diagnosed and I know that I would have a lifetime of regret if something bad happens and I could have treated my condition but didn't.

One question that I do have is seeing how I haven't used my cpap at all in the past 6 years is it safe to jump back on the machine without seeing a doctor? Please know that I completely understand that no one can give me medical advice and that this is strictly your opinion. What makes me hesitate is what if my condition has changed whether better or worse? That maybe isn't even possible I don't know. How in the world do you get used to this? One of my other major issues is that I had a bilateral total joint replacement on my TMJ jaw joints and I have severe chronic pain and the face mask is so uncomfortable on my face and I've pretty much tried all of the different types of masks available. Obviously no one in their right mind wishes they had sleep apnea in any form but Jesus I truly wished that I DIDN'T have this. It really is a nightmare especially when left untreated.

Thanks so much for your advice or help. I'm not sure what my first step should be.

_________________
TmjTerri
Diagnosis: Severe Complex Sleep Apnea
My Equipment:
ResMed Vpap Adapt S9 #36007
ResMed H5i Heated Humidifier
NewLife Elite/Intensity/QuietLife 5 Oxygen Concentrator
Respironics CPAP Nasal Mask with Headgear - ComfortGel Blue Size Petite
Pressures 17/30
My paperwork also says..
Asv-Epap 10cm rate
Auto Min PS=4cm Max PS=15cm
CMS50F Pulse Oximeter Recordable
CPAP Hose Lift v5


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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Thu Aug 18, 2016 12:03 am
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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I'm no doctor, or even a pro like Jason, but I have had some discussions with doctors, and one of the more rational ones was with a doctor that was playing with ASVs like yours, and he told me that he didn't think that a person *could* hurt themselves with one... so, I would take that as an endorsement of it being safe.

I've got a couple friends that use the new resmed P10 nasal pillow on their ASVs, it's one of the most minimal masks, putting no pressure anywhere near your jaw. you might give it a try. it's certainly nothing like what was around 6 years ago, in fact, there's a number of new masks on the market.

I'd suggest you try and get another mask, or failing that, at least get yours as comfortable as possible, and wear the mask while doing other things, like watching TV... to get used to wearing it again.

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TmjTerri
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Thu Aug 18, 2016 9:20 am
User avatar

Joined: Sat May 05, 2012 7:26 am
Posts: 22
PAP Mask: Mirage Softgel Petite
PAP Machine: ResMed Vpap Adapt S9 36007
Humidifier: ResMed H5i Heated Humidifier
Pressure Setting: 17/30 My paperwork also says Asv-Epap 10cm rate auto Min PS=4cm Max PS=15

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That's an excellent point that I hadn't even thought of is to look at new masks that weren't available when I was diagnosed. I will definitely check out the one you suggested.

This is probably a stupid question but do any of you who has been diagnosed with any type of sleep apnea ever get repeated sleep studies? Even if it is every few years? I'm just curious if there is ever a need to recheck it.

Thanks so much for all your help. It's very much appreciated!

_________________
TmjTerri
Diagnosis: Severe Complex Sleep Apnea
My Equipment:
ResMed Vpap Adapt S9 #36007
ResMed H5i Heated Humidifier
NewLife Elite/Intensity/QuietLife 5 Oxygen Concentrator
Respironics CPAP Nasal Mask with Headgear - ComfortGel Blue Size Petite
Pressures 17/30
My paperwork also says..
Asv-Epap 10cm rate
Auto Min PS=4cm Max PS=15cm
CMS50F Pulse Oximeter Recordable
CPAP Hose Lift v5


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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Thu Aug 18, 2016 1:58 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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TmjTerri wrote:
This is probably a stupid question but do any of you who has been diagnosed with any type of sleep apnea ever get repeated sleep studies? Even if it is every few years? I'm just curious if there is ever a need to recheck it.


lots of people get sent by their doctors for repeated sleep studies, the cynical among us could say it's because of $$$$$.

a modern machine with full data (such as yours) gives most of the information, and far far more of it, than any sleep study.

think about it, your sleep study is a few hours in a foreign environment. once you start using your machine, you'll see how your sleep varies through the night, and from night to night, we don't sleep the same way all the time... so by looking at days and days of data, you can find out more about how well you're being treated than any few hours in a sleep lab.

