Need Help Dialing in My APAP Settings

Because my first in-clinic sleep study went so poorly, I had another. This time, I shaved my head to allow them to tape the sensors to my head and adhere better. I also took a sleeping pill. Finally, I ended up in a more comfortable bed. I actually got 4 hours and 11 minutes of sleep, so they had good data. They tested me with Bilevel and Bilevel ST with BUR (whatever that is). My AHI was 48.5, with an Obstructive Apnea Index of 0.0, Central Apnea Index of 11.5, Mixed Apnea Index of 0.2, and a Hypopnea Index of 36.8. Because there's some indication I have Central Apneas, there will be a follow-up in-clinic sleep study to determine whether I have Central or Complex (?) Apnea. They stated there is some possibility that the machines they used could make it appear I have Central Apnea. I'm not happy that we haven't reached a solid diagnosis and treatment, but I am happy that we may progress to a solution because they appear recognize more needs to be done and that I am committed. They will be testing with ASV titration. Luckily, I have no history of heart issues, other than high blood pressure.

BTW: I've continued to use my Dreamstation 2 APAP in the meantime and it reports I have an AHI of 4 to 5. Given how restless my sleep is and how bad I understand this machine's algorithm for AHI is, I am not surprised at the disparity.

i have a dreamstation 1,straight out of the box the settings were terrible, 5 min/20 max. now 4 years later i have no choice but to use it. so with much trial and error and perseverance i found 8 min / 14 max work well for me. the average ahi less than 2,clear airway apneas 4, obstructive apneas 5,total hypopneas 6. on occasions the ahi is less than 1. now sleeping comfortably for 8 hrs or more. good luck.keep at it.

I had my 3rd in-clinic sleep study recently. This time, they tested me with ASV, as my previous study indicated I had central apnea. The ASV study went well. Way better than my previous studies. At this point, I am being prescribed an ASV machine. It will be a rental. I guess this is to get more time with an ASV for them to verify this is indeed the correct treatment, before actually purchasing a machine. I'm not thrilled with the idea that I have central apnea, but am glad that I have a real potential path towards treatment and healthful sleep. It also seems the pressures are much lower than I've been attempting with my APAP, which makes it possible for me to use my nasal pillows again.

I communicated with the sleep doctor to get some clarification. She wrote back that my initial diagnosis of severe sleep apnea was made by a home sleep study. She suspects I had obstructive sleep apnea from the home sleep study, but cannot confirm for certain because a home sleep study cannot determine for certain if one has central vs severe sleep apnea. My subsequent studies at the sleep lab were on different PAP machines- a CPAP, a BIPAP, an ASV machine. I had centrals on CPAP and BIPAP which she suspects were treatment emergent central apneas (this is also called 'complex sleep apnea'). ASV seemed to treat my obstructive and central apneas.

I've been on the ASV for 5 days. Definitely feeling better, though I know it will take time to get the full benefits and for the docs to tweak the settings, now that I am on a machine Kaiser supports (ResMed AirCurve 10 ASV). I did not have an SD card for the machine for the first 3 days, so I was unable to look at the data for that time, but have had an SD card for the past two. Not sure what graphs to show here for best feedback, but here is what I have. I know there is room for improvement. Have been having some mouth leaks. I'm trying to avoid dry mouth also. Just as likely to happen with a full face as nasal pillows (dry mouth), but more likely, in my case, to have a mouth leak with full face than the nasal pillows. Have been trying mouth taping, but am still getting dry mouth.

So, as far as my graphs are concerned, it's early days with the ASV and I'm not looking to tweak them myself. Just wondering what you peeps think will be areas of improvement that I can/should expect.

Thanks.

You might try a chin strap to keep the mouth shut.

I had my humidity settings at 4. This is on a ResMed. On a Phillips, my old machine, 5 was the max. On reflection, I realized that the ResMed was set for 4 of 10. Oops. I cranked it up to 8 and my dry mouth is much better. I may try bumping it up or wait a few days to see if 8 will suffice. I think I may still be feeling the residual effects of when I had it set for 4.

The soft cervical collar has arrived and I'll try that as well.

In case you missed it, I have been mouth taping and I had dry mouth with the humidity at 4 of 10. Much better with mouth taping with humidity at 8 of 10.