Advice please: central/obstructive question

[chief900]

Hi Guys,

I have just checked through my history here and it looks like I have been on the CPAP for almost 3 years. I looked at one of my earlier posts and I asked "how long until i'm normal", but the question has arisen for me again. So after the initiation of my therapy my life has been a bit of a roller-coaster and I considered that the therapy was almost optimised and I concentrated on dealing with other stressful aspects of my life (the root of these problems have been because of tiredness and lack of motivation". Anyway I have muddled through and find myself in a stage of my life with less stress. It gave me time to think about my therapy so i give you the quick background below.

1) Without the CPAP I feel super tired, my conclusion is that it must be helping to some extent.
2) I do, however, still feel tired and every morning do not feel refreshed in anyway. Its troublesome starