Anyone got bad cardiovascular health from this?

[squid13]

After my wife went through all the testing her heart Doctor told her to take 400 MG of Magnesium Oxide at bedtime and she very seldom feels one anymore, but see your Doctor.

[sventory]

Right now I have 8.5-13 range set. I was originaly set to 6-12 when I got the thing, but noticed I would occassionally have OSA and had more hyponeas. So I tried to increase to help that, helped my events, but didn't make my sleep any better (or worse) on it. I have very few events, but I also maybe sleep only 30% of the time I am using it, which is worse then when I just sleep without it. My original AHI from a home sleep study test was 5.6, but I know from my prevous in lab study I had a 6.8 AHI from just RERAs before I was diagnosed with apnea.

Are you using Sleepyhead software to monitor your therapy?
Are your pressures changing alot during the night?
If so, could the pressure changes be disturbing your sleep?
Do you have lots of Flow Limitations? Are they bumping your pressures to prevent other events?

Could you post a report?


Den

.

Sure Den, here is two days as an example:









I've never looked at the flow rate before, what does that entail? I do notice that even though my starting pressure is 8.6, everytime when I am awoken it's usually around 10+. Yet often times when I check my logs, there was no event, so why does the pressure increase so much? The 90% pressure time is usually 9.5+ as well, but I have very few events, so why can't I sleep!

Another thing is I've got two user flags set to record, 20% flow rate for at least 8, or 40% flow rate for at least 9 seconds. As you can see I'll often have more of those than actual apneas or other events to count towards my AHI. Should I be concerned with these things? They aren't full apenas which as I understand it is 10 seconds or more of no flow rate? But 20% for at least 8 seconds could indicate some difficultly breathing?

[ChicagoGranny]

I've never looked at the flow rate before, what does that entail?

You need to familiarize yourself with the flow rate graph and what it means. Zoom in on some individual breaths. The ones where events are occurring are the most interesting. This bit of interpretation may help you - http://www.apneaboard.com/wiki/index.ph ... Rate_graph

Also, learn how to organize your SH charts for posting here -

On the left side turn off the calendar by clicking on the triangle by the date.
Also the pie chart doesn't give us very much info so you can turn it off by going to File - Preferences -Appearance - Uncheck Show event break down pie chart
That allows us to see the machine details on the left.

The graphs that are usually helpful are:
1. Event Flags
2. Flow Rate
3. Pressure (not mask pressure)
4. Leak
5. Flow Limit (only with Resmed machine)
Put your graph in that order by grabbing, by the labels, with your mouse and dragging it where you want it.
Now grab the line between the graphs and resize them until you get them in one screenshot.

Take a screen shot after you organize your graphs.
F10 will close the right sidebar ( or click file - view - uncheck right side bar).
F11 ( or click file - view - check fullscreen toggle) on your keyboard before you take your screenshot and it makes it full screen with no ID info.
Take a screenshot by pushing F12 or under View - click on Screenshot
Screenshots are found on my computer under Documents - SleepyHeadData-Testing - Screenshots

Then at Imgur you have to sign up for an account then sign in. upload your pic.
Click on the triangle by your ID in the upper right corner and a menu will drop down.
Choose Images this will take you to a screen with your uploaded images on it. Click on the image you want.
Click on Large thumbnail then copy the Linked BB code into your reply. Here is an uploaded screenshot for example.

[robysue]

Sure Den, here is two days as an example:

None of the images are showing up. Can you check the url's?

I've never looked at the flow rate before, what does that entail?

The flow rate graph is a graph that shows each and every breath you took while using the machine. You are inhaling when the flow rate graph is above the 0-line and you are exhaling when the flow rate graph is below the 0-line

I do notice that even though my starting pressure is 8.6, everytime when I am awoken it's usually around 10+. Yet often times when I check my logs, there was no event, so why does the pressure increase so much? The 90% pressure time is usually 9.5+ as well, but I have very few events, so why can't I sleep!

If your pressure is increasing from 8.6 up to 10+ and there are no events, then the machine is most likely responding to flow limitations or snoring.

Technically speaking a flow limitation is a misshaped inhalation part of the flow rate curve, with the most common flow limitation shape being a flattened top as opposed to a nice round top. The CPAP designers and the docs they work with think that flow limitations can be a very early warning that the upper airway is somewhat compromised and at higher risk of collapsing, and hence the machines are programed to increase the pressure in response to FL in an effort to make it harder for the airway to actually collapse. Resmed machines respond quite aggressively to flow limitations; PR machines respond a bit less aggressively, but there is still a noticeable increase in pressure when FL are detected during times where no OAs or Hs are occurring.

Another thing is I've got two user flags set to record, 20% flow rate for at least 8, or 40% flow rate for at least 9 seconds. As you can see I'll often have more of those than actual apneas or other events to count towards my AHI. Should I be concerned with these things? They aren't full apenas which as I understand it is 10 seconds or more of no flow rate? But 20% for at least 8 seconds could indicate some difficultly breathing?

