Inconsistency with Centrals from night to night?

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partialpaul
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Re: Inconsistency with Centrals from night to night?

Post by partialpaul » Tue Aug 26, 2014 7:46 pm

Pugsy,

I picked up the large size nasal pillows and, as of last night, I'm not suffocating thanks to your recommendation!
I was also prescribed a 30 day supply of Ambien 5MG dose and last night was the first dose...I slept 8 hours last night with an AHI of 9.0 (68 total events), though those were centrals or clear airway events, I'm still so thankful. What will happen in the next 30 days, I'm unsure but finally some sleep.

I actually felt like a human being when I woke up.

Oh, and yes...I changed 2 things in one night with the pillows and Ambien but they were both sorely needed.

Thanks again, I'll keep you posted!

Paul

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Re: Inconsistency with Centrals from night to night?

Post by Pugsy » Tue Aug 26, 2014 7:54 pm

I am so glad that you has some success last night and rested reasonably well without the suffocation feeling.
Don't blame you at all for changing 2 things at once. Sometimes we just gotta do what we gotta do. I would have done the same thing if I had been in your shoes.

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Re: Inconsistency with Centrals from night to night?

Post by partialpaul » Sat Aug 30, 2014 6:32 am

Pugsy,

After a week now on the large nasal pillows and Ambien, I've been wearing the CPAP (and sleeping) about 7 hrs per night. With that consistent nightly duration, my nightly AHI ranges from 7 to 10, almost all of which are Centrals. It also shows I average about 60 events per night ranging from 10 to 25 seconds. My appointment with my ENT is Sept. 15th...I'm thinking he'll look at my numbers and decide to put me on BIPAP ASV...just curious if you agree? Also, thanks for helping my son pspearsjr, he's doing so much better now thanks to your recommendations!

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Thanks again,
Paul

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Re: Inconsistency with Centrals from night to night?

Post by Overflow » Sat Aug 30, 2014 6:46 am

Pugsy wrote: Good sleep hygiene is more than just the no caffeine thing...google good and bad sleep hygiene and you will get lots of reading.
One of the no nos is using the computer or watching TV right before bed time (and another no no is watching TV in bed) and while I don't have a TV in the bedroom...I watch TV and use the computer right up to the time I go to bed.

Pugsy if you don't use it already, f.lux turns the screen's color temp warm at night to help mimic sunset, then goes back to normal blue when daytime hits.

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Re: Inconsistency with Centrals from night to night?

Post by Pugsy » Sat Aug 30, 2014 7:50 am

partialpaul wrote:AHI ranges from 7 to 10, almost all of which are Centrals. It also shows I average about 60 events per night ranging from 10 to 25 seconds. My appointment with my ENT is Sept. 15th...I'm thinking he'll look at my numbers and decide to put me on BIPAP ASV...just curious if you agree?
That's what I am thinking unless those ugly central clusters go away by the time you have the appointment and
1...I don't know that they will
2...if there was a chance that they would go away on their own it would take more than a couple of weeks for the body to adjust and the numbers to reduce.

Do you always have this sort of pattern? Half the night kinda ugly and the second part of the night things look decent?
I wonder why the ugliness doesn't happen all the night and only happens part of the night. Got me scratching my head on that one.

Some centrals are normal and not that big of a deal...like the second half of the night last night.
But moving on to the ASV type of machine would deal with the ugliness when/if it happens and still deal with the obstructive stuff.
I am using the S9 Adapt right now which is a type of ASV machine and I love it.

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Re: Inconsistency with Centrals from night to night?

Post by Pugsy » Sat Aug 30, 2014 7:53 am

Overflow wrote: Pugsy if you don't use it already, f.lux turns the screen's color temp warm at night to help mimic sunset, then goes back to normal blue when daytime hits.
Thank you.
I had heard of this before but never had a link for it right in front of me so hadn't done anything about it. This time I downloaded it and will get it up and running shortly.

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Re: Inconsistency with Centrals from night to night?

Post by partialpaul » Sat Aug 30, 2014 8:02 am

Pugsy,

You hit the nail on the head...scratching head here too. My gut tells me once I'm in a deep sleep, I'm fine...we've discussed the onset centrals before and I can tell I'm real "jumpy" while trying to get to sleep. I don't doubt I have apneas, but I'd love to see a sleep study w/o CPAP and just good sleep with something like Ambien.

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Re: Inconsistency with Centrals from night to night?

Post by Pugsy » Sat Aug 30, 2014 8:19 am

You know maybe they are just sleep onset centrals (those ugly times) and not CompSA but there's enough of them that there's the potential to have a significant O2 level drop during those clusters.

Do you find yourself bouncing in and out of sleep for a while before things settle down when you seem to go into good solid sleep with not much going on?

I didn't realize that pspearsjr was your son.....he's easy to fix...plain jane vanilla OSA and all we are doing is a tiny bit of fine tuning of the pressures. No head scratching with him. Wish they were all that easy.

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Re: Inconsistency with Centrals from night to night?

Post by partialpaul » Sat Aug 30, 2014 10:07 am

Exactly, for about 2 years now, while trying to get to sleep, it's like I was being shocked awake at the exact moment I was about to drift off....that process would repeat itself over and over until I finally fell into a deep sleep. So, I started taking ZzzQuil which helped to a degree but eventually I began having side effects from it. That's when I decided to go to the Dr. who ordered the sleep study and eventually the CPAP which I've had for 3+ weeks now. BTW, you mentioned my O2 levels...the PDF from my sleep study shows it never dropped below 93 either night.

The screenshots I shared today were with Zzzquil and the first couple of hours was miserable trying to settle in...if I take 10MG of Ambien I'm spared that misery. Last week, I tried just 5MG of Ambien and I don't think I ever went into a deep sleep all that night...sort of a light sleep.

All said, whether it be the CPAP or the Ambien or the combination of both, I'm sleeping the best I've slept in years...my wife told me recently that I've always "jerked" in my sleep which I was unaware of. I hope the Doctor will look at my readings and prescribe another machine but the question remains if that alone will get me straightened out but I'm very encouraged nonetheless.

Thanks!
Paul

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Re: Inconsistency with Centrals from night to night?

Post by Pugsy » Sat Aug 30, 2014 11:45 am

Sleeping pills just help you sleep a wee bit deeper so less chance of those sleep onset centrals (assuming that is what is going on here) don't awaken you to the point you are totally awake. It's not stopping the centrals from happening though. At least your oxygen levels don't appear to be dropping much ...at least on the sleep study. They are probably very brief so you don't spend a lot of time not breathing because you get bounced out to a awake/semi awake stage where you breathe.

If the doctor thinks this warrants the ASV type of machine then the machine will give you a big burst of pressure to kick start the breathing mechanism into action. That burst of pressure can be disturbing to some people. I see this with my machine but the burst never bugs me. I sleep right through it. I can see a pressure increase from 9 cm to 20 cm in about 20 seconds. I sleep right through all of it.

While sleeping pills have their place in life, they aren't something we want to take long term and every night. Plus it isn't fixing the problem...only covering it up.
There's risks vs rewards with all this and something you just need to talk over with your doctor.

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Re: Inconsistency with Centrals from night to night?

Post by palerider » Sat Aug 30, 2014 1:22 pm

Pugsy wrote:
Overflow wrote: Pugsy if you don't use it already, f.lux turns the screen's color temp warm at night to help mimic sunset, then goes back to normal blue when daytime hits.
Thank you.
I had heard of this before but never had a link for it right in front of me so hadn't done anything about it. This time I downloaded it and will get it up and running shortly.
another thumbs up for f.lux and things like that...

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Re: Inconsistency with Centrals from night to night?

Post by partialpaul » Mon Sep 01, 2014 8:02 am

Pugsy,

The only thing different last night was when I turned in I waited as long as I could before turning on the CPAP...when I awoke this morning, my AHI was 3.5...I left the CPAP on until I was awake enough to get up and looked back and my AHI was 4.7!

This with the usual 5MB of Ambien....in disbelief, I think I may try this again. I could see such a fluctuation if I was a drinker or if something else was different last night...but nothing...just the same routine other than what I explained above and that I went to bed a bit late since today's a holiday, that's all.

Happy Holiday!
Paul

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Re: Inconsistency with Centrals from night to night?

Post by Pugsy » Mon Sep 01, 2014 8:19 am

If (Big IF) you are only having the sleep onset central thing perhaps you were able to sleep through them and not get bounced out of the transition to sleep last night.
So if pressure isn't causing the centrals...once you get passed the sleep onset stage and sleep decently without the wake ups and the repeated chance for sleep transition centrals to happen...you sleep decently.

Also if you were laying awake for prolong periods of time in the past some of those centrals could have been awake/semi awake breathing flags which weren't real.

Any events that get flagged while awake/semi awake have to be set aside. They don't count. The machine can't tell the difference and it only flags the breathing changes. It's easily fooled.

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