Kenny's CPAP Thread

[tattooyu]

Well, I'm starting to backslide a bit. My AHI has been creeping up slowly this whole past week, and I'm not sure why. Last night I had what I thought was very restful, deep sleep. I dreamed a LOT (lots of REM?) and woke up this morning to these numbers:

AHI: 6.8
AI: 1.0
HI: 5.8
Leak: 0.00 L/s

Now, I'm sure some of you are saying that this isn't so bad, but I'm used to numbers like this:

AHI: 1.8
AI: 0.2
HI: 1.6
Leak: 0.00 L/s

A huge difference for me. Today may well be one of those days.

This past week, I have been experience more than average panic attacks, but they subsided in the past few days. I'm also having body symptoms: ectopic heartbeats (PVCs) which are usually benign, what I think are some swollen lymph nodes, some tightness in my upper chest, a burning spot on my right chest muscle, etc. I do have an appointment for a Holter monitor and some blood work.

Last night I did start a self-hypnotherapy program for IBS, so I was quite relaxed (moreso than usual) before I went to bed. I'm thinking of turning EPR off (or increasing my pressure) for a week to see if that helps, but I'm nearly at my limit with the gastric insufflation, even with Gas-X and Pepcid, and don't know how much more discomfort I can take.

What's troubling me is that my machine doesn't seem to be compensating for the apneas. My guess is this because of the A10 algorithm, my pressure being 14-17 AND there are no snores preceding the apneas (snap-shut kind). Either that or they are centrals, which I certainly hope they are not.

It's been a week, so I hope this ISN'T the start of some backward trend.

[birdshell]

Kenny, if it ain't broke, there is no need to fix it!

In other words, you are still in good shape with your values. There are so many little variables that, unless you find some negative consequences, there is no need to change anything. These things may vary a little, but you still feel great. You may be doing something one night that you do not do another.

In my opinion, there are many more things about which I should worry than treatment values that are still good. You have an APAP; give it a while to see if this is really something about which you should worry.

Karen,
Whose values have varied too

[tattooyu]

I understand what you are saying, Karen, but the fact is: I don't feel great. In the past week, I've felt extremely lousy. It's hard to say if the sleep issues caused that or vice versa.

<sigh>

[GaryG]

I know it may sound silly, but how long have you had your current mask? Maybe you need a replacement. If you have a backup mask, try it, and see if the numbers look any better.

[tattooyu]

I actually just got new headgear and nasal pillows for my Swift LT. By the way, and I was going to post this on the thread about the difference between old and new ResMed nasal pillows: THESE NEW PILLOWS SUCK! I'm not positive, but I'm pretty sure I was still getting the old "milky" colored ones the whole time. These new, slightly clearer ones are much flimsier. However, my leak rate is usually very good. Just thought I'd throw that in there for good measure.

[rested gal]

I understand what you are saying, Karen, but the fact is: I don't feel great. In the past week, I've felt extremely lousy. It's hard to say if the sleep issues caused that or vice versa.

<sigh>

I agree with Karen (birdshell) that your numbers look fine. I'd be looking for other reasons for feeling "extremely lousy" -- reasons that have nothing whatsoever to do with how your cpap treatment is going, 'cause what CPAP is supposed to do (keep your throat open nicely for breathing while you sleep) looks like it's still going great.

[birdshell]

Sorry, Kenny...I sort of skipped over your other symptoms, without meaning to lessen their significance.

I still think that you may have to give yourself more time and more credit. It is NOT AT ALL as if you are ignoring your health. Rather, I am thinking that you are getting overly anxious about small changes. You may need to do further investigations before drawing your conclusions. It can be tough to pin down these little differences.

Are you still better than you were before CPAP? I am guessing that you are. If you are like me at all, then "better" becomes the new norm, and it is all too easy to forget how badly I was doing before. Keep hanging in there.

Karen,
Who tries to put things into perspective

[tattooyu]

Thanks, RG. When my AHI was over 5 this morning, unless you divide the HI by 2 , it kind of made me go...

