Hi
Pedrx,
I'm writing to you from the UK, and I have a bit of knowledge about the system.
From a common-sense PoV, this doesn't look to me like heart disease. The apneas are so bunched together. In my layman's understanding, if it were heart failure, both obstructives and centrals would more likely be spread out. And in both of these charts, you have a spell of five hours where there are no, or very few, events at all.
What's puzzling are these swodges of centrals – 40 minutes, 60 minutes, 70 minutes long. They might be the kind that are a reaction to pressure. But they don't look quite like it.
And neither do they look like 'sleep-wake junk' – although some of them might be that too.
Then there's the reports of CS breathing.
Please note: these machines are supremely sensitive to 'periodic breathing', perhaps overly so. But periodic breathing does not automatically mean heart failure. There are six degrees of severity in periodic breathing, and cardiologists use four stages of heart failure. You can look them up on the net and decide if, for example, you're at the stage of 'hardly can get up out of a chair and walk across the room' or 'rendered breathless and unable to talk by two flights of stairs'.
Doesn't seem from what you say that you are.
We have to ask: what's changed? What is true of you now that wasn't true six months ago?
Some people have more of their apneas – both obstructive and central – when they are dreaming. And they do more of their dreaming in the later stages of sleep – the lighter stages. Ie, in the last two hours of a notional eight-hour sleep.
I note also that, on the nights you show charts for, you slept for a good 10 hours. Have you always been a long sleeper?
As far as the NHS sleep-medicine department goes, in previous, non-covid years, you would have a live, in-person review once a year. With these results, you could ask for that to be brought forward – that is, for you to be seen outside of the annual review cycle.
IMO, there is a case here for having you in for an over-night sleep study. I say this knowing that (a) not all of the NHS foundation trust hospitals has a sleep lab, and that (b) even in non-covid times, fewer that 10 pc of possible-sleep-apnea patients get assessed in one. The majority 90 pc of patients are assessed via a home study.
A
repeat home sleep study here would not answer the question – which in laymen's terms can be expressed as 'wtf is going on?'
In other words, what these charts show is so unusual that it warrants a full-monte over-night in-lab sleep study. Whether you will get one in these very stressed and long-waiting-list times is another matter. You can only ask.
I would write rather than call, I would tell them you have used shareware – but say that "it tentatively shows unusual behaviour." And that you know it is not definitive, it is not the software they use. Say that what really troubles you is that you are fatigued and unrefreshed
in spite of treatment.
I really do mean: underline that last bit.
If you have any other conditions, or people dependent on you, mention them. All of them.
With a bit of luck, they will fit you in somehow, or send you 'out of area' to another hospital or a privately-run sleep lab if the hospital you go to doesn't have one.