(waits to see if I get smacked by Jason for that ;))

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JasonInAlaska
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Fri Aug 19, 2016 10:32 pm
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Joined: Wed Jul 06, 2016 1:23 pm
Posts: 87
Location: Palmer, Alaska, USA
PAP Mask: DreamWear by Philips Respironics
PAP Machine: DreamStation Auto CPAP Machine by Philips Respironics
Humidifier: DreamStation Heated Humidifier & heated hose by Philips Respironics
Pressure Setting: 9-18

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diamaunt wrote:
think about it, your sleep study is a few hours in a foreign environment. once you start using your machine, you'll see how your sleep varies through the night, and from night to night, we don't sleep the same way all the time... so by looking at days and days of data, you can find out more about how well you're being treated than any few hours in a sleep lab.

(waits to see if I get smacked by Jason for that ;))

I am curious to his response, too. I'm guessing he might say something about how if you are using oximetry and are going in for the standard type test they do (chest strap, nasal cannula,and finger O2 sensor), you are likely not far off. If they are actually hooking you up to a sensors that can tell if you're asleep there might be value in it.


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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Sat Aug 20, 2016 1:02 am
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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JasonInAlaska wrote:
diamaunt wrote:
think about it, your sleep study is a few hours in a foreign environment. once you start using your machine, you'll see how your sleep varies through the night, and from night to night, we don't sleep the same way all the time... so by looking at days and days of data, you can find out more about how well you're being treated than any few hours in a sleep lab.

(waits to see if I get smacked by Jason for that ;))

I am curious to his response, too. I'm guessing he might say something about how if you are using oximetry and are going in for the standard type test they do (chest strap, nasal cannula,and finger O2 sensor), you are likely not far off. If they are actually hooking you up to a sensors that can tell if you're asleep there might be value in it.


even so, it's still a brief snapshot taken in a foreign environment.

I saw a post recently, from someone who was worried about her husband coming out with a very mild diagnosis, saying that he has good nights, and much much worse nights, and that she thinks he had his sleep test on one of his better nights, so it looks much better, result wise, than the average.

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TomR48
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Tue Aug 23, 2016 5:13 pm

Joined: Tue Aug 23, 2016 4:30 pm
Posts: 1
Location: Texas
PAP Mask: Res Med Mirage Quattro Full Face Mask
PAP Machine: Res Med S9
Humidifier: Res Med H5i
Pressure Setting: 13 i think

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You say "I honestly find it impossible to keep it on let alone try and sleep with it." My sister-in-Law had a similar problem on the mask leaking and knocking her Nasal Mask off during the night. I have used a full face mask for about 15yrs now with no such problems. I compared the way she routed her air-hose and the way I routed mine. She ran straight from the machine to her (level with the nightstand it was on). I run my air-hose above my head behind and over the headboard of my bed. This way the air-hose is coming straight down from the headboard and when I toss and turn the hose stays free and the swivels work properly. Hope that is helpful for you.


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TheLankyLefty
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Wed Aug 24, 2016 11:08 pm
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Posts: 4650
PAP Mask: Practically tried them all.
PAP Machine: Use Phillips Respironics System One APAP with Aflex for mask testing
Humidifier: None
Pressure Setting: When testing, I use APAP with a range of 5-10

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What a great topic!!!

TmjTerri wrote:
This is probably a stupid question but do any of you who has been diagnosed with any type of sleep apnea ever get repeated sleep studies? Even if it is every few years? I'm just curious if there is ever a need to recheck it.
People do. The idea being that the prescription changes over time just because of age and weight loss and weight gain.

For the average user I think that this is a good idea. CPAP forums is a bad place (in my opinion) to get a feel for this. The average user really doesn't give a rip about CPAP other than their doctor told them to wear it, so they do. They don't care how it works, why it works, or how it's working for them. They literally question nothing. I will try to engage some people just to see what their understanding of CPAP is and if they have questions. I get shut down more often than not. Complete lack of interest....and it CAN'T BE ME!!!! I'm entertaining as hell!!!! ;) CPAP forums are full of people that are seeking answers and have really good questions (said Mr. "Cheap Applause"). Seriously, more inquisitive folks are here, so the perception of patients as a whole is very skewed. 9 out of 10 don't give a flying rats ass.

