Early morning central clusters

[Ograx]

Well I think I finally got my treatment down to a fairly good AHI that is hovering around 2 nightly. I will post Oscar data when I get home at lunch.

The only events I am really experiencing based on Oscar data is happening around 430-5:00 am with some nights having no flagged events til a 12-15 event cluster early in morning and close to my wake up time.

Is this normal to have a cluster near wake up time?

[Dog Slobber]

For many, yes.

I used to get a lot of centrals while laying awake, while drifting off to sleep, or waking up. Often referred to as Sleep/Wake/Junk (SWJ).

As I became to accustomed to CPAP, slept better, and became accustomed to breathing while hosed-up the clusters lessened, and all but disappeared.

[Ograx]

Well here is the Oscar data with various zoomouts and zoomins so you can idea of the events. Its pretty consistent in time and looks almost exactly the same day to day. My concern is it almost looks like a CSR event is starting to form and while I did have issue with CSR looking breathing when I had EPR on I definitely have zero heart issues. (ECG,Echocardiogram confirmed)

Is this normal SWJ or just my body still adapting to CPAP treatment? (Month 2 now)


Anything to be concerned about??

[Ograx]

Another few images I couldnt attach to last post.

[palerider]

For many, yes.

I used to get a lot of centrals while laying awake, while drifting off to sleep, or waking up. Often referred to as Sleep/Wake/Junk (SWJ).

And technically referred to as "Transition Apnea" (if you want to google for more info.)

[Ograx]

Is that what it looks like? On my posted images?

[Pugsy]

I vote for transitional apneas...in and out of sleep repeatedly late in the session. I have seen this happen myself. Once I had 17 centrals in 17 minutes. Did look ugly but meant nothing.
If it were my report I would shrug my shoulders and move on.

[Ograx]

Thanks for the input. So if I take those out of the picture my actual AHI is somewhere around 0.3 on most nights. Leaks are usually less than 5l. Is this where I want to be at ?

I know palerider has recommended on my last posts that I try to up pressure to keep my pressure lines a little more even.

I still experience 5-6 wake ups a night which you and I have discussed Pugsy so I guess I’m just looking for where to go from here.

[Pugsy]

I would be more than happy with AHI of less than 1.0 and leak numbers 5 or less (heck I am happy with higher anyway)...as long as the leaks weren't contributing to the wake ups. That's the only warning I have about the leaks. Your sleep is so fragile anyway and even if a leak is teeny tiny and it wakes a person up it is unwanted.

I don't know what to tell you about the sleep maintenance insomnia (all those wake ups) except keep trying things to see what you can figure out might reduce the wake ups.

I don't know if smoothing out the pressure line by using a little more minimum will help or not.
It's not like you are seeing a range of 7 to 18 or something like that. You really aren't moving around all that much in terms of pressure...it looks worse than it is due to the scale of the graph. Last night the highest it went to was 11.5 cm...that's not a massive range.
But it might help and is certainly worth trying. Some people do say they sleep better if the pressure line doesn't move much.

I have a sneaky suspicion that your sleep quality issues and those wake ups are related to other issues that you have.

[Ograx]

What are some possibilities of other issues that I should investigate or look into?

I’ve been tested for pretty much everything except a brain MRI honestly and my doctor says constantly I’m the healthiest person numbers wise he’s ever seen so I’m at a loss for why I experience these sleep issues.

[palerider]

Thanks for the input. So if I take those out of the picture my actual AHI is somewhere around 0.3 on most nights. Leaks are usually less than 5l. Is this where I want to be at ?

I know palerider has recommended on my last posts that I try to up pressure to keep my pressure lines a little more even.

I still experience 5-6 wake ups a night which you and I have discussed Pugsy so I guess I’m just looking for where to go from here.

There is more to sleep disturbed breathing than just the AHI... All those jumps in pressure are because of some breathing disturbance.... Those might contribute to your awakenings.

[Pugsy]

I may have you mixed up in my mind with someone else. I thought you had a long laundry list of problems....sorry.

I know you didn't like the insomnia word but that's what you have....sleep maintenance insomnia but I don't know why or what is causing it. The list of potential culprits is miles long...and airway issues are but one item on that very long list.

You can try the more minimum pressure thing....just beware that with more minimum comes the chance of the aerophagia monster returning and already know you don't like him hanging around.

[Ograx]

I’m a little confused.....

If I’m understanding Pugsy correctly she is saying that the pressure is only looking like big jumps because of how I have it set and that 7-11 isn’t that big of pressure change.

You are saying however that it is possible that 7-11 pressure differential is possibly too much and is a possible cause for wake ups?

Just making sure I’m getting everyone’s opinions and thoughts correct.

[Ograx]

Is it also possible for the behaviour to be ingrained in that I have done it and woken up for years and it’s just a habit that needs to be broken?

[Pugsy]

I think he is saying that whatever might be going on in the airway to cause the pressure increase could be a factor in causing the wake ups.
Granted not a massive increase but maybe what it wants to kill with those increases is a factor in the wake ups.
People often blame the pressure changes when they wake up but maybe it was what the pressure was responding to that was responsible for the wake up in the first place.