Hi from new member (tried taping my mask)

[Pugsy]

See if you can get the wife to watch this video...maybe it will educate her (if she will let it) so that she has a better understanding of whats going on and hopefully be more supportive and less negative about all this.

https://www.youtube.com/watch?v=-gie2dhqP2c

It's not something that just happens to people that might weigh too much. I was a skinny assed thing when I was first diagnosed. Menopause did me in...not only did the boobs and butt start to sag...so did the tissues in my airway. I never had any symptoms at all until menopause.

[leptic]

It would have been interesting to know the approx. times of your centrals, whether they were falling-asleep and awakening ones, or throughout the night and/or clustered. However...

The PDx report has graphs but they are hard to read on the photocopy I got. Have asked them to email the original pdf file, which should be easier to review on computer.

Do tell your wife that apnea is thought to put on weight, not that weight creates apnea. Big difference!

This has been my impression as well - I used to love cross-country skiing and cycling (did it for fun, not to lose weight) but after feeling increasingly 'off' the last few years (and having small kids) that just fell by the wayside. I was biking 6km to work every day up until March, but the fatigue got to the point where this was just not sustainable.

And if her reaction to your having a serious condition is to call you lazy... but that's for you to deal with.
Maybe she needs to do some reading, at the very least, and not listen to water cooler opinions (if that's relevant).

Yeah I realize this is not a marriage counselling forum, nor the place to air a bunch of dirty laundry. I'm working on it, but it's very hard to overcome the attitude of 'you brought this on yourself by eating too much and could have fixed it six months ago just by exercising some self-restraint'. Part of the problem is that, like a lot of people, I tend to try and cheer myself up with food. Feeling like crap from sleep deprivation, combined with guilt about work performance and meeting domestic expectations, leads to a lot of need for cheering up.

[leptic]

See if you can get the wife to watch this video...maybe it will educate her (if she will let it) so that she has a better understanding of whats going on and hopefully be more supportive and less negative about all this.

https://www.youtube.com/watch?v=-gie2dhqP2c

Thanks - the video is really well done. Will send link to my wife.

It's not something that just happens to people that might weigh too much. I was a skinny assed thing when I was first diagnosed. Menopause did me in...not only did the boobs and butt start to sag...so did the tissues in my airway. I never had any symptoms at all until menopause.

Yeah I've also had to come to terms with the fact that I'm not 20 (or 30, or 40) any more... I'm 6'2" and 220 lbs, which gives a BMI of 28 (high end of overweight). Ideally I would be 190 lbs to be at the high end of 'normal'. I realize that the BMI is just an approximate formula, but 220 lbs does feel like way too much for me (and I was 190lbs in 2013 before I started snoring).

I agree with Julie's point that sleep apnea can cause weight gain; I really enjoy running, biking, and xc-skiing. I used to run at night, but for the last few years I've been on the verge of collapse after getting my kids into bed (which is also frustrating for my wife, as that would normally be when we could spend time together). Sleep disruption can also really mess up your hormones (insulin, cortisol), which also impact hunger.

The problem is that if you google 'sleep apnea', every link that comes up specifies 'obesity' as the first risk factor (not saying it isn't the case).

In my case, the snoring started around the time of some injuries for which I was prescribed opioid pain meds (among other things; haven't needed the pain meds in a long time). Of course the injury had to happen around Christmas holidays - normally I take a week off and do a lot of xc-skiing and eat accordingly. That year I did zero activity but kept up the usual Christmas overeating; the weight, constrained sleeping position due to injury, and opiod medication (a respiratory suppressant) were likely triggers.

[IDontSnoreISwear]

If I were you I would share these results with your sleep doc sooner rather than later. If you have an 80 AHI (which I'm not qualified to determine that you do), it might get you pushed closer to the front of the line for your testing/titration/Rx.

Best of luck.

[leptic]

If I were you I would share these results with your sleep doc sooner rather than later. If you have an 80 AHI (which I'm not qualified to determine that you do), it might get you pushed closer to the front of the line for your testing/titration/Rx.

Best of luck.

Thanks - the earlier AHI of 80 that was mentioned was averaged over a short time period. I finally did get the results, and my nighttime average AHI was 'only' 28. I got my Rx yesterday and started titration last night.

Last night the DreamStation reported an AHI of 20 - although I assume this is still way above target, it was the first morning in a long time when I didn't feel like someone had beaten the crap out of me in my sleep.

[Pugsy]

Last night the DreamStation reported an AHI of 20 - although I assume this is still way above target,

What are your pressure settings?

What is the event category breakdown of that AHI?

Did you sleep decently or did you have a gazillion wake ups?

[leptic]

Thanks for looking in on a newbie

What are your pressure settings?

min 5, max 15 cmH2O

What is the event category breakdown of that AHI?

Here is the plot from SleepyHead.



It includes a bunch of events from a short nap I took in the afternoon. I saw there is a setting to split days at noon or another time; not sure if there's a way to separate naps from nighttime sleep (or if it matters).

Am I correct in assuming that 'Clear Airway' refers to an apnea (presumably central) that occurred without obstruction?

