I could really use some help trying to figure out whats up!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
bill-008
Posts: 3
Joined: Wed Jul 19, 2017 11:16 am

I could really use some help trying to figure out whats up!

Post by bill-008 » Thu Jan 18, 2018 11:36 pm

Hi, this is my first time posting here so apologises if I don't provide the correct info or I'm posting in the wrong section.

I was diagnosed with OSA early last year when I was 33 years old. For a long time I'd always had trouble sleeping and waking up during the night with a racing heart beat feeling anxious. Until 1 day I woke up with my heart beat going crazy. I was told I had paroxysmal atrial fibrillation and was asked about my sleep in general. A few days later I had a sleep study done and was told I had mild-moderate OSA.

After this I bought a DreamStation pro and ordered a generic full face mask from Thailand where I am living. I was amazed that this seemed to instantly fix the problem. I was sleeping better again, not waking up in the middle of the night and not having any racing heartbeats at any point. This went on for 8+ months and I thought everything was fixed.

However last month I went back home for Xmas which seemed to mess up my sleeping, which I thought was due to jet lag. Since I've been back in Thailand Ive started waking up again like clockwork with racing heartbeats and feeling really anxious. This is really worrying as I don't want the irregular heart beat to come back or something worse. I'm really scratching my head as to why the CPAP machine seems to have stopped working.

Is it possible someone could look at my Sleepyhead stats and see if anything has changed?

A few things to note-

1. When going back to the UK I bought a DreamStation Go travel CPAP and used it for 10 days there with a new mask (Airtouch 20). Those 10 days I seemed to sleep fine and was not waking up during the night.

2.Since getting back home I've been using my normal Dreamstation with the Airtouch 20 and this is where the problem started. I first put it down to jetlag but it's been 20 days and counting now, and if anything seems to be getting worse. The mask fits, feels and seems to work great though. And it says I'm getting no air leakage.

Sorry that was a bit longer than I planned! If someone is able to view my sleepyhead should I screenshot certain pages or export the file and attach here?

Thanks for your help

USMCVet
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Re: I could really use some help trying to figure out whats up!

Post by USMCVet » Fri Jan 19, 2018 12:46 am

Definitely post up your sleepy head data. I don't think mine is set up perfect either but something that looks like this would be helpful.

https://imgur.com/a/WAKHM

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bill-008
Posts: 3
Joined: Wed Jul 19, 2017 11:16 am

Re: I could really use some help trying to figure out whats up!

Post by bill-008 » Fri Jan 19, 2018 2:50 am

Thanks, I added a bunch of screenshots of the past few nights plus the total overview since using the machine

https://imgur.com/a/bTCft

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Pugsy
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Re: I could really use some help trying to figure out whats up!

Post by Pugsy » Fri Jan 19, 2018 9:02 am

The only thing I see is some minor clustering of stuff (not all of the stuff is included in the AHI) going on during the night.
Might be related to REM stage sleep or maybe you are on your back or maybe a little bit of both.
You are using a very tight range of pressures and for the most part that seems to work well in preventing whatever is showing up in those times with minor clustering.
The RERAs are indications of possible arousals which go along with your history.

On Wed the 17th at 1:30...see the pressure max out at 12 and there is a corresponding cluster of a couple of OAs, more hyponeas, some Flow limitations (think of them as flow reductions that don't earn an OA or hyponea flag for some reason)...all this means is the machine likely wanted to go higher but couldn't.
Now this didn't happen on some of the other times where some minor clustering of events happen.

Something changed so that the pressure isn't able to do its job and hold the airway open optimally....usually when things work well for most of the night and then it doesn't we look at REM or supine sleeping pressure needs. It's quite common to need more pressure and have our OSA be worse in both REM and when we are on our backs.
Some people get a double whammy with markedly worse with REM and supine sleeping is combined.

Don't know what is going on with you but from the pattern of the clustering my first suspect would be REM because the pattern looks like when we would normally expect a REM cycle to happen.

If it were me I would increase the max pressure setting from 12 to maybe 14 and see where the machine wants to go. If the machine still doesn't do better job preventing that clustering (and the FLs, and RERAs are part of the cluster and the evaluation) then I would increase the minimum maybe 0.5 cm...

Now are these minor clustering of stuff the cause of the arousals......don't know but they might be so it's something to try in an effort to reduce them arousals.

Your machine hasn't quit working but instead something has changed in what is needed for it to do a good job and you have its little hands tied so tightly with that 10 to 12 pressure range it can't do much.

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bill-008
Posts: 3
Joined: Wed Jul 19, 2017 11:16 am

Re: I could really use some help trying to figure out whats up!

Post by bill-008 » Fri Jan 19, 2018 8:08 pm

Hi Pugsy,

Thanks for the detailed reply! Last night I increased the max pressure and I forced myself to sleep on my side. I still woke up once during the night but I think I fell back to sleep quicker than previous nights which is good. The machine didn't want to go over 12cm2 pressure also which is interesting. My AHI was 1.01

I'll give it a few more nights and see how things go and then post the screenshots. Thanks again for your help. And if anyone else has any ideas it would be much appreciated

ajack
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Re: I could really use some help trying to figure out whats up!

Post by ajack » Fri Jan 19, 2018 8:31 pm

2nd pugsy 10-14 going by your stats
The dreamstation likes to have the min pressure close to the 95%. You can backsleep if you want to. Normally you don't have a choice and you wake up on your back. You may need more max pressure setting for this, to give the machine more room to move.

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TedVPAP
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Re: I could really use some help trying to figure out whats up!

Post by TedVPAP » Fri Jan 19, 2018 8:42 pm

bill-008 wrote:Hi, this is my first time posting here so apologises if I don't provide the correct info or I'm posting in the wrong section.

I was diagnosed with OSA early last year when I was 33 years old. For a long time I'd always had trouble sleeping and waking up during the night with a racing heart beat feeling anxious. Until 1 day I woke up with my heart beat going crazy. I was told I had paroxysmal atrial fibrillation and was asked about my sleep in general. A few days later I had a sleep study done and was told I had mild-moderate OSA.

After this I bought a DreamStation pro and ordered a generic full face mask from Thailand where I am living. I was amazed that this seemed to instantly fix the problem. I was sleeping better again, not waking up in the middle of the night and not having any racing heartbeats at any point. This went on for 8+ months and I thought everything was fixed.

However last month I went back home for Xmas which seemed to mess up my sleeping, which I thought was due to jet lag. Since I've been back in Thailand Ive started waking up again like clockwork with racing heartbeats and feeling really anxious. This is really worrying as I don't want the irregular heart beat to come back or something worse. I'm really scratching my head as to why the CPAP machine seems to have stopped working.

Is it possible someone could look at my Sleepyhead stats and see if anything has changed?

A few things to note-

1. When going back to the UK I bought a DreamStation Go travel CPAP and used it for 10 days there with a new mask (Airtouch 20). Those 10 days I seemed to sleep fine and was not waking up during the night.

2.Since getting back home I've been using my normal Dreamstation with the Airtouch 20 and this is where the problem started. I first put it down to jetlag but it's been 20 days and counting now, and if anything seems to be getting worse. The mask fits, feels and seems to work great though. And it says I'm getting no air leakage.

Sorry that was a bit longer than I planned! If someone is able to view my sleepyhead should I screenshot certain pages or export the file and attach here?

Thanks for your help
Glad to see that you are treating your OSA as it will cause heart arrhythmias. I did not start PAP until after my third heart ablation procedure. I recommend you try to lower your AHI so that you minimize your risk to Atrial Fib especially since you have already had episodes. AF begets AF. Raising your lower pressure by 0.5 or 1 should help reduce your AHI. Avoid back sleeping can also lower your AHI.

_________________
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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: AutoPAP 16-20, Ultimate Chin Strap http://sleepapneasolutionsinc.com/
Use data to optimize your xPAP treatment:
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how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur