My Chart - Feeling Strange

[Julie]

Now I would be curious to know what your sleep study said... you can get a copy (full one, not just the summary) by law from your doctor. Has anyone suggested the possibility that you could have complex apnea? It's a mix of obstructive events with centrals, the kind that don't respond to regular Apap machines (and Apaps don't really register them) because they're not about obstruction, but about your brain simply not signalling your system to breathe. Most of us may have a few centrals on falling asleep or before waking, but if you have many throughout the night that's another story.

You also need more knowledgable people here to respond about this because I'm not one of them... and I'm sure they'll be around very shortly to explain all this better. And I may be completely off base in any case with my speculation!

[SilverSleep]

Now I would be curious to know what your sleep study said... you can get a copy (full one, not just the summary) by law from your doctor. Has anyone suggested the possibility that you could have complex apnea? It's a mix of obstructive events with centrals, the kind that don't respond to regular Apap machines (and Apaps don't really register them) because they're not about obstruction, but about your brain simply not signalling your system to breathe. Most of us may have a few centrals on falling asleep or before waking, but if you have many throughout the night that's another story.

You also need more knowledgable people here to respond about this because I'm not one of them... and I'm sure they'll be around very shortly to explain all this better. And I may be completely off base in any case with my speculation!

Yes, I have a copy of the report and here is the quote from the writeup: " Mild OSA @14.4, Supine @ 27.9 and Supine REM @ 47.2."

Also, although the machine might not pick up the event, would it appear in the Flow Rate / Respiration Rate data?

[palerider]

do it like this: https://sleep.tnet.com/resources/sleepyhead/shorganize

I can do that... Thanks!

take a look at what was requested, what you did was close, but still missing a good bit.

[SilverSleep]

do it like this: https://sleep.tnet.com/resources/sleepyhead/shorganize

I can do that... Thanks!

take a look at what was requested, what you did was close, but still missing a good bit.

Fixed:

[SilverSleep]

About to head to bed and roll the dice for another night on the CPAP. Tonight I am raising the pressure to min:6.6 Max:13 and removing the EPR (as this all started the night I turned on EPR, although, I turned it down to 1 last night and had a HORRIBLE day today, so I doubt they are related). I can understand feeling the same or slightly better with an AHI down from ~30 to ~2, but feeling MUCH WORSE is frightening. This actually happened last time I tried CPAP two years ago and I couldnt continue. I am determined to hang on and try to get through this and hopefully there is a light on the other side. Thanks all for your help and I will update tomorrow.

[palerider]

About to head to bed and roll the dice for another night on the CPAP. Tonight I am raising the pressure to min:6.6 Max:13 and removing the EPR (as this all started the night I turned on EPR, although, I turned it down to 1 last night and had a HORRIBLE day today, so I doubt they are related). I can understand feeling the same or slightly better with an AHI down from ~30 to ~2, but feeling MUCH WORSE is frightening. This actually happened last time I tried CPAP two years ago and I couldnt continue. I am determined to hang on and try to get through this and hopefully there is a light on the other side. Thanks all for your help and I will update tomorrow.

I'd raise it to 7.6.

[SilverSleep]

I'd raise it to 7.6.

Sure, I will give that a try, done.

[SilverSleep]

Well, the new pressure created some really bad aerophagia so I woke up for a while (but didn't sleep without the mask).. quick question, is this normal that the APAP ramps all the way to max pressure with no events (right at the beginning), shouldnt it stay low until it registers an event and THEN ramp up?

Here are the stats, not quite sure if I am feeling better today, still really frazzled from the horrible last few days:

[Pugsy]

shouldnt it stay low until it registers an event and THEN ramp up?

No, that's not the way that the auto algorithm works.
The pressure increases mainly because of snores, flow limitations and to some extent OAs & hyponeas when they happen close together.
It doesn't increase because it says to itself..OMG an OA,... I need to increase the pressure to blow open the airway. They don't work that way at all. They can't because they can't provide enough pressure fast enough to push the collapsed airway tissues back and open up the airway.
Instead they try to learn what was going on when it happened and increase the pressure to try to prevent it from happening again.

The increasing of the pressure actually takes several minutes. It doesn't go for 8 to 11 in the blink of an eye or even in 30 seconds.

Flow limitations are the main driving force behind pressure increases when you aren't seeing a bunch of flagged OAs and hyponeas. Your snores don't look too bad and I have seen much worse flow limitation graphs but there is a little activity there.
Do you by any chance have any nasal congestion going on?

If the aerophagia persists and gets too bad you may want to make a compromise and limit the maximum and allow maybe a few flow limitations to happen in return for a reduction in aerophagia relief.

For the aerophagia first before limiting the max I would change EPR to 3 full time. See if that offers enough relief from the aerophagia issues.

[SilverSleep]

Thanks, thats good to know (was really irking me as to why that was happening). I might have some nasal congestion, I had a small cold last week and its humid and hot here the past few days.

I have tried the EPR before, but each time I turn that on is coincidentally when I start the downward slide in to feeling awful. As I cant seem to find anything that has changed (on the days I feel worse), my only theory is that I am not playing nice with the EPR, even though my AHI numbers have remained fairly consistent. Right now, the only thing I can see changing that aligns with my downward slide was the EPR. That said, I will deal with the Aerophagia and, if I ever feel better and stable, then perhaps attempt the EPR again. Thanks for the feedback and thoughts.

[Pugsy]

Something to think about in regards to EPR and it may be related to feeling crappy.
When you tried it before your minimum pressure was less and the drop during exhale could maybe have been allowing more flow limitations or arousals which might account for your feeling crappy (though I didn't see anything horrible on that first report) but using EPR now with the higher minimum may do a better job preventing the airway collapse....and IF (big if) that was behind the feeling crappy it may not happen now with the new minimum.

But in case your body just doesn't like EPR but it also doesn't like the higher pressures you could still limit the max and keep EPR off or set to 1 and maybe keep aerophagia away that way and not allow too many apnea events slip past the defenses.

Some other things to look at....do you take any medications?
Any changes in medications?
How many hours of sleep are you getting? And are those hours fragmented with wake ups and if so, any idea why.

[SilverSleep]

Your perspective on the EPR might be right, I will give it a shot if I can get stable. Right now my primary goal is to reduce the awful state I am in - its not the fatigue that really gets me, its the severe brain fog stuff - I just feel confused, dizzy, lethargic and depressed (I have felt this way to varying degrees for years, and I speculate that its due to lack of REM, but it has escalated this past week on CPAP - which, in some way, might prove that Apnea is the reason I have been feeling so poorly for so long). Although, considering the list of symptoms I am experiencing, I hesitate to attribute so many things to Apnea as most people seem to just feel really, overly tired and not many mention symptoms of extreme confusion and anxiety.

Some other things to look at....do you take any medications?
Any changes in medications?
How many hours of sleep are you getting? And are those hours fragmented with wake ups and if so, any idea why.

Nope, no medications or changes. I am getting as much sleep as the reports are showing - usually to bed around 11:30 and up around 6:30. I have been waking up in the middle of the night, but randomly and usually right back to sleep and most usually due to aerophagia.

[Julie]

Acid reflux (GERD) is very common with apnea, and you might try half a TUMS before bed (too much can backfire) to see if it helps... it's often called 'silent' reflux but wakes many of us a lot of the time unless we cut way back on caffeine after noon (or at all) and other acidy stuff.

[SilverSleep]

Acid reflux (GERD) is very common with apnea, and you might try half a TUMS before bed (too much can backfire) to see if it helps... it's often called 'silent' reflux but wakes many of us a lot of the time unless we cut way back on caffeine after noon (or at all) and other acidy stuff.

Haha... yes, actually, thats one of the symptoms that pointed me to Apnea - I noticed that my more severe "Loopy" days were accompanied by GERD. I figured it was more anxiety / stress causing both but, finally, my doc suggested a sleep study. I have since taken Prilosec for 7-day stints when it gets bad - which hasn't been for a couple of months now. Thanks!

[sleepychar]

I am concerned that whatever is going on may not have anything to do with your CPAP therapy... for you to be feeling so very bad... I'm thinking you might want to touch base with your physician about this... please take care of yourself...