Up late and Centrals? Coincidence?

[ColCpap]

Bottom Line Up Front: Does your level of tiredness affect your rate of centrals // can switching to nasal pillows increase centrals??

Details:
Started CPAP in March 11. I recently (about a month ago) switched to the Swift FX nasal pillow from the Comfort Gel [lots of little leaks and discomfort were the primary reasons]

ANYWAY... I noticed the first couple of nights on the pillows that my Centrals shot up a lot from averaging <1/hr to 4-5/hr. After approx 2-3 days things went back to normal and other than not getting enough sleep [job related] I was resting great.

Fast forward to this week and I have been wiped out. So I went and downloaded data to investigate. My AHI on Friday night was 10! [since being on CPAP 0.5-1.5AHI was average; prior to CPAP in the triple digits]. So I went back and looked at the last month and there is an interesting trend:

On "school nights" I am normally in bed around 12 and up at 6:30. But on Friday and Saturday nights I can be up til 1:30 or 2 and then sleep in till I wake up (~8 hrs or so).
What is alarming is on the nights I stayed up late I had an average AHI of 8.6, 75% CA and 20% HA [school nights its been around 2AHI]. The events are almost all grouped at the end of the night approx 6 hrs into it and/or aorund 7:30 or 8 am.

Any thoughts on why Fri and Sat are so bad??

NOTE: Behaviorally eveything is about the same other regardless of the night (caffiene, nicotine, alcohol, food, routine before bed, etc etc), I just normally seem to be up later watching a movie with the teen or hanging out with the wife.

Thanks for any inputs
Fletch

[FizzyWater]

Not sure if there's a real correlation, but it seems to me the longer I'm asleep, the higher my numbers are. Could just be that you're sleeping longer, and in those last hours (which are not the deepest levels of sleep) you have more centrals/whatever...?

[JointPain]

I tend to have two phases during the night. During the first phase, I have lots of "events" (OA, H, Flow limitations) that cause the APAP to bump the pressure up. Towards the morning, my pressure line is much lower and flatter, but sometimes I'll have a few to a lot of short centrals (10-15s). Sometimes the two sleep phases are separated by a middle-of-the-night bathroom break.

If I'm tired, I tend to have more "events" in the first half of the night. I haven't noticed any effect of tiredness one day on centrals that night.

[pap4life]

Very interesting post..

Coincedentially, the second half of the night is when I have the most centrals also.

[Pugsy]

The events are almost all grouped at the end of the night approx 6 hrs into it and/or aorund 7:30 or 8 am.

Is it possible that these groupings are related to semi awake stage? Sort of like sleep onset in reverse?

[Otter]

Maybe it's not so much that you're up late as that you're sleeping later. The sun, noise from neighbors, or your habit of waking up earlier may be rousing you, and that could cause the centrals. Or maybe it's simply that your alarm is waking you up on weekdays, preventing you from scoring drowsy centrals as you wake up naturally.

Do you think the change to pillows is disturbing your sleep? If not, the wiped out feeling may be a good sign. Many people go through a stage where they feel tired again, perhaps even more tired than they did before starting therapy. I think this sometimes has to do with the need for periodic shots of adrenalin to keep breathing. The adrenal glands seem to get stuck partly on, but after a few months of, oxygen-saturated sleep, they calm down, and it becomes obvious that the years of sleep debt haven't been paid off yet. Serotonin levels returning to normal could have a similar effect.

[Bobby269]

The less sleepy I am the more central clusters I have. I try to go to bed the same time each night. If I stay up an hour past that time I don't sleep as deep and
my central clusters are there in the morning. Wednesday and Thursday I get up very early. So Thursday night Friday morning I sleep very deep little or no
Apnea's
When I keep my sleep to no more than 7 1/2 hours a night and life is good.

[wolewyck]

Can't advise about the sleep timing thing, but it's true that some people have centrals increase when on CPAP or BiPAP therapy, even though the obstructive events are treated effectively (I am one of those folks). If problems persist, you may want to see about getting another sleep titration study, using an ASV machine, which can address both centrals and obstructive events very effectively.