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Permalink Reply by Judy on March 26, 2009 at 1:11pm

I'm taking a rough guess here, Henning, so will first ask, what is your LEAK rate w/that autoPAP on the nights w/the various AHIs you''ve posted. What pressure range do you have your APAP set to? And what brand and model APAP are you using? What mask are you using?

As I said I'm making a very rough guess here but is the pressure range set wide open, like 4 cms to 20 cms? Better to narrow the range, maybe starting 2 cms below your previously titrated pressure and 2-3 cms above your previously titrated pressure. Is your reported Leak rate more than 10 L/M above the allowed vent rate for your mask at your pressure setting? Are you using a Resmed APAP and what Mask Selection if so.

Was your current (since surgery) Dx of "mild" OSA arrived at via an in-lab titration and if not have you given serious consideration to having a current in-lab titration done?

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Permalink Reply by Henning on March 26, 2009 at 1:21pm

My APAP is a RESMED S8 with humidifier.

My leak rate is within the normal range. I use a nasal mask.

My pressure range is between 6 to 10 H2O.

So everything should be "normal".

Since my surgery I have had a full PSG sleep study.

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Permalink Reply by Mike on March 26, 2009 at 6:23pm

First off, my attitude is that everyone is different and that if surgery works for you and not CPAP, all the better -- yay surgery! But you do raise a fascinating question on an intellectual level: how ever could CPAP cause apnea events? I have heard of CPAP causing central apneas in certain circumstances, and that makes sense to me: the brain essentially shuts off its own work to make breathing happen because it recognizes that a machine is doing the work for it! But if CPAP is causing more obstructive events, then I'm at a loss to explain it.

Can you tell us for sure that the events were obstructive and not central apneas?

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Permalink Reply by Duane McDade on March 28, 2009 at 7:29am

The Can of Worms!! 1.) Yes, APAP can cause apnea "like" events. A.) Pressures too high will cause what looks like Apneas. The high pressure will happen with APAP because it's compensating for leakage, Mouth opening, and anything that the small micro-computer is told is an "APNEA". 2.) Well I don't have anything possitive to say about APAP every case thats come to my attention SCREAMS this technology needs more time to develope. there are just way to many variables. I don't mean to step on any toes. It's just my observation. 3.) There is no 3.

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Permalink Reply by Henning on March 28, 2009 at 5:16pm

I know for sure that my sleep apnea is obstructive. My average pressure is 8.8 H2O.

But most of my events are hypopneas and Resmed is known perhaps to over count them.

So now I have ordered the ResScan software and card reader so I can analyze my AHI by myself.

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Permalink Reply by Duane McDade on April 1, 2009 at 1:39am

The companys who produce the machines Res Med , Resperonics, etc, etc.... Will tell you that their Machines work so good that you don't need a Doctor or a sleep study to know how you're sleeping. Just put this machine near your bed and presto! I don't agree I've only done about 6000 sleep studies so I don't know if I'm quaified to make this statement but here goes......Have it done in a sleep lab! There are just way to many variables for some small computer in a little machine to do you or your health justice.

Henning said:

I know for sure that my sleep apnea is obstructive. My average pressure is 8.8 H2O.

But most of my events are hypopneas and Resmed is known perhaps to over count them.

So now I have ordered the ResScan software and card reader so I can analyze my AHI by myself.

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Permalink Reply by Henning on April 2, 2009 at 2:12pm

Well, I agree with you that a sleep study is the best method. I just had a PSG sleep study. That night was a good night, and showed only mild sleep apnea. But that was only a single night.

For my part, I have big differences between the individual nights, and of course I can’t get a sleep study every night.

So the next best would be to rely on readings from the CPAP machine.

But the problem as I see it is that everything is average figures.

I have just received the software and card reader for my Resmed machine.

It gave me some surprises.

My average leakage is very fine. But when I analyze each night, there are large fluctuations. And I have indeed large leaks sometimes.

The higher CPAP pressure the higher number of hypopneas. I have spoken with Resmed and been told that I should not worry about hypopneas, because they will always be well treated, although they count towards my AHI.

My average apneas is also <5 But when I analyze individual nights it shows that they typically occurs in 2 periods of approx. a half an hour’s at night. (With a lot of hypopneas just before).

I have a check with my machine every year. But the detailed data is only for 5 days. The rest of the year is average figures.

This means that I always am told that I am well treated. Although some nights I can have up to 40 apneas within a half an hour.

I have a feeling that it is when I sleep on my back I have problems.

So now I will do some experiments on myself.

Duane McDade said:

The companys who produce the machines Res Med , Resperonics, etc, etc.... Will tell you that their Machines work so good that you don't need a Doctor or a sleep study to know how you're sleeping. Just put this machine near your bed and presto! I don't agree I've only done about 6000 sleep studies so I don't know if I'm quaified to make this statement but here goes......Have it done in a sleep lab! There are just way to many variables for some small computer in a little machine to do you or your health justice.

Henning said:

I know for sure that my sleep apnea is obstructive. My average pressure is 8.8 H2O.

But most of my events are hypopneas and Resmed is known perhaps to over count them.

So now I have ordered the ResScan software and card reader so I can analyze my AHI by myself.

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