New, Severe, Really Concerned

[NewToSleepApnea]

Anyone know what Sleep onset apnea or transitional sleep apnea is?

[Pugsy]

Anyone know what Sleep onset apnea or transitional sleep apnea is?

Usually central apneas where there is no air flow but not because of soft tissue blocking the airway...central apneas are when there is simply no effort to breath. Hold your breath for 10 seconds...that's essentially a 10 second central apnea. No air is moving but the reason is because there is no effort to breathe.
It's quite common to have a central apnea happen when we transition from awake to asleep. Not a big deal unless we have a truckload of them and they keep bouncing us out of sleep.

I did NOT see evidence of this when I examined your flow rate up close but I will go back and look again with specific attention to when you fall asleep.
People mistakingly often think that it is low O2 levels that drive the breathing but it's actually the levels of carbon dioxide in our blood that cause the brain the send the "breathe" signal to the body. Central apneas happen when the blood level of carbon dioxide aren't high enough for the brain to send the breathe signals.

[NewToSleepApnea]

From everything I’ve read on transitional sleep apnea, it is the exact symptoms I have.

Sudden occurrence 16 days ago. I feel great when I actually sleep on the CPAP machine. But I felt great before this whole thing started too.

Last night - couldn’t truly fall asleep for about 6 hours. Then did for I dunno 90 mins?

I’ll post the data. If I could just actually fall asleep, I feel as if I would have no issues at all.

[Pugsy]

Your breathing is a bit weird looking when transitioning to sleep or trying to transition but there's no evidence of central apneas.
Some waxing and waning but I don't know if it's enough to be a problem or not. From the flow rate graphs....it's very minor. I have seen much worse but that doesn't mean it's not enough to be a problem for you.

This is one of those things we talked about that really needs to be evaluated in a sleep lab setting by someone with more expertise than me and more tools than we have with just the machine flow rate data being available for helping to figure out what is going on.

We simply don't have enough data available from the machine to dig deep into all this.

I do know what once you do fall asleep...that sleep is still extremely fragmented with arousals for some reason. Something is really messing with your sleep but we can't tell what it is from the data we have available. It doesn't seem to be central apneas though.
There's a lot of irregularities but not many actual cessation of air flow itself either central or obstructive.

[NewToSleepApnea]

Thank you so much. I can tell something is wrong. Unfortunately I can’t get a sleep lab due to covid right now. Hopefully they open up in a few weeks.

[Pugsy]

Understood. It is what it is and we have no choice but wait it out.
All I know to do is what we have already discussed...continue to try to use the machine based on the home sleep study results and work on trying to improve sleep quality.

Did you try a double dose of Vistaril last night?

[NewToSleepApnea]

I tried without it last night.

I’ll try double tonight.

[NewToSleepApnea]

First Graph is the whole night. Second Graph is when I was finally so exhausted I slept on my stomach and fell asleep. Only from 5:45-7:30pm did I fall asleep. The rest I was in that weird rest limbo where everything is slowed down but conscious.

Whole Night

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Just Fully Asleep

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[Pugsy]

How long have you been using the Vistaril and is it something you pretty much have relied upon on a nightly basis or has it been more of a random prn basis?

[NewToSleepApnea]

Got prescribed to me 2 days before I got the CPAP. Out of 8 nights I've used it about 6 times. Last night I didn't try to use it at all.

Would love to use something to get me to fall asleep but worried about anything that makes Sleep Apnea worse (Ambien, Benzos, Etc)

[Pugsy]

I understand the concern about various RX meds and their potential impact on the apnea itself.
It's a sticky wicket for sure. The risks have to be weighed against the rewards for sure and often doctors have to choose between 2 choices that are neither very desirable.

It's why I always defer to the professionals when it comes to RX sleep aids. There is a time and place for everything and that includes RX sleep aids. We have a forum member here who has had long standing battles with insomnia and then she got OSA to battle and documented her struggles and experiments often in the past. Forum member RobySue...when you have time you might scroll through a lot of her posts especially her last trial with the latest in RX sleep aids. They all come with some baggage...the trick is figuring out if the medication baggage is worse than the insomnia baggage. She didn't want to take RX sleep aids and fought it tooth and nail but finally after working with her medical care team came to a compromise of sorts as to when she would finally resort to RX sleep aids.
I wish she were still active here to offer her input but she's been MIA for quite some time now. So we can't draw upon her wealth of knowledge.

I will share this though....my own sleep doctor told me that sometimes the RX sleep aids are a better alternative and the sleep apnea worsening aspects are minimal when compared to the problems that lack of sleep itself might cause.
This was after a discussion I had because of my own sleep maintenance insomnia issues secondary to chronic pain. The stuff needed to treat my chronic pain worsens OSA...that's a known fact but the chronic pain causes chronic sleep issues which come with its own set of problems. Muscle relaxants would help with sleep but they are known to make OSA much worse...the choice was muscle relaxants or RX sleep aids and something like hydrocodone for pain management....she preferred Ambien and hydrocodone over muscle relaxants....meaning those potential problems were at least less of a danger than what muscle relaxants might do to OSA.
Nothing is ever perfect. Everything comes with baggage and risks vs rewards.

[Julie]

Just googled side FX of Vistaril - have you?

[palerider]

First Graph is the whole night. Second Graph is when I was finally so exhausted I slept on my stomach and fell asleep. Only from 5:45-7:30pm did I fall asleep. The rest I was in that weird rest limbo where everything is slowed down but conscious.

Set your pressures min 10, max 20.
I don't see any evidence of transition apneas, I see obstructive apneas, and hypopneas,

I can actually feel my breath get low and shallow, arms start to go tingly/numb, and then my chest stops and I jerk and wake up or have to gasp.

centrals don't cause recovery breaths, obstructives do.

[NewToSleepApnea]

Yes - thats the firs thing I did. Only thing I saw for Vistaril side effects were:

dizziness,
drowsiness,
blurred vision,
dry mouth,
stomach upset,
or headache.
restless muscle movements in your eyes, tongue, jaw, or neck,
tremors (uncontrolled shaking).

I am only using that because that is what the sleep doctors suggested.

[NewToSleepApnea]

Not a perfect night. But Powered through the apneas or whatever is happening immediately upon falling asleep. I could fell and know the postions where my O2 levels drop etc but instead of rolling over, I just forced through it. That must be why the pressure raised so high. So far the higher the pressure goes, the worse the AHI night has been. Chicken or egg scenario.

Wondering what it will feel like to have an AHI of 1 for a whole night of sleep!

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