Extreme pain...Please help interperate s9 results on SleepyHead

[R3LOADED94]

Hey guys,

along with sleep apnea I have very severe chronic pain (No pain medications only marijuana, dose hasnt changed for 4 years). For the past year my sleep was perfect but on Jan 19th I started going from AHI<5 to 10+ ... I have included daily and overview data. Whats interesting is when this problem started Jan 19 Sleepyhead also shows a trend in large leaks starting Jan 19.

Helpful Info:
-For the past 30 days my pain has gone through the roof and I find myself restless and unable to fall deeply asleep during the final few therapy hours (When the central apneas start showing) but falling asleep is super easy
-I feel very unrested, the same I felt 5 years ago before starting CPAP, made my vomit this morning from the feeling of nausea and tiredness (feels like I have been pulling collage all nighters even though I sleep 6-8hrs)
- I have increased alcohol consumption to 2 to 3 drinks a night 5 days a week since December but have been trying to reduce since January but my poor sleep trend is getting worse





Links to images: https://i.imgur.com/vjhDnD8.jpg
https://i.imgur.com/b6lxfZT.jpg

[R3LOADED94]

sorry guys heres a better pic without my cursor covering things!

https://imgur.com/a/AD9qd

[USMCVet]

I don't know much but your having a lot of Central apneas. Could try to reduce pressure to see if that helps or go back to doctor to see if you warrant an ASV machine to deal with centrals.

[USMCVet]

Do you have graphs from when things were better?

[Pugsy]

I am wondering if those centrals are post arousal centrals because the pain is waking you up so much.
Meaning awake/semi awake breathing centrals and not real centrals. The machine doesn't know if you are awake or not. It can only measure air flow and when we wake up and toss and turn we often will hold our breath or pause our breathing and the machine will think it is a central.

Can you zoom in on a small number of those centrals and let's look at the flow rate under the microscope and see if it looks like awake breathing or asleep breathing.

Go to SH and click on the Events tab...you will see the various categories...CA/ClearAirway/Central...click on that category.
Scroll down to around 13:30ish and pick a central flag that is sort of in the middle of a couple of other central flags.
Highlight one of those flagged events...the graphs on the right will zoom in on those 2 or 3 events...get me a screenshot of that zoomed in graph.

At this level of zooming in....hopefully you can get 2 or 3 or 4 flagged events in one screen shot.

[Pugsy]

Jason has some good videos here
http://freecpapadvice.com/sleepyhead-free-software
and I think that you would benefit from watching especially the bottom video where it talks about cpap pressure causing centrals.
It can for some people but it's not all that common and when it happens it doesn't normally happen like you are seeing your centrals.

Before we start talking about different machines and worrying about the centrals we need to try to figure out if they are real or not first.

[R3LOADED94]

Thanks for the fast response guys!
Here are the zoom ups of some CA events
https://imgur.com/a/r91Gu

[Pugsy]

Looks like post arousal....the breathing before the event flagged at approx 13:30:30 is preceded by irregular breathing that is probably awake/semi awake breathing. Can you now just back out of this level of zooming so that you can see maybe 5 or 6 minutes of breathing instead of 2 minutes?

This is what asleep breathing looks like.



and this one not quite so zoomed in but you can see how smooth and regular it is.



And here's one where you can see the irregular arousal breathing and the flagged event and when it changed from asleep to arousal and then back to sleep

[Pugsy]

So.....I think that you need to address the pain and the frequent wake ups and then see if the centrals reduce.
And trust me...I personally know how that is easier said than done.
Any idea why the pain has gotten so much worse lately?

[R3LOADED94]

Here are 2 zoom outs of 5 and 10 mins of breathing
https://imgur.com/a/Q3IBc

Does this mean they arent actually central apneas? Is there any explanation to why Im so uneasy and unable to sleep during the tail end 2 hours of my sleep and poor overall sleep quality feeling?
I hate being such a noob but Im pretty young (Got diagnosed with sleep apnea in my teens) and for the past few days I have been trying to read as much as I can and educate myself
Youre the best pugs!

[R3LOADED94]

I see what you mean with regular breathing vs sleep breathing as in this image here where I zoomed into the middle part of my sleep
https://i.imgur.com/RwrSP8q.png

I have fibromyalgia and some injuries in my jaw and upper neck/back from sports and usually around winter (this one has been a bad one) it gets worse. What puzzles me is that my stress triggers have actually gone down the past month and I have had time to relax (along with warmer weather) so its weird how a month ago my pain was actually getting better before my sleep got utterly disturbed thus leading to more pain, loss of energy and fatigue along with my s9 telling my im in the AHI=>10!

[Pugsy]

Some of the centrals are probably "real". It's normal to have a few here and there. Like sleep onset central when transitioning between awake and asleep.

But as you scroll through your central clusters and get a feel for asleep breathing vs awake breathing I think that a big chunk of your centrals are probably not real.

As for not feeling so great. It might just be the crappy sleep because of the pain. Crappy sleep usually means feeling crappy and it doesn't always have to be from sleep apnea.

Now what you might think about doing is getting one of the overnight recording pulse oximeters to see if by chance your oxygen levels are dipping very much with so many pauses in breathing. You can get a good one for $60 to $100 that will work with SleepyHead.
If your oxygen levels are dropping much (a little drop during sleep is normal) then you need to get with your doctor sooner than later.

Probably would be a good idea to alert your doctor anyway and see if he has any ideas about what is going on and what maybe could be done about it.
We can't fix centrals with your Elite anyway.

Now you could maybe try turning EPR off just to see if the centrals reduce any. There's a very small % of people who have centrals get triggered because of EPR but if you have beein using it this long and not had a problem...highly unlikely but it's an experiment that is easy to do and doesn't cost any money.

[ajack]

Has there been any changes in meds, it started on jan 18, like a switch being turned.

You have deep breaths preceding the CA you have shown, This makes me think some may just be clear airways and waiting till the co2 to built up again and trigger a breath. Without other data and sp02, that a sleep study will show, we are guessing. You need to get back to the doctor and possibly another sleep study to another machine.
Is your copay ok, or do you need to work it out yourself?

[R3LOADED94]

Im in Ontario, Canada so everything is covered (I am actually due for a new CPAP machine this month!!). So I guess the next step is for me to book with my sleep doctor? Any suggestions for what to say to try to get booked early....around here they tend to slack unless its a emergency and I have been feeling so down lately and poorly rested

[R3LOADED94]

Has there been any changes in meds, it started on jan 18, like a switch being turned.

Now that I go back through the haze I remember I was taking 50 to 100mg of codeine contin twice a day for a 1 month but I stopped taking them the first week of Jan. About a week or two of gap between stopping and this sleep issue starting.

I don't know if it's related but recently the past few days straight my eyelid is also twitching similar to how it twiched being sleep deprived and stressed back in non CPAP days...also developed hemmeroids but I don't understand I'm not really stressed (It's reading week for us at University)