Alright, I'm attaching my recent titration study interpretation and what they used in lab to treat it. I know that in the lab they used an OmniLab for the titration. I wore my own P10 mask for the titration study. I have basically been treating with APAP since last year. Some days it would work and others I would have a ridiculous amount of events for no rhyme or reason. In APAP, I figured out that my max was 9cm and I would usually start out at 8cm and have it set to ramp to 9cm if needed. EPR was set to 3 full-time on an Air Sense 10 Autoset. Yet I also have central apneas that the APAP of course cannot treat.
So last month I had my titration study. The sleep tech started with CPAP and central apneas spiked (got really dizzy, the room was spinning with my eyes closed, had an out-of-body experience likeI floated up to the ceiling), so she switched me to BiPap. As you can see, in the lab they apparently brought it under control to reduce my hypopneas, obstructive apneas and central apneas using BiPap. Then I was holding for a BiPap appointment with my sleep doctor. Just had that Wednesday morning.
I researched the various BiPaps ahead of time. Some people were telling me to push for BiPap ST instead of S for me centrals because the timed mode helps with centrals. I sent an email to my doctor's office ahead of time asking about the type of machine. I also called. They gave me the, "Whatever machine you get will be based on your titration study."
Ended up with Air Curve 10 S. 6 months rent to own if I'm compliant for like 70% of the month and sleep at least 4 hours per night on the machine for about 21 nights.
Per the lab titration results, my settings needed were 9 IPAP and 5 EPAP. Easy-breathe is on. Ti max is default at 2.0s and Ti Min is 0.3s. Trigger set to Med, Cycle set to Med. 20 minute ramp time. Start EPAP is 4.0 and goes to 5.0 after 20 minutes.
This was my first night on it last night. I pulled it off a few times to take a break because I woke up feeling like I wasn't breathing (central) even while using the machine. I felt awful this morning.
Looked at my data in OSCAR and I saw 45 CA events in 5.25 hours with just a couple of hypopneas and apneas.
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The sleep manager lady who set me up with the machine to take home was rude and direct. She gave me her card yesterday and said, "If you have any questions, reach out to me."
So this morning I emailed her with the same screenshots from OSCAR that I'm posting here. My email to her said: "I picked up my Air Curve 10S BiPap yesterday and wanted to share results of my first night. I had an extremely rough night and as you can see from the screenshots, I have followed the exact settings given to me 100%. There were a few times when I had to take my mask off for a little break because I kept waking up so much from whatever was going on. I use a software called OSCAR, which is commonly used to review CPAP/BiPap data for patients. I also use the ResMed MyAir app. It registered 45 Clear Airway (Central Apneas), 1 hypopnea and 3 obstructive events for the 5 hours 16 minutes that I kept the machine on. My obstructive apneas are pretty much gone and my hypopneas are gone, but my centrals are quite high. Do you have any advice that might be of help?"
Got a rude reply:
"Sir,
This is the first night you use the machine. It is not a magic wand. Also the software you are currently using is not FDA approved. 45 clear airway is also not central apneas, the abbreviation is probably the same but central apneas is not clear airway. Just continue using the machine and we will analyze it when you come back from you visit. For the mask, you are in the adjustment period. Give it a time to adjust.
Thank you"
If they are not centrals, what else could they be? She's from another country and obviously the language skills for typing are not there. I'm confused. My understanding is that CA in OSCAR is central apneas. Centrals went down in the lab titration, but spiked at home. Using the same P10 mask (she gave me a new one with the machine, too). What do you make of this?
Primary care doc is going to do an MRI of my head next week to check for various stuff.
I toss and turn all night, every 30 minutes or less per the motion camera trained on my bed. But in between, I probably move all night long about every few minutes. I just shift in position on my bed or move an arm or leg just a little. I'm thinking this may be centrals...I saw a little boy's central apneas video one time while he was sleeping and he woke up sometimes seconds apart without a machine. Wondering if my centrals are doing that.
Any advice?
If the BiPap S is not working, what will happen to it? Get another machine on the insurance and keep this one or return it? Doc doesn't seem to like used machines. I asked my sleep doc about my APAP (Air Sense 10 Autoset with low hours) that I was self-treating with before and my sleep doc said, "We usually just throw them away. Nobody will want it, especially around this time." I saw someone with an auction for one on Ebay at $400.
I have an appointment at 1 months, 2 months and 3 months from now and they want me to bring the machine to each appointment.
What is the reason why I'm so miserable while using the BiPap at home if it worked in the lab? I also have times in the later afternoon while just resting/sitting where I'll just get short of breath like I'm going to faint and it comes and goes in waves. Odd twitches/feelings/tingles all over my body. Primary care doctor suspected POTS/Dysautonomia. Heart was checked by Cardiologist - good. Full Stress EKG and ultrasound with ColorFlow. Had my thyroid checked by an Endocrinologist. Nothing wrong. Lots of blood work. All fine. I have times when I feel like I have to force myself to breathe while sitting upright during the day. It is like I have central apneas sometimes while sitting up during the day and I just "stop" breathing until I force myself to breathe. Very odd. Should I see a Pulmonologist?