Severe mixed apnea at the age of 35

[ozij]

Have you considered showing your breathing patterns to your doctors, and discussing it with them?

[Herbert]

Have you considered showing your breathing patterns to your doctors, and discussing it with them?

yep. they said periodic breathing itself is not "too harmful" - whatever that's supposed to mean. I should wait for 6 months and in case is still buggers me they would prescribe O2 as additional measure. Don't know what to think of that....

[ozij]

Have you considered showing your breathing patterns to your doctors, and discussing it with them?

yep. they said periodic breathing itself is not "too harmful" - whatever that's supposed to mean. I should wait for 6 months and in case is still buggers me they would prescribe O2 as additional measure. Don't know what to think of that....

It means they were hoping your breathing would settle down with the help of Positive Air Pressure therapy.

And looking at the overview you uploaded, it looks like much of it has.
I understand you've got about a month left of those 6 months.
I suggest you keep a log of how you slept and how you feel during the day - maybe even "check in" with yourself and log the response a number of times a day.
See if you can do that without looking at OSCAR.

It seems to me you're very worried - understandably so for a person your age who suddenly finds his heart misbehaving.
You really have to have a serious discussion of the whole issue with you cardiologist, make him/her understand what's worrying you, and try to get answers to all your concerns.

I hear a deep current of dissatisfaction and distrust of your doctors - I'm not saying "trust them". I'm saying: you need to find doctors you can trust.

As for your CPAP therapy: For some people, especially those with mixed or complex sleep apnea, getting used to the CPAP therapy takes time.
Your therapy overview shows positive changes, your doctors want you to give yourself half a year to get used to things, but you say:

It's not like they are from 2019 and everything could have changed meanwhile. But I tried to search for more recent ones and didn't find much"flagged" as CSR.

Don't let the "CSR" terminology used by ResMed freak you out - they use it easily, erring on the side of caution.
Don't obsess about "what was wrong then when my machine flagged CSR?"
Do try to focus on your therapy now and on how you feel.
And, as I said, try to find a doctor who you can trust.

You may find reasons to trust members of this forum - I certainly did when I joined, and know who I trust today - but we are a bunch of strangers on the internet, some wiser and more knowledgeable than others, but none of us has the info your doctors have.

At the very beginning of this thread, Rubicon told you:

Analyzing sleep requires looking at about 12 channels of data. You got like 2. Trying to come up with a conclusion therefore requires a lot of WAGs and assumptions. Hence, what I come up with is only a guess, and it might be totally wrong.

A WAG is a Wild Assed Guess. I doubt you're the type of person who would really trust WAG's.

Do you have your sleep study results? Would you like to upload them (personal data hidden) for people to help you understand them?
Will that make you feel better?
By all means, do that if it will help. And even then, I still think it's crucial for you find a doctor you trust.
You write:

That's why I'm so obsessed with finding out why CPAP is working to some extent for me. To get a glimpse of what is causing my misery. Is there any obstructive component that is messing up my breathing or not... While for obstructive you nearly have no chance to get rid of it except with complex surgery for some cases, for centrals and periodic you might get rid of it, if you can find the cause and treat it. (That's just me trying to be positive somehow... you could call it the last straw).

I don't know where you got the idea that " for centrals and periodic you might get rid of it, if you can find the cause and treat it." It's quite possible that medical knowledge at this point can only offer you CPAP or ASV support or one of them with oxygen to help you sleep and be healthy.
Some people need glasses to help them see.
Some people need hearing aids to help them hear.
Some people need machines - with or without additional oxygen to ensure their breathing, when they sleep, is giving their body the needed oxygen, in the right way.

[Rubicon]

Do you have your sleep study results?

And any/all medications.

[Herbert]

Okay - here they are. Unfortunately in german, but most of it should be self explanatory. In case of questions please let me know. I will also translate the summaries.

Medication: NONE at all, as mentioned except for this sh*tshow and the sporadic afib im healthy

This is the first night without therapy. The summary says: "Slept turbulent, many hypopneas with mild desaturations, breathing partly paradox, laying on his back central apneas in the morning, moderate snoring"


This is with therapy. Summary: "Slept turbulent, woke up several times, breathing partly a little periodic, some hypopneas or RERAs with mild desaturations, only a few central apneas, partly restless legs, no snoring"


This was the control night after 3 months. Summary: Beautiful sleep structure, CPAP well tolerated, sporadic RERAs or hypopneas without relevant desaturations, very good oxygen levels with 95% during sleep, no snoring" Regarding the Arousal index: I asked them directly and they said its the automatic result and they didn't correct it manually, so I should not pay it any attention.

[palerider]

It's not like they are from 2019 and everything could have changed meanwhile. But I tried to search for more recent ones and didn't find much"flagged" as CSR.

But but but, I had 6 broken ribs back in 1977, surely that should be relevant TODAY!!!

You're LOOKING for trouble, and you're going to find it, very few people sleep perfectly fine, I can dig into my nightly results and point at things that 'aren't perfect', probably every night.

But the two attached screenshots show that I had periodic breathing. And this went on for hours that night. Any suggestions, opinions?

My suggestion would be to quite obsessing about this stuff.

I'd also be interested in what your machine would do if it were on auto, whether it would raise or lower your pressures in response to your breathing pattern.

[Rubicon]

Medication: NONE at all, as mentioned except for this sh*tshow ...

Could you explain what that means?

[Herbert]

Medication: NONE at all, as mentioned except for this sh*tshow ...

Could you explain what that means?

I take no medication. the sentence after "NONE" refers to generally being of best health except for my two conditions sleep apnea and afib.

[Rubicon]

OK but to what "sh*tshow" are you referring to?

[Herbert]

OK but to what "sh*tshow" are you referring to?

= having central apnea without any known reason. maybe this term means sth different than what I thought. sorry, as I said I'm not a native speaker

[Herbert]

@ozij: thanks a lot for your long post. what you said sounds reasonable. my heart has already been checked very well. my cardiologist says the breathing problems are not linked to my heart in his opinion, since everything is fine except the sporadic afib. so the breathing problems is either caused by some underlying neurological problem, which has not been found yet, linked to covid (maybe even a Form of long covid) or just some disorder of my chemosensors that cause it... I will talk to a long covid specialist next week. and I'm in contact with another sleep doctor from which I hope to get more explanations. I like your hint with the LOG very much. I think I might do that.

[Rubicon]

There appears to be a pattern re: respiratory rate in the previously submitted SleepHQ files:

[Pugsy]

There appears to be a pattern re: respiratory rate

Does the respiratory rate increase in REM?
Sure looks like a REM pattern there IMHO.
All this is above my pay grade.

[Rubicon]

It can, but usually only in phasic REM, and as I'm sure you've noted, usually not like this.

But it do look like more than a coincidence!

The arousals numbers in the NPSG don't seem to add up. It claims a lot of respiratory arousals, but there doesn't seem to be enough respiratory events. At any rate, big arousal numbers.

Does long-haul Covid create respiratory instability? Certainly a good thought.

Yo Herb, did you say you have oximetry data?

[Rubicon]

Virtually all the central apneas occurred on Right Side, and disappeared upon position change.

Obstructive apneas occurred supine.