People on forums could....9 times out of 10, figure it out on their own.

So for most people, they do need a technologist there to observe and "fix" any problems that they see with that persons therapy. (I can go off on a tangent on this)

Much of the retesting is caused by insurance rules. I can't remember the exact timeframes, but after a certain amount of time they want proof that you still have apnea and are using CPAP or they will stop paying for your supplies or machine rental. All contracts are different, but this isn't uncommon. So many times a physician will order a test because they have been contacted that if a test isn't redone they prescription for supplies will end. I don't think this is communicated to patients at all.

Changing to a different mode of therapy I think is good to have done in lab. This is especially true with Bilevel. It's just complicated to get right. ASV is mostly insurance. That's an expensive machine that they want to make sure works before writing the check.

I don't know that I answered that completely, but you get the gist.

diamaunt wrote:
(waits to see if I get smacked by Jason for that ;))
:lol: Too funny!!! Come on, you know I'm not like that!!! :) I'm too busy afraid I'm going to be smacked by you! ;)

diamaunt wrote:
even so, it's still a brief snapshot taken in a foreign environment.
The one thing I would say about this is that once you fall asleep, the breathing is fairly consistent. I say this based on studies from my home sleep testing business. The number is pretty low....roughly 5. These patients didn't believe their original diagnosis because of the strange environment etc. The difference between an in lab study and mine doesn't have to do with the numbers, but the experience. The one thing that increases is total sleep time (or more accurately sleep efficiency). The AHI is usually in the range that I would consider statistically the same. Some studies are botched, but in general they are pretty close with regards to the AHI. I do notice most labs don't break down the data by body positions....but again another tangent.

Even people that have been retested several months or years apart (in the same lab.....the one I work at. I say this because our methods are consistent), the numbers are very consistent unless there was a drastic weight change or time gap between the two (more than 2 years).

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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Thu Aug 25, 2016 10:51 am
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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TheLankyLefty wrote:
diamaunt wrote:
(waits to see if I get smacked by Jason for that ;))
:lol: Too funny!!! Come on, you know I'm not like that!!! :) I'm too busy afraid I'm going to be smacked by you! ;)

what? never! 1) you da boss, and 2) you also didn't miss the clue train!

TheLankyLefty wrote:
diamaunt wrote:
even so, it's still a brief snapshot taken in a foreign environment.
The one thing I would say about this is that once you fall asleep, the breathing is fairly consistent. I say this based on studies from my home sleep testing business. The number is pretty low....roughly 5. These patients didn't believe their original diagnosis because of the strange environment etc. The difference between an in lab study and mine doesn't have to do with the numbers, but the experience. The one thing that increases is total sleep time (or more accurately sleep efficiency). The AHI is usually in the range that I would consider statistically the same. Some studies are botched, but in general they are pretty close with regards to the AHI. I do notice most labs don't break down the data by body positions....but again another tangent.

Even people that have been retested several months or years apart (in the same lab.....the one I work at. I say this because our methods are consistent), the numbers are very consistent unless there was a drastic weight change or time gap between the two (more than 2 years).


Fair enough. I was thinking more of titration studies, especially after looking at many peoples traces where part of their night is great, and part is crap, because of different sleep phases, and how many titration reports I've seen indicate that the 'good pressure' was only used for half an hour, or something, out of a whole nights worth of time. my bad on not being clear about what I was talking about.

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TmjTerri
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Thu Aug 25, 2016 1:14 pm
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Quote:
Complete lack of interest....and it CAN'T BE ME!!!! I'm entertaining as hell!!!! ;) CPAP forums are full of people that are seeking answers and have really good questions (said Mr. "Cheap Applause").


ROTFLOL Jason! You seriously crack me up! I absolutely love your sense of humor. When I watch your YouTube videos you sometimes have me laughing so hard to where my cheeks hurt. A lot of times it totally makes my day! For real! Plus you are so flippin' cute!

