36.6 AHI with CPAP machine

[vintagepimpage]

Thanks all. Turning off the ESR and hoping it helps. Lately I'm dreading going to sleep. I'll post results tomorrow.

[palerider]

maybe excessive co2 blowoff.

Yeah...but why now and of this magnitude now just recently? It just doesn't compute logically.

Let's see if lightening strikes and we get lucky turning off EPR. If we do I am running out and getting a Powerball ticket.
It's worth trying though.

well, yeah, sometimes you get lucky, and it doesn't hurt to try...

I wish I knew more about the impact of those meds on respiration...and the coming off of the Effexor.

Abrupt termination of effexor can lead to :

Reported symptoms include agitation, anorexia, anxiety, confusion, impaired coordination and balance, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, flu-like symptoms, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting.

so..., I don't see anything that looks very respiratoryish.

And why again...the last half of the night ? I am not content with the "it just happens" explanation.

I dunno, more rem?

[palerider]

Thanks all. Turning off the ESR and hoping it helps. Lately I'm dreading going to sleep. I'll post results tomorrow.

epr, look forward to it, maybe it'll be better

[Pugsy]

Whatever it is, it looks like steady pattern to me.

It is indeed a consistent pattern but an abnormal pattern.
If this was a random happening we wouldn't be so concerned but there's a truckload of it going on.
As to why...we don't know.

For some people (very small subset of people who develop Complex Sleep Apnea) EPR triggers the unstable breathing and the centrals happen.
Hence the idea to try turning EPR off to see if it helps or not.
It won't hurt to try and there is a remote chance it might help.

[palerider]

I think turning the EPR off is certainly worth a try.

there's no waxing of the breaths, just waning, and based on the flow during FOT, I'd say they are centrals as flagged, and legit ones.

maybe excessive co2 blowoff.

For a newb like me... what does that mean? The waxing and waning? What is the flow rate in general? I see the graph for those five minutes but I'm not sure what I'm looking at there. Whatever it is, it looks like steady pattern to me.

waxing and waining, ebb and flow, crescendo and decrescendo, growing and shrinking of the respiratory flow.

the flow rate is your breathing in and out, above the zero line is inhaling, below the center line is exhaling.

it's a steady pattern of a few deep breaths, tapering off to nothing for a while, and repeating.

read the first post thread up there in the announcements area on the front page of the forum.
look at how things look on your chart around 03:00 for something more like what it should look like.

[vintagepimpage]

Pugsy and Palerider... you two have been a huge help. Thanks again. Here was last night with EPR turned off:

http://imgur.com/a/fLnva

Much better! Seriously that is a huge relief. I'm going to keep monitoring it and hope this continues. As to why it started happening... that I still don't know. Either way it means a ton that you guys have taken the time to help me at least partially figure this out. I'm glad I stumbled upon this website!

[Pugsy]

We can live with those results.
I am going out right now and buy myself some lottery tickets.

We don't know exactly what caused the unstable breathing but if turning off EPR helps fix it....that's an easy fix.

Just watch things closely and if those centrals return in those large numbers again....you really need to see a doctor who specializes in sleep disorders.

Turning off EPR, with no other changes, effectively increases the overall pressure and maybe that overall pressure did a better job preventing the OAs/Hyponeas which maybe reduced arousals and thus maybe reduced the chance of the centrals being post arousal...those are a lot of maybes though.
Or maybe EPR was causing a little too much carbon dioxide wash out and that triggered the unstable breathing.

The abrupt change from Aug 26 bugs me...because something changed but we don't know how or what it was.
At any rate...if those centrals stay below 5 per hour and/or you don't see massive clustering of them...we can live with this result.

Good job. I was secretly crossing my fingers that turning off EPR would help but at the same time not holding my breath. It was a long shot for sure. Let's hope it holds.

[palerider]

I'm not going to celebrate yet (though I may get a lotto ticket ) because of how variable sleep is, I'm just going to cross my fingers and hope that this continues to be acceptable.

I'm hoping last night was due to the EPR change, and not just an unusually good night.

[palerider]

Turning off EPR, with no other changes, effectively increases the overall pressure and maybe that overall pressure did a better job preventing the OAs/Hyponeas which maybe reduced arousals and thus maybe reduced the chance of the centrals being post arousal...those are a lot of maybes though.

these things are true, but his centrals didn't look like post arousal centrals... breathing just tapered off to nothing, there wasn't regular breathing then disturbed breathing, then the central... unless you want to call the whole hours long episode disturbed (and that'd be hard to argue).

[Pugsy]

these things are true, but his centrals didn't look like post arousal centrals..

Yeah, I know they didn't look like it...that's why I included a whole bunch of maybes in that possible scenario.
I was going out on a very long and very skinny limb with that idea. I knew it when I voiced it.
It is interesting that the OAs seemed to have reduced though. That was my in my plan when I said don't change anything else. Cover that potential with a little more pressure....just in case the OAs had anything to do with the unstable breathing in some way that we don't understand or know about. There were more OAs/Hyponeas than I wanted to see in that AHI of 30 something.

At this point, I am just hoping that this continues to hold and the uglies don't return.
While I love my ASV...if regular cpap/apap gets the job done there's no sense in going down that road unless absolutely necessary...it's a road with a pricey toll fee what with another sleep study and a different machine and all that.

The other scenario is that the aliens are having a good time screwing with people during the last half of the night.

[palerider]

The other scenario is that the aliens are having a good time screwing with people during the last half of the night.

maybe if you'd put some milk and cookies out for 'em, they'd eat that, and get sleepy, and leave the rest of us alone!!!

[Arlene1963]

Been following this thread with interest because although my AHI is fairly low, it's almost entirely made up of CA events, and also with the majority occurring in the second half of the night. So, last night I experimented and turned off the EPR which had been set to 3.

Only one CA event for the whole night, compared with 24 on a really bad night last week.

Slept more soundly with the EPR off. So which came first, LOL, the sound sleep or the reduced clear airway events. Oh well, whoohoo anyway, and long may it last.

But, as Palerider cautions, we have good nights and bad nights. I'm curious to know how your AHI is doing, Vintagepimpage, are the Clear Airway events still under control? I hope so.

EDIT MANY MONTHS LATER FOR AN UPDATE:
I eventually switched EPR back to 3 because it turns out that I sleep a lot better with EPR on than off. My centrals were less with EPR switched off but since I only have low numbers anyway it is not enough to warrant sleeping without EPR. If I had a very high number of centrals that were causing major disturbance I might consider switching EPR off, but not in the numbers I experience. I made a newbie mistake here and confused low AHI with sleep quality!

[LSAT]

If your AHI is low, you can ignore CAs, even if all your events are CAs.