It might be that I'm just exhausted from the panic attacks, am fighting off a cold. I hope it's nothing serious. I'm going to have my thyroid checked as well. I suspect I may have an enlarged thyroid (it just feels huge and kind of bumpy) or possibly Hashimoto's Disease, where you can cycle back and forth between hypo- and hyperthyroid, depression/fatigue/weight gain and anxiety/palpitations/weight loss. I'm sure a number of different situations could produce that, but I thought it was interesting that it described me to a "T" like that. Thyroid disease runs in my family as well, even thought it's more common in women.

[Autopapdude]

Kenny, if you look at the increase, it is mostly hypopneas, not apneas. So, it is unlikely to be an increase in Centrals. I'd guess on stress, as you have panic disorder (welcome to the club), and that causes all sorts of physiological manifestations. Sounds like your life has been more stressful this week, and that would account for it---your numbers are still more than satisfactory, and I don't think an area for concern. Your feeling "lousy" is an area to be addressed aside from the OSA.

[tattooyu]

Kenny, if you look at the increase, it is mostly hypopneas, not apneas. So, it is unlikely to be an increase in Centrals. I'd guess on stress, as you have panic disorder (welcome to the club), and that causes all sorts of physiological manifestations. Sounds like your life has been more stressful this week, and that would account for it---your numbers are still more than satisfactory, and I don't think an area for concern. Your feeling "lousy" is an area to be addressed aside from the OSA.

Agreed. However, today I feel almost like I did pre-CPAP, as I have for this whole week, week and a half. Earlier in the week, I had a nightmare like I've never had in my life. Something funky is going on in my "upstairs" and with my body. If it's not my OSA, then I'm glad! Still... gotta figure it out. In the immortal words of Johnny Five, "Malfunction! Need input!"

[Hawthorne]

Kenny - I was reading your symptoms and may be way off base but I would feel badly if I did not mention what I thought as I read.

The swollen lymph nodes popped out at me and I thought - maybe the flu - H1N1 maybe.

I don't know. It may be that and other things are getting out of hand because of it.

I just don't want any possibilities to be missed.

[tattooyu]

Thanks, Hawthorne. I don't have any fever at all. These past couple of weeks I've been feeling like my body might be fighting something off. Then again, my friend's dad felt the same way I did and died of a massive heart attack a few days later. He was 60 and a smoker though.

[Autopapdude]

Thanks, Hawthorne. I don't have any fever at all. These past couple of weeks I've been feeling like my body might be fighting something off. Then again, my friend's dad felt the same way I did and died of a massive heart attack a few days later. He was 60 and a smoker though.

Dude, I am no shrink, but I think you're having somatic manifestations related to panic. This has happened to me before, and I think a lot of folks who have OSA are prone to similar things. If you take panic meds, you might want to consider using them PRN, and talking to a doctor so as to reassure yourself. Your reactions sound normal for someone who has 1) OSA, 2) Clinical Panic disorder, and 3) stress in his life. Check things out to make sure you are okay, but I doubt it is the Apnea, as the numbers aren't radically different. Sounds like some things are bugging you. I don't know if you see a therapist, but if you do, sounds like time to drop the dime to him/her.

[tattooyu]

You could be right. I went for a 25 minutes walk this afternoon, and now I'm feeling pressure right below my sternum. It is in fact freaking me out. I am taking Klonopin PRN currently, which usually works well. I'm considering taking something like BuSpar (buspirone) daily, which a lot of people seem to like since it's not addictive, doesn't create a tolerance and has no withdrawal when stopped. I tried one SSRI (Celexa), which was absolutely awful; not sure I'd try one of those again.

[Muse-Inc]

...have my thyroid checked as well...

Not sure if it'll apply to you or not, read up on low iodine (not great blood tests, there is a 24-hr urine catch but it's questionable). If you're like many, you don't eat a lot of salt or processed food or fish or seaweed -- all good sources of iodine. I read The Heart Scan Blog http://heartscanblog.blogspot.com/ where cardiologist Davis discusses it (amongst other heart related topics) and what happens to your lipids as TSH rises...interesting reading. After reading lots and watching my TSH rise to 5.5 (I've been complaining that my thyroid's wonky again since last fall, so docs ever listen?), I started taking Iodoral about 6 wks ago; at the same time, my primary finally put me on levothyroxine which I have to fail before he'll put on me on Armour *sigh*. Worth reading about and seeing if it might apply.