Could be that those things might be significant---if they are accompanied by a real O2 desat or an EEG arousal, but your CPAP can't tell you either of those things. You can, of course, get recording oximeter if you had a tendency towards significant O2 desats on your diagnostic sleep test. You can sometimes infer whether an arousal occurred by looking for so-called "recovery" breaths at the end of the user flagged event.

But my advice for right now is to NOT worry about those events. The first task is for you to get to where you are using the machine for more than 2-3 hours of sleep. (See viewtopic/t111549/HELP-overwhelmed.html for more details on sventory's problems with usage.) Until you are able to consistently sleep for a full night with the machine, the AHI recorded by your machine and the number of custom user-flagged "events" is not really relevant to how you are feeling during the daytime. You are sleeping with the machine for only 2-3 of those hours: Hence you are still sleeping most of the time in an environment where you are experiencing 50+ OAs and Hs per hour of sleep, and the sleep time with the untreated OSA is what's causing you to see no improvement in how you feel and function during the daytime.

[BlackSpinner]

Wear your cpap during the day to watch a movie, play a computer game to get your mind used to it being used and that it is safe to use.

At night reward your self for using it NOT for not using it. Plan a reward for during the day "If use use it for 4 hours then I get to have X" where X is something special. Focus on the reward when trying to sleep.

[sventory]

I've fixed the images, why is none of my flow rate below 0 if it should be when I exhale? Also I've used the machine for 6-7 hours too normally. I just sleep worse. I'm not sleeping when during the time you see these usuages, or maybe I can but only light sleep, what has been happening recently is I will sleep and have weird dreams, but I am aware I am dreaming and could wake up at anytime if I chose, but I choose not to cuz hey even lighter sleep is better than no sleep. I mean I've been using this thing for over 6 months, can't fall asleep any easier. What I normally do is use it before bed while reading, then when I feel sleepy enough to fall asleep, take the mask off. Sleep around 3 hours in a chunk of deep sleep, wake up from an apnea or something, and then put my mask on for 3-5 hours depending on the time, during which I'll have that weird lucid dreaming sleep, or none at all. That's what I've had the most energy on and provides the most reliable results. IF I try to just keep the mask on then... I never end up really falling asleep. So I don't know what to do, I'm not bothered by the mask at all, I'm not annoyed using it or the machine. I've accepted it and it's little weirdness of noises and stuff don't bother me anymore at all, but I still can't ever quite fall asleep with the mask on at the start.

[robysue]

I've fixed the images, why is none of my flow rate below 0 if it should be when I exhale?

Still don't see any images even when I go back through the whole thread.

Are you sure you are looking at the Flow Rate graph instead of the similar sounding Flow Limitation graph?

[palerider]

I've fixed the images, why is none of my flow rate below 0 if it should be when I exhale?

look again, your flow is centered on 0.

[sventory]

Oh yeah, my mistake, was looking at the wrong graph. Looking at my flow rate like roby sue says. Looks like my user flags could be causing potential awakenings. I have the larger flow rate right after a reduced rate:



Seems like I have quite a few of them, but also saw quite a few user flags where there is no large flux after the flag. So yeah, just not sure what else to do at this point. My palpitations have gotten worse and I feel them all day everyday now, but doctors did echo and EKG, everything is fine from there. Just noted frequent PVCs. I thought I was improving because I didn't have them for a week, but now they are back worse than ever. Sigh...just want to sleep.

[robysue]

Looks like my user flags could be causing potential awakenings. I have the larger flow rate right after a reduced rate:

You have the cause and the effect reversed here. I think the leak caused the first wake and the user flagged event was a failed attempt to get back to a sound sleep.

Here's a slightly edited version of your data:

It appears to me that you woke up during the time inside my Red Box that is on the left. My guess is that the large leak woke you up. Notice the large, quick inhalations in the Red Box---they are why I think you woke up at this point in time.

You pretty quickly fixed the leak and started to drift back to sleep---that's the stuff in the middle Green Box. Your breathing starts to settle back down during this time frame. Towards the end of the Green Box is your user defined event. It looks to me like the user flagged event was probably a failed attempt to transition all the way back to a sound sleep. In other words, it looks to me like your body is in the process of handing off control of the respiration from the voluntary nervous system to the autonomic nervous system, but for some reason, instead of sliding back into real sleep, you wind up arousing all the way to wake with the big breaths at the start of the Blue Box. Moreover, the appearance of the breathing in the Blue Box is more typical of a mixture of wake and sleep breathing that is commonly referred to as "Sleep-Wake-Junk" around here. In other words, you may have dozed a bit after that user flagged event, but it doesn't look like you actually got back to sleep.

Given the fact that this user flagged event occurs so close to when you woke up for the morning, it really looks like this one was just a pretty normal "transition to wake" that followed a wake or an arousal triggered by the large leak.

[sventory]

Wow thanks so much for that analysis. really helped me to understand what I am looking at better. I have a lot of sleep/wake junk. I often have light dream sleep too on the mask, where I am dreaming uncontrollable crazy dreams, but I am aware I am dreaming.

