repetitive central apneas & possible cause

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
kvck
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repetitive central apneas & possible cause

Post by kvck » Thu Mar 31, 2022 11:59 am

Helllo,

I wonder if anyone could comment on my OSCAR reading of yesterday. I've started taking Tolvon for sleep maintenance and in my second night with it I had a good sleep but my AHI result was unusually higher than the average, with repetitive CAs. I thought it could be because of some sort of mask leakages but I am not sure to be honest.

I wonder if anyone can comment on this part in particular with repetitive CAs. Thanks in advance for your comments.
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palerider
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Re: repetitive central apneas & possible cause

Post by palerider » Thu Mar 31, 2022 12:14 pm

They look more like obstructives to me. Strong response in the mask pressure, and recovery breaths afterwards.

However, they're few throughout the night, and I'd just ignore them and focus on
kvck wrote:
Thu Mar 31, 2022 11:59 am
in my second night with it I had a good sleep

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Rubicon
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Re: repetitive central apneas & possible cause

Post by Rubicon » Thu Mar 31, 2022 2:54 pm

kvck wrote:
Thu Mar 31, 2022 11:59 am
I almost every day wake up at around 4am to 6am and stay awake around 5 minutes, then go back to sleep.
https://www.cpaptalk.com/viewtopic/t183 ... index.html

My guess in the pool would be the machine is correct and they're sleep-onset centrals.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

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palerider
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Re: repetitive central apneas & possible cause

Post by palerider » Thu Mar 31, 2022 8:47 pm

Rubicon wrote:
Thu Mar 31, 2022 2:54 pm
kvck wrote:
Thu Mar 31, 2022 11:59 am
I almost every day wake up at around 4am to 6am and stay awake around 5 minutes, then go back to sleep.
https://www.cpaptalk.com/viewtopic/t183 ... index.html

My guess in the pool would be the machine is correct and they're sleep-onset centrals.
We're placing bets now? when did this start? :D :lol: :lol: :lol:

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Pugsy
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Re: repetitive central apneas & possible cause

Post by Pugsy » Thu Mar 31, 2022 9:15 pm

palerider wrote:
Thu Mar 31, 2022 8:47 pm
We're placing bets now? when did this start? :D :lol: :lol: :lol:
Can I get in on the action?
My first thought when I saw them was a strong sense of "sleep onset" went through my mind.

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chunkyfrog
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Re: repetitive central apneas & possible cause

Post by chunkyfrog » Thu Mar 31, 2022 10:01 pm

Split the difference, kids.
Divvy up the pot.

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Rubicon
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Re: repetitive central apneas & possible cause

Post by Rubicon » Fri Apr 01, 2022 5:02 am

OP keeps the money.

He had the answer already (even if he didn't realize it).
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

kvck
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Re: repetitive central apneas & possible cause

Post by kvck » Fri Apr 01, 2022 9:32 am

Sleep onset.. it is the problem without any solution I suppose :?

It's been around a year when I started using my Apap (epr:2, 5-9 pressure, resmed S9), and similar time period I had sleep disruptions without palpitation, sweating, etc. Just sudden awakening with full open mind :shock:

It is called sleep maintenance insomnia as per my doc but still not sure about causality whether Apap is the cause or something else.

I've recently had a sleep study and the doc said the maintenance problem may be cause of stress, anxiety... though I am not sure about it too.

All in all, I am stuck with no solution with this problem. The real problem is not the disruption during the night, but the tiredness and bad mood in the mornings. :|

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Pugsy
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Re: repetitive central apneas & possible cause

Post by Pugsy » Fri Apr 01, 2022 9:53 am

kvck wrote:
Fri Apr 01, 2022 9:32 am
The real problem is not the disruption during the night, but the tiredness and bad mood in the mornings. :|
The tiredness and bad mood comes from poor sleep quality which is caused by the wake ups during the night.
Now what the cause of the wake ups might be??? That of course is the million dollar question.
If you didn't wake up during the night and try to go back to sleep then you wouldn't have little clusters of sleep onset centrals to make the sleep quality worst.

Figuring out the cause of multiple wake ups....it's hard sometimes and even when we know the cause the fix isn't necessarily easy to accomplish anyway. Trust me...been there and done that myself.

Sleep maintenance insomnia is a real bitch to deal with because so often we can't put a finger on the original cause that creates the cascading of the negative problems. Poor sleep quality itself can cause more negatives like stress, anxiety, etc which in turn feeds that sleep maintenance insomnia monster even more. So a round robin of cascading worsening of everything.

When we don't sleep good...whatever the reason...we can't expect to feel so good during the day.

I don't know you entire history but for people like you we start with the basics to try to isolate the cause of the sleep maintenance insomnia.
While I know the knee jerk reaction is to put the blame on the cpap settings and hope that little tweaks might be just the trick. You want to put the blame on the sleep onset centrals instead of putting the blame on what caused the wake up in the first place that created the going back to sleep situation which in turn allows the sleep onset centrals to pop up and create more sleep disruption.

What about the basics first in terms of potential causes?
Medication side effects messing with sleep....do you take any meds of any kind, even OTC????
Any other physical or mental health issues going on? We already know that you admit to some stress or anxiety as a result of the crappy sleep. Anything else? Bed comfort? Mask comfort? Aches and pains?

Has there been a discussion of maybe trying some sort of sleep aid either RX or OTC to help maybe break the round robin cycle??? You know that sometimes there is a time and place for some extra help.
It's hard I know because most of the sleep aids out there are designed to help with falling asleep and not so much the staying asleep problem.

How old are you? Any health conditions that might make taking some sort of sleep aid causing a problem?

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kvck
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Re: repetitive central apneas & possible cause

Post by kvck » Sun Apr 03, 2022 5:01 am

Pugsy wrote:
Fri Apr 01, 2022 9:53 am

What about the basics first in terms of potential causes?
Medication side effects messing with sleep....do you take any meds of any kind, even OTC????
Any other physical or mental health issues going on? We already know that you admit to some stress or anxiety as a result of the crappy sleep. Anything else? Bed comfort? Mask comfort? Aches and pains?

Has there been a discussion of maybe trying some sort of sleep aid either RX or OTC to help maybe break the round robin cycle??? You know that sometimes there is a time and place for some extra help.
It's hard I know because most of the sleep aids out there are designed to help with falling asleep and not so much the staying asleep problem.

How old are you? Any health conditions that might make taking some sort of sleep aid causing a problem?
Dear Pugsy, thanks for your long reply, and time.

Your point of view about blaming the CPAP and the real cause of SMI is pretty reasonable. So, I agree with you.

Pill: I've been taking an antihistaminic pill over the last 1-2 years. Besides, I've been taking Metformin in the last 6 months for insulin resistance.

Mental: pandemic related factors changed my life style for sure like most of the people. Moreover; work, dealing with people, etc. have become more stressful.

Physical: I lost around 10 kg in the last year, I've become more active (walking more), a better diet etc. I've been on intermittent fasting in the last 1-2 years. Last meal at around 5-6pm and the next (first) one is around 1pm. No meal for around 16-18 hours.

Sleep Hygiene: My bed, mask and others are OK. My leakage is moderate. No restless leg syndrome etc.

Sleep Aid: I've started using Tolvon (10mg) and it looks like it has some positive impact on the maintenance but it's been just 5 days. So, I suppose I need some more time to understand the real impact. But, it is promising.

Age and other factors: I'm 41. My dad have similar sleeping problems, like nightmares when he is in stress. That may be some sort of genetic thing...

Overall, the current culprit is on the mental stress :roll: but I suppose I need to give myself some time and change my focus to different matters for sure.

Thanks again for the kind support. It is always appreciated.

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Julie
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Re: repetitive central apneas & possible cause

Post by Julie » Sun Apr 03, 2022 5:05 am

Antihistamines can keep you up a lot (why I take melatonin at night) and shouldn't be dismissed.

kvck
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Re: repetitive central apneas & possible cause

Post by kvck » Sun Apr 03, 2022 5:10 am

Julie wrote:
Sun Apr 03, 2022 5:05 am
Antihistamines can keep you up a lot (why I take melatonin at night) and shouldn't be dismissed.
Hi Julie,

Agree, I read similar things. Tolvon is also used as an antihistaminic. So, I've stopped using my previous antihistaminic.