Centrals and obstructive apneas in the same night — how to adjust pressure?

[nikkwong]

Hi, last night I had a bunch of obstructives, followed by a central which woke me up.

What would you guys do in such a situation? I am trying to adjust my pressure to improve my therapy, but not sure what to do now. I always seem to wake up at the 4-5 hour mark after a large apnea. Wisdom would tell me that centrals mean my pressure is too high, but higher pressure would more likely quell the obstructives.

Thank you.

[LSAT]

DO NOTHING! You are doing fine. You will never eliminate all events.

[nikkwong]

I would not have a problem with that advice—however, my sleep is very unrefreshing. I have to sleep ~9+ hours per night just to get through the next day. This is not optimal treatment.

[Julie]

Without something to look at, like Sleepyhead charts, it's hard to comment.

[D.H.]

To the OP. I can't open the acctchment. I assume that the person who commented was able to do so.

[nikkwong]

I think there was a bandwidth issue. I've reuploaded. Thank you!

[OkyDoky]

This night looks good. If you need to post pics in the future these links will help you to show the best information that we can use.
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/resources/sleepy ... screenshot
https://sleep.tnet.com/reference/tips/imgur

[nikkwong]

Thanks. It looks good, but I feel awful. It's been months on end, and I am feeling very depressed about it. Do you guys have any suggestions?

[TASmart]

No problem, no issue, you are doing great

[nikkwong]

Sigh. I'm not doing great. I feel awful. I can't participate in any of the activities I usually do. I can't work. I appreciate the participation, but if anyone has actual advice I would love to hear it. Thank you.

[TASmart]

The night data you posted does not support you saying you had a "bunch" of obstructives. If you have some data showing that post it. here may be other issues besides sleep apnea also. so that would be a much more difficult problem. Are you on meds? Other Health conditions? have you consulted with your primary care physician about fatigue? Maybe some health condition not related to sleep apnea at all.
Are you waking at night? how many time per night? I do see some flow restriction that may be causing arousals, but we cannot tell from what you have told us. More data gives a better chance of fruitful ideas.

[nikkwong]

Thank you!

I don't have any other data. This is a pretty typical night for me which results in a lack of restful sleep. No, I'm not on meds or other health conditions. I'm 26 and in very good physical shape. I've talked to my primary care and they've done about every test under the sun—the sleep apnea is the issue, and it's been very difficult to treat.

I often wake during the night, but only at the end of the night (6-9th hour of sleep)—I'm pretty much in and out of sleep for that entire period. I treat my condition very seriously—no caffeine, no blue light, wear earplugs, night mask, cool room, etc, etc...

If you have any advice I'd love to hear it! I was a high producing professional before this all hit, and really eager to get back out into my field again. Thanks so much!

[Julie]

You say no other conditions, but how many have you been tested for... or has your MD only gone with the most obvious for your age/sex, etc?

And is it possible you're trying to sleep too long thinking you have to when in fact using Cpap has shortened the needed time?

Reaching here...

[nikkwong]

I've had several panels of blood tests—is there anything else in particular I should be looking for?

The problem is the sleep, some days I feel great, most I feel terrible. Not sure if I'm sleeping too long, when I wake up after 6 hours I feel like death.

Thanks.

[palerider]

Hi, last night I had a bunch of obstructives, followed by a central which woke me up.

What would you guys do in such a situation? I am trying to adjust my pressure to improve my therapy, but not sure what to do now. I always seem to wake up at the 4-5 hour mark after a large apnea. Wisdom would tell me that centrals mean my pressure is too high, but higher pressure would more likely quell the obstructives.

I'd do nothing, actually, I might lower your min pressure a little, sneak it down a cm per week till something happens and you're not flatlined on pressure all night long. A bit less pressure might result in more restful sleep.... or it might not, but it's worth considering.

As to the central, it's *highly* unlikely that it woke you up, centrals aren't violent, centrals aren't disturbing... you just pause your breathing for a bit... it's much more likely that you were waking up, and during that process, you had a transitional central... they're fairly common when transitioning from awake breathing to asleep breathing, and back.... and absolutely nothing to be worried about. In fact, if it happened during a sleep test, they wouldn't count it.

Also, "wisdom" would be wrong, only about 1 in 7 people have centrals that are exacerbated by more pressure.... are you one of them? probably not, looking at your chart above.

Recently, there's been talk on the forum about magnesium helping with sleep, and a lot of people don't get enough in their diet. You need to get one that has high bioavailability... Magnesium glycinate is one of the better, plus someone unearthed something recently that said that glycinate also helps with sleep.. (you can search the forum for more info)... so magnesium glycinate is a double shot. It seems to be helping me sleep less restlessly, but maybe that's just the placebo effect... but I pop 400mg before crawling into bed.