Anyhow, your answers made complete sense. What I was curious about is if a person loses weight and has complex sleep apnea can that weight loss (or gain I guess) have any affect on the central apneas? I *think* I already know the answer but I'm not positive. I'm guessing that it definitely would have an affect on the obstructive apnea but not so much on the central? Even though I have been diagnosed with complex sleep apnea for a few years I really don't know that much about it as I did my darnest to ignore it like I didn't have it. Not smart I know.

Oh and you were right about my questions coming from the same person on YouTube and here. That was actually pretty impressive that you figured out it was me especially since I have a completely different user name there. Well unless you were thinking of someone else...LOL

P.s. I'm a lefty too and darn proud of it!

_________________
TmjTerri
Diagnosis: Severe Complex Sleep Apnea
My Equipment:
ResMed Vpap Adapt S9 #36007
ResMed H5i Heated Humidifier
NewLife Elite/Intensity/QuietLife 5 Oxygen Concentrator
Respironics CPAP Nasal Mask with Headgear - ComfortGel Blue Size Petite
Pressures 17/30
My paperwork also says..
Asv-Epap 10cm rate
Auto Min PS=4cm Max PS=15cm
CMS50F Pulse Oximeter Recordable
CPAP Hose Lift v5


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TheLankyLefty
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Sat Aug 27, 2016 2:56 pm
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diamaunt wrote:
Fair enough. I was thinking more of titration studies, especially after looking at many peoples traces where part of their night is great, and part is crap, because of different sleep phases, and how many titration reports I've seen indicate that the 'good pressure' was only used for half an hour, or something, out of a whole nights worth of time. my bad on not being clear about what I was talking about.
Gotcha.

I think that all night titrations are better than Split night (baseline and then CPAP) (I know you know this, but for other people reading) recordings just for that reason. You do have more of an opportunity to get supine REM (usually the worst in terms of apnea) at several pressures. The purpose of a titration night is to get as many "good samples" as possible to show that a pressure will or won't work. Supine REM is preferable, but you still want to see NREM and REM. Some pressures are quickly changed because they're clearly not working.

That said, it's a pain in the butt for the patient for what I consider to be a very small "reward". The doctors (in my area) really don't make any money by sending people in for studies. None of them own their own lab. It's just not set up that way. I do notice that some small private labs to have some skeptical business practices, but usually the larger hospital organizations are pretty fair about it (from my experience) I think that APAPs with follow-up during the first month (frequent communication and data downloads looking at stuff that actually matters) is plenty good. They aren't going to make any money on that though, so the close follow-up doesn't happen.

For the "typical" patient, an in lab titration study is a better option. It's my opinion that this is why on forums there tends to be a feeling of being fleeced. These are the people that watch it like a hawk. So to them there is understandably no value in an overnight in lab titration study.

TmjTerri wrote:
When I watch your YouTube videos you sometimes have me laughing so hard to where my cheeks hurt. A lot of times it totally makes my day! For real!
Thanks. My family and my best friends family piled into a car to look at local Christmas lights last year. His wife loves my videos despite not having sleep apnea or even an interest in the subject....she's just amused by them for whatever reason. So my friend says he's going to put on Christmas music and instead they start feeding the audio from some of the videos. I got extremely embarrassed which made my boys laugh harder than I've ever seen them laugh. I think they liked watching me squirm!!! Rotten children. Take after their father. :?

TmjTerri wrote:
What I was curious about is if a person loses weight and has complex sleep apnea can that weight loss (or gain I guess) have any affect on the central apneas?
No. No effect at all on the Central Component.
TmjTerri wrote:
Well unless you were thinking of someone else...LOL
If you are Two Pink Peas then I nailed it!!! :lol: If not....I hang my head in shame.

TmjTerri wrote:
P.s. I'm a lefty too and darn proud of it!
I'm actually ambidextrous (like most "lefties"). Some stuff only left handed, but most right and left. When thinking of a screen name starting the YouTube channel "The Lanky Lefty" sounded much better than "The Rotund Righty" or "The Average Ambidextrous". ;)

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TmjTerri
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Mon Aug 29, 2016 2:29 am
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Quote:
I got extremely embarrassed which made my boys laugh harder than I've ever seen them laugh. I think they liked watching me squirm!!! Rotten children. Take after their father. :?