Did you sleep decently or did you have a gazillion wake ups?

I kind of always have a gazillion wake-ups; it was not bad for me, although could be better. I am sleeping on a really crappy little bed in my basement - there's not a lot of room to roll over, so I tend to spend too much time on my back.

To give an idea of how much I've always woken up at night: for years I've always had to have a clearly visible large font LED clock in the room when I sleep, as it provides a sense of security knowing what time it is during the gazillion times I normally wake up. I feel quite uncomfortable without this, and keep a large digital clock screen saver (at minimum brightness) running on my computer in hotels when I travel.

[leptic]

PS please let me know which screen shots from SleepyHead are most useful for getting help and feedback, and if there are any tricks to get summary views/printouts that work well on the forum (I think my screenshots might be a bit large for some devices).

Thanks again for all the help!

[Pugsy]

This thread has examples of what we commonly like to see on the reports.
The AHI breakdown is on the left side.
Can you do another image with the AHI on the left (hide the calendar and pie chart) and these graphs on the right..
Events
Flow rate
Pressure
Leak
don't need all those others.

There is a way to turn off short sessions or naps if you feel the need but it isn't that big of a deal.
Below the statistics on the left you will see the sessions...just double click on the one you don't want to show up and it will disappear...easy to turn it back on if you wish.

Yes...clear airway means central. They may or may not be the real deal since you report waking often. The machine doesn't know if you are awake or not and often it will report awake/semi awake breathing irregularities as some sort of apnea event usually central.
So lets not get on the central apnea worry wagon just yet....this is one night.
Those centrals could be post arousal centrals from the OA events...meaning the OA event could have caused the arousal and the central is a by product of the arousal. It's possible that if we reduce the OAs that the centrals will reduce if they are a by product of the OAs.

Need to see the statistics on the left side and the pressure graph...I suspect the 5 cm minimum needs to be higher to better prevent the airway collapsing. It's common. The machine can't respond quickly enough when the pressure is too low. I had similar reporting when my apap minimum was 8...but the clusters cleared up when the minimum was 10. The maximum isn't so important unless you are maxing it out for a good bit of the night.

Edit......I am going to be away from the computer for pretty much the rest of the day so if I don't respond back quickly...don't worry...I will when I get home this evening.

[leptic]

Thanks Pugsy - much appreciated! Will copy other graphs later today.

For what it's worth, I hooked up my pulse ox and diaphragm belt last night, and still saw a bunch of these:



I showed the older (similar) plots to my sleep doc, and he agreed these look like centrals due to the apparent lack of respiratory effort.

Another observation, decidedly anecdotal at this point: I took my kids out of town over the long weekend to visit my father, and forgot to take my Cipralex (SSRI) with me. The night I got back, I hooked up my improvised home sleep lab and the next morning noted that I had almost *zero* of these presumptive central events (they are easy to recognize from the desats, periodicity, and lack of respiratory effort).

I asked the sleep doc about it, and he thought the most likely explanation is that my centrals are associated with a certain sleep phase, and that the Cipralex is altering sleep structure in a way that indirectly influences the apneas. I have a feeling that my 'depression' is really a side-effect of sleep disturbances, and will discuss tapering off of it.

[Pugsy]

Just heading out but saw the mention of Cipralex
Google its side effects...also google SSRIs and sleep...they are well known to not only have the usual unwanted side effects during the day (fatigue, drowsy,etc) they are well known to really mess with sleep architecture in general and could very well be a factor in those gazillion wake ups. Not saying it is 100% the problem but could very well be a factor.

[leptic]

Just heading out but saw the mention of Cipralex
Google its side effects...also google SSRIs and sleep...they are well known to not only have the usual unwanted side effects during the day (fatigue, drowsy,etc) they are well known to really mess with sleep architecture in general and could very well be a factor in those gazillion wake ups. Not saying it is 100% the problem but could very well be a factor.

Thanks - very much in agreement. I've had my gazillion wakeups before and after periods of being on SSRIs, but suspect that in the long run they have not really helped.

[Julie]

Plus they've been known to upset stomachs and I'd want to get checked for 'silent' acid reflux, something that affects a lot of apnea patients. You might check into it on your own by taking e.g. a half of one small Tums (too much can backfire) overnight x a few before bed, and see if you sleep any better.

[chunkyfrog]

As for the failure of a spouse or other people around you to support your therapy;
or even to acknowledge the very existense of apnea; the world is full of kibitzers,
who know nothing, but spew BS to compensate for their ignorance.
Ignore what they all say--your health depends on YOU. Your wellness will speak for itself.

[leptic]

Plus they've been known to upset stomachs and I'd want to get checked for 'silent' acid reflux, something that affects a lot of apnea patients. You might check into it on your own by taking e.g. a half of one small Tums (too much can backfire) overnight x a few before bed, and see if you sleep any better.

Thanks Julie - this was another red flag I ignored. I've actually had nocturnal heartburn and even esophageal spasms that have been increasing in severity (food gets stuck), which I suspect is apnea-induced GERDS. I talked to my pharmacist yesterday and he recommended Zantac, although treating the apnea may resolve the reflux.