This mask has been causing my new problems that disrupt my sleep.

Three things wake me up or prevent me from going to sleep:

1. Stupid wheezing noise from the mask. I can only assume this is caused by humidity causing a exhale hole to get blocked by a glob of water. Very distracting noise wakes me up, if I unplug the tube from the mask and let it blow a bit it usually resolves it, but it wakes me up.

2. A high pitched whine noise coming from the machine itself. It's caused by the air lekaing out throuhg the water chamber or some crack in it, because if I jiggle and force it in harder ,it eventually stops. Requires a lot of fineggling.

3. I apparently move a lot in my sleep, tons of spasms, and I've ripped the hose out twice now in the past weke, also wakes me up.

Ugh I feel so hopeless, been about 8 months on this damn thing and if I use it I still sleep HORRIBLY. My sleep doctor didn't help me do jack, he just said CPAP controls apnea, if you can't sleep still its insomnia and in your head and i should take meds. Awesome help.

[Sheffey]

I apparently move a lot in my sleep, tons of spasms,

Sorry, I haven't followed your case, but did you have an in-lab sleep study? What did it show as far as "spasms"?

[sventory]

I apparently move a lot in my sleep, tons of spasms,

Sorry, I haven't followed your case, but did you have an in-lab sleep study? What did it show as far as "spasms"?

Well nothing, no restless legs or anything else, but my in lab was in 2012, my doctor would only give me a home one last year because "I just had one", but my wife says when I drift off I twitch and hypogogia a lot, which I know that is normal, but maybe not my level, but perhaps it's normal for how sleep deprived I am, I've read that makes it worse.

[DreamStalker]

Recently had a cardio check up with a holter monitor. Says I have frequent PVCs, which are not outright dangerous, but they have gotten worse since then even. Before I would only notice the palps early in the morning when trying to sleep and maybe shortly after getting up. Now they occur all throughout the day and when I am really super tired it stresses my body to where they happen several times an hour and are stronger in intensity, this really worries me. Anyone else have something similar? Cardiovasclar health apparently is heavily effected by sleep, and I still get shit sleep. 6 months on CPAP now, I've gotten used to pretty much most everything, but still I can hardly sleep on it. I'm not bothered by the noises, or the sensation, but I still can't sleep well on it. Just totally feel hopeless, I'm under 30 and not overweight and I see my health slowly fading, it just shouldn't be.

Find another cardiologist and do it now. Five out of six cardiologists are complete idiots. I know this from personal experience. I fired my first one after watching one of his patients keel over and die right in front of me in the waiting room. The cardio doc came out to his waiting room, took a brief look without bending down to take a closer inspection, turned to one of his freaked out nurses and told her to call 911, then he turned around and calmly walked back his private room area without ever attempting CPR or touching the patient to see if he was still alive or anything. A nurse then came and guided me to the back to a private room and after about 45 minutes of waiting came back and asked if I could reschedule the appointment and quickly shuttled me out the back door of the building. When I came around to the front, where my truck was parked I saw the EMS bring out the dead patient in a body bag. I said to myself ... no way that is going to be my next visit to this doc.

Anyway, with time, your PVCs will turn into VT (ventricular tachycardia) putting you at high risk for sudden cardiac arrest, which if you survive may still cause irreparable heart damage.

Holter monitors are the cheapest first approach diagnostic (provides insufficient data to find any real cause) -- it's only the first step in the "standard of care" algo set up by the health insurance criminal cabal ... I mean industry.

For the next step, they'll Rx you beta blockers or calcium channel blockers ... they will try a bunch of different ones but they don't work to fix the real problem. They only mask the symptoms with a slower heart rate allowing the real cause to fester and make things worse. They may also add rat poison (warfarin or some variant blood thinner) to their Rx cocktail to prevent stroke risk -- but the rat poison will just kill you more slowly by dissolving your vascular system until you begin to die one tiny little piece at a time or to very quickly and completely bleed out and die suddenly.

Then the "standard of care" tells them to suggest a pace maker implant. Again, this may work -- but only temporarily .... inevitably, this approach also fails too. By then, they've wasted a lot of precious time and f'd you up real good.

You have to find the cardiologist/electrophysiologist team willing to do the real science needed to find the exact cause and the knowledge and skill to fix the source of the problem rather than just follow "standard of care" insurance protocols to cover up the symptoms until you are dead and no longer a problem to them. Ask them for the data and then research and educate yourself on your condition. Be proactive and ask the doc lots of questions. And if they are not interested in answering your questions, fire them and search for another. After a half dozen or so attempts to find the right doc(s), you should get a solution to your heart condition.

[sventory]

Holy, this is somewhat right on the money. So far I've got a "mild" diagnosis of 1000 PVC per day. Doc said he doesn't want to give me anything for it but if it gets really bothersome take some metropolol as needed. But he also did do an ultrasound and Echo of my heart and said there is nothing structurally wrong with it. So just says a minor irregular heart beat nothing to worry about. Though a year ago I did t have it. Is this your experience? Is there any other tests I should demand?