26 seconds without breathing last night...very concerned

After several nights with my new s8 autoII machine my AHI numbers went from 7 on the first night down to 2 by the fourth night. Thrilled with those results. My pressures were set between 8 and 18. Two nights ago my AHI went back up to 5 so I increased the pressure to an 11 minimum last night and with a an AHI of 9.9. I woke up feeling terrible. Headache, brain fog, dizziness coming back, and of course very tired. Here's what's weird: The first hour showed 3 apneatic events without breathing registering 12, 17, and 26, all within 15 minutes of each other and again all within my first hour of sleep. For the next 5 hours however, I had NO Apneatic events and only Hypopneas with a total of 9.5 Hypopnea index for the night. Leaks were minimal. Median pressure was 11.0, 95th percentile was 11.4 and my maximum was 11.8. And by the way my EPR is on and it is set on 2 (medium) for exhalation relief.

So, a couple of questions:
1)Isn't more pressure better in terms of keeping my throat open as long as I'm comfortable with the pressure (which I was)?

2)Why such terrible symptoms upon waking and throughout the day if my apneas were within the first hour of sleep and I had no apneas for the rest of the night?

Starting to wonder if I have OSA and Central Apnea. Getting scared of going to sleep. I appreciate anyone's help. I truly cannot function like this.

spookydoo wrote:After several nights with my new s8 autoII machine my AHI numbers went from 7 on the first night down to 2 by the fourth night. Thrilled with those results. My pressures were set between 8 and 18. Two nights ago my AHI went back up to 5 so I increased the pressure to an 11 minimum last night and with a an AHI of 9.9. I woke up feeling terrible. Headache, brain fog, dizziness coming back, and of course very tired. Here's what's weird: The first hour showed 3 apneatic events without breathing registering 12, 17, and 26, all within 15 minutes of each other and again all within my first hour of sleep. For the next 5 hours however, I had NO Apneatic events and only Hypopneas with a total of 9.5 Hypopnea index for the night. Leaks were minimal. Median pressure was 11.0, 95th percentile was 11.4 and my maximum was 11.8. And by the way my EPR is on and it is set on 2 (medium) for exhalation relief.

So, a couple of questions:
1)Isn't more pressure better in terms of keeping my throat open as long as I'm comfortable with the pressure (which I was)?

2)Why such terrible symptoms upon waking and throughout the day if my apneas were within the first hour of sleep and I had no apneas for the rest of the night?

Starting to wonder if I have OSA and Central Apnea. Getting scared of going to sleep. I appreciate anyone's help. I truly cannot function like this.

Slow down a little. Making changes less often than once a week is asking for trouble. When did you start on your therapy and at what sleep lab titrated pressure? Some people react differently to auto CPAP and do better on straight CPAP. Most of us had a lot of problems starting out, many of which were caused by mask leaks, mouth breathing and other events that must be ruled out before changing pressure makes any sense at all. Higher pressure under those circumstances may only make the mask leaks and mouth breathing worse! Give us a little background and maybe someone can give you some assistance.

spookydoo wrote:2)Why such terrible symptoms upon waking and throughout the day if my apneas were within the first hour of sleep and I had no apneas for the rest of the night?

Is there some particular reason you imagine that only your apneas can create a problem? I'm afraid you may have fallen victim to the board bias: hypopneas don't matter and are not particularly harmful. That's the myth, but the reality is quite different.

I'll give you a little history since you asked for it. I was on a Respironics M Series A Flex for two years. Starting last Fall I began to get dizzy off and on. Three months ago I became dizzy , tired and brain fogged full time every day. Had a thorough examination on balance issues as well as a brain MRI. All turned out negative. Did some research and realized it might be OSA problems again even though I've used the CPAP continually . I have been operating my M Series on C Flex only, because the A Flex would try to breathe out before I was finished breathing in. Knowing that I would have to have another machine while I sent the M Series in to be check/fixed, and hearing all the great things about the Resmed s8 Auto, I decided to get that. The first several nights on it were better. But as I laid out, I started experiencing some problems the last few nights.

As far as a sleep study, I had one 7 years ago and have another scheduled in a month. So, obviously I'll find out a lot more then.

You asked about leaks. Last night when my AHI was 9.9 and my Hypopnea index was 9.5, my Leak rate was 95th percentile-0.1 L/sec and Maximum of 0.3 L/sec.

I appreciate any help you can give.

Spookydoo,

I've used a Resmed CPAP, ResMed Auto, and a Respironics M Series CPAP. Can't say I prefer one brand over the other. It's a matter of what works for each person. My first success was on the ResMed Auto, now use the Respironics CPAP. Had equally low numbers on both. Now and then would have some bad nights (data) but didn't make changes unless they proved not to be transient.

Theoretically it would seem that more pressure would result in lower numbers, but I've read where others describe a "sweet spot" that going either below or above resulted in higher numbers. Maybe I missed it, but what was your pressure usually around when the range was 8-18? Maybe that number would be good to start just below. (I saw the numbers from when the lower pressure was increased. Did you choose to start at 11 based on the pressures you were reaching before?) I agree with the prior posts about the changes - maybe too much too soon?

Hypopneas can cause a drop in oxygen and sleep stage disruption, so they certainly do matter. I may have misunderstood, but I thought the discussions about hypopneas were in relation to how the machines differ in their reporting of them, rather than if hypopneas in and of of themselves matter. At any rate, I would think they could make you symptomatic.

Let us know how this progresses.

Kathy

kteague wrote:I may have misunderstood, but I thought the discussions about hypopneas were in relation to how the machines differ in their reporting of them, rather than if hypopneas in and of of themselves matter.

The discussions about how the machines differ in their reporting of hypopneas is an exacerbator to the perception that many posters seem to have: hypopneas don't matter. If you will note, spookydoo is only looking at apneas for whether or not he had a good night's sleep by the numbers.