Is my Deviated septum cause of poor sleep or something else?

[RafaelP]

Hello! I went to the Dr. originally due to sleepiness, brain fog and difficulty breathing through nose while lying down. I was diagnosed with mild sleep apnea with an in office sleep study. Results were 7.7 AHI with significantly fragmented sleep architecture; 1.7 Obstructive index, 2.2 Central index, 3.7 Hypopnea Index. I have a low BMI and am in overall in good health. The only medication I currently take is Wellbutrin in the AM.

I have been using the Airsense 11 with F40 mask for three months. I feel pretty comfortable with the cpap and mask now after the initial struggle. I have gotten leak issues under control over the last month. There has been some minor improvement to sleep, and no snoring now(although it was very mild before) but it is still not good.  The CPAP is set to 4cm-10cm. I set the EPR to 2 after some experimenting. Humidity is set to auto.

I have deviated septum that I have an appointment with a surgeon to look at. Here are the ENT notes transcribed if anyone can understand what it means: Significant deviation into L nasal cavity with compensatory internal nasal valve collapse if R nare with deep inspiration, turbs +2 does have a positive modified cottle bilaterally.

To be able to breathe through my nose at night I need a Breathe-Right nose strip, daily Zyrtec, and Flonase and Azelastine sprays. I purchased a more supportive pillow and change the sheets regularly to help with dust. I clean the mask and cpap regularly and only use distilled water. Even with all of this I still get congested for at least part of the night. Due to the deviated septum I also can really only sleep on my left side.

Attached is last night's Oscar chart with some details. Overall it was a better than average night in terms of events, but I still took off the mask with what felt like difficulty breathing after the event.

Overall it may not look like a lot of CA events, but they are grouped together and often wake up about 2-4 times per night. When it was really bad I have had to take off the cpap, as it sometimes felt like it was fighting or out of sync with my breathing, but that happens rarely now. After the events I often have to get out of bed a bit to calm down to be able to fall back asleep.

I am trying to understand the data from Oscar so I can share my thoughts with the sleep Dr for an upcoming appointment. Is it possible to tell if these issues are directly related to a deviated septum or is there something else going on that I should look into? Thank you!

[Charlieboy UK]

Your issue is central apnoea... so from your brain.. need to talk to your doc, but its not that bad.

[Pugsy]

Is it possible to tell if these issues are directly related to a deviated septum or is there something else going on that I should look into?

Look up the side effects for Wellbutrin for one thing. It's well known to carry some excess baggage that messes with sleep.

I don't know of any way for the machine to be able to distinguish if your issues are related to the deviated septum or not.

And you DON'T have any issues with having central apnea. You weren't sound asleep for the time frame you zoomed in on so they don't really count other than to point to not being asleep for some reason. I suspect the prior flagged centrals are also arousal/awake related.

[Nocibur]

Your issue is central apnoea... so from your brain.. need to talk to your doc, but its not that bad.

That snippet is simply wake-- turning over, perhaps scratching something (eww).

[Pugsy]

Your issue is central apnoea... so from your brain.. need to talk to your doc, but its not that bad.

No....totally incorrect information. He doesn't have an issue with central apnea. He has an issue with staying asleep and the centrals are just a symptom of not being sound asleep.

Here's what real central sleep apnea looks like.

[RafaelP]

Thanks for the responses!

I have been on Wellbutrin for a while, and take it first think in the morning to try to keep issues to a minimum. I did have sleep issues before starting it.

Attached Here is one from a particularly bad night. Is this just me moving around a lot? After this event I took the mask off for the rest of the night, since it felt like I was fighting against the machine, nose was probably clogged too. I find it difficult to sleep breathing through my mouth even though it has no obstruction and I am using a F40 mask.

[Pugsy]

On the Sun Jan 11 report.....you weren't asleep when all those centrals were flagged.

[mlmollenkamp]

Regarding the deviated septum. If you can't breath through one nostril by all means get the surgery. I had septum & turbinate surgery a few years ago, trust me, breathing is better than not. I had issues with nasal congestion and still do. The difference is that I never get to the point where air doesn't pass through my nose. It may or may not fix your sleep, but for me at least it was well worth it.

[ChicagoGranny]

Regarding the deviated septum. If you can't breath through one nostril by all means get the surgery. I had septum & turbinate surgery a few years ago, trust me, breathing is better than not. I had issues with nasal congestion and still do. The difference is that I never get to the point where air doesn't pass through my nose. It may or may not fix your sleep, but for me at least it was well worth it.

+1

It also helps with daytime breathing.