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CDG
Unread post  Post subject: Sleep study data: does it point to complex apnea?  |  Posted: Sun Nov 06, 2016 10:47 pm
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First, THANK YOU for great info I've absorbed so far... particularly how the CPAPs flag apnea events where none appear to be (based on flow rate graphs) and all the info on central apneas (plus mixed and complex apnea explanations). Huge help.

I have my first follow-up appt with my sleep Doc in a week and want to know if I have reason to suspect complex sleep apnea. I have lots of CA events on my scorecard over my 32 days of APAP use, and I had mixed and central apneas on my sleep study, which all seem to point in that direction. But this is all very new to me, and sometimes I jump to conclusions... so I'm hoping for insight.

My sleep study was completed on 7/21/16 - not a split study. (I am attaching a summary of the apnea data generated from the sleep study.) Titration study was done 2 weeks later. Rx came on 10/1 and I got my equipment on 10/5. Have been using it every night, altho some nights only for short intervals due to "adjusting" challenges. I also have insomnia and wake up a lot. I take temazpam every night so I can fall asleep.
When I look at my daily flow rate graphs, I see a lot of CA event flags that I think Jason would toss. So it's hard to know what is really going on. Overall, the last 32 days averages are: AHI 16.45, Obs Index .52, Hypo Index .70, Clear Airway Index 15, RERA .22, % of time in SCR .37%. (That includes a 1hr 40min nap two days ago (in and out of sleep) with a CA index of 61! (I assume not real.)

Thanks for any insight... truly grateful.
Attachment:
Sleep Study Apnea Results.png
Sleep Study Apnea Results.png [ 109.31 KiB | Viewed 3311 times ]


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TheLankyLefty
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Mon Nov 07, 2016 10:39 am
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A screenshot of these flagged centrals somewhat close up would help. (5 minute window usually good)

Usually when the CA index is that high they are real. Would be best to see everything together though as well as the exact settings and at the time of the events.

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trish6hundred
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Mon Nov 07, 2016 7:50 pm

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Hi CDG,
WELCOME! to the forum.!
Hang in there for more responses to your post and good luck to you on your CPAp journey.


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CDG
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Mon Nov 07, 2016 10:25 pm
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TheLankyLefty wrote:
A screenshot of these flagged centrals somewhat close up would help. (5 minute window usually good)


I've viewed a lot of my flow rate graphs, and picked pieces of a few of them that appear odd to me (based on what my O2 deprived can make sense of).
They are from last Thursday night & Friday night.

Also, I want to add that my anxiety level has reached new highs recently and feels like it is affecting my awake breathing, so may be affecting my sleep breathing. Ironically, much of the anxiety is tied to this disorder. Just throwing that in the mix and would appreciate any feedback about it as well.

Much thanks!


Attachments:
File comment: Data for Friday night.
Fri Night Data.tiff
Fri Night Data.tiff [ 101.12 KiB | Viewed 3293 times ]
File comment: These look like okay flows, but they are flagged.
Fri Night1.tiff
Fri Night1.tiff [ 49.95 KiB | Viewed 3293 times ]
File comment: Data for Thursday night.
Thurs Night Data.tiff
Thurs Night Data.tiff [ 101.08 KiB | Viewed 3293 times ]
File comment: Not sure about some/most of these CA flags.
ThursNight2.tiff
ThursNight2.tiff [ 60.1 KiB | Viewed 3293 times ]
File comment: Looks like a few CA events that should not be flagged (?)
ThursNight1.tiff
ThursNight1.tiff [ 58.08 KiB | Viewed 3293 times ]
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TheLankyLefty
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Fri Nov 11, 2016 10:29 pm
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Am I the only one that can't see the tiffs? :(

Can you convert them to jpgs and re-upload?

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diamaunt
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Sat Nov 12, 2016 1:13 am
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TheLankyLefty wrote:
Am I the only one that can't see the tiffs? :(

Can you convert them to jpgs and re-upload?


I didn't see any way to download anything... I can view tiffs, but there weren't any DL links for me.

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CDG
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Sat Nov 12, 2016 1:00 pm
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i will upload these another way and use jpgs as soon as I get a bit of time. sorry for the problem. I am using a mac with OS 10.11.6. and safari 10.0. don't know if this might be at cause. (seemed like it was working as i sent added each file.) thanks for trying!


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diamaunt
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Sat Nov 12, 2016 4:20 pm
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just use the 'take screenshot' feature in sleepyhead, either f12, or 'take screenshot' off the view menu.

it's much easier.

full instructions, three pages, read all three:
https://sleep.tnet.com/resources/sleepyhead/shorganize

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CDG
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Sat Nov 12, 2016 7:57 pm
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Joined: Sun Nov 06, 2016 8:47 pm
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Location: Boulder Creek, CA
PAP Mask: DreamWear Nasal CPAP Mask with Headgear
PAP Machine: AirSense 10 AutoSet For Her w/HumidAir™ Heated Humidifier
Pressure Setting: APAP currently set at 6 and 8

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Trying again; sending only jags - from last night. I get many flagged CA events that create a high AHI, but look false.
Also wondering if there some false HA flags.

This is the entire night:
Attachment:
lastnight.allnight.jpg
lastnight.allnight.jpg [ 594.72 KiB | Viewed 3250 times ]


Are these not real central apneas? Hypopnea labeled incorrectly?
Attachment:
lastnight.1.jpg
lastnight.1.jpg [ 109.49 KiB | Viewed 3250 times ]


Another false CA and HA?
Attachment:
lastnight.4.jpg
lastnight.4.jpg [ 172.98 KiB | Viewed 3250 times ]


These are frequent CA event flags that I question.
Attachment:
lastnight.5.jpg
lastnight.5.jpg [ 163.64 KiB | Viewed 3250 times ]


Thanks!


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diamaunt
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Sun Nov 13, 2016 2:35 pm
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turn off EPR

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CDG
Unread post  Post subject: Re: Sleep study data: does it point to complex apnea?  |  Posted: Thu Nov 17, 2016 8:48 pm
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Location: Boulder Creek, CA
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PAP Machine: AirSense 10 AutoSet For Her w/HumidAir™ Heated Humidifier
Pressure Setting: APAP currently set at 6 and 8

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Thanks diamaunt for your suggestion.
Saw my sleep Doc a couple of days ago. His advice was to turn pressures down a bit. (APAP Rx originally 10-12, but I had already lowered to 8-10.) My OSA index has been quite low, so it makes sense to see if I can lower pressure another unit or two to reduce CA without making OSA problematic.
I will do some experimenting - taking the advice that I've read here - about giving each change a 3 day trial to assess affects.


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