LOL..That's so cute! I bet it is hilarious watching them watching your videos!
Quote:
No. No effect at all on the Central Component.
That's what I thought but I wasn't sure. One question that I meant to ask you but forgot is once you find the right pressures on your, well my machine cause this question is specific to me, why am I not getting any REM sleep? Will REM sleep return to normal or am I doomed for life? lol Sorry trying to find some humor in this situation.
Quote:
If you are Two Pink Peas then I nailed it!!! :lol: If not....I hang my head in shame.


Man you're GOOD! I knew you guessed it right! No hanging your head down in shame! Well done!

_________________
TmjTerri
Diagnosis: Severe Complex Sleep Apnea
My Equipment:
ResMed Vpap Adapt S9 #36007
ResMed H5i Heated Humidifier
NewLife Elite/Intensity/QuietLife 5 Oxygen Concentrator
Respironics CPAP Nasal Mask with Headgear - ComfortGel Blue Size Petite
Pressures 17/30
My paperwork also says..
Asv-Epap 10cm rate
Auto Min PS=4cm Max PS=15cm
CMS50F Pulse Oximeter Recordable
CPAP Hose Lift v5


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TheLankyLefty
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Wed Aug 31, 2016 3:26 pm
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TmjTerri wrote:
why am I not getting any REM sleep? Will REM sleep return to normal or am I doomed for life? lol Sorry trying to find some humor in this situation.
Let me ask this. How do you know that you're not getting any REM sleep?
I'll give you a hint. Remembering dreams is not an accurate predictor of the amount of REM that you're having.

Frequent vivid dreams (sometimes violent) often means that you are waking up from REM sleep because of Apnea. So this definitely not good. Dreams are usually only remembered when we wake up during them. There are studies that I have read about with this. Waking people out of different stages of sleep, then asking if they were dreaming or not.

Stage1 and 2 there were no reported dreams.

Stage 3 (Delta) people would recall a dream, but when asked to describe it they could only describe a scene, or an image, but no action.

REM sleep: people would recall dreaming. When asked to describe the dream they would be able to tell a story like the dream was a movie.

Pretty interesting.

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TmjTerri
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Sat Sep 24, 2016 6:00 pm
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Joined: Sat May 05, 2012 7:26 am
Posts: 22
PAP Mask: Mirage Softgel Petite
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TheLankyLefty wrote:
TmjTerri wrote:
why am I not getting any REM sleep? Will REM sleep return to normal or am I doomed for life? lol Sorry trying to find some humor in this situation.
Let me ask this. How do you know that you're not getting any REM sleep?
I'll give you a hint. Remembering dreams is not an accurate predictor of the amount of REM that you're having.


Well the reason I asked and know is because every sleep study that I have had all say that I do not go into stage REM sleep. I'm not saying that I don't go into REM sleep ever because there have been some times I do remember little parts of a dream but they are mixed...some good some bad/violent. But to be fair I have PTSD from a extremely abusive relationship so I have always chalked my bad/violent dreams to stem from that. But honestly I was curious because of my sleep studies saying that. Obviously a sleep study is a short snapshot compared to normal every day life and so I do get that.

_________________
TmjTerri
Diagnosis: Severe Complex Sleep Apnea
My Equipment:
ResMed Vpap Adapt S9 #36007
ResMed H5i Heated Humidifier
NewLife Elite/Intensity/QuietLife 5 Oxygen Concentrator
Respironics CPAP Nasal Mask with Headgear - ComfortGel Blue Size Petite
Pressures 17/30
My paperwork also says..
Asv-Epap 10cm rate
Auto Min PS=4cm Max PS=15cm
CMS50F Pulse Oximeter Recordable
CPAP Hose Lift v5


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diamaunt
Unread post  Post subject: Re: Severe Complex Sleep Apnea from hell! My sleep reports  |  Posted: Sat Sep 24, 2016 7:36 pm
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TmjTerri wrote:
I'm not saying that I don't go into REM sleep ever because there have been some times I do remember little parts of a dream but they are mixed.

fact is, you can dream in any sleep stage, it's just more common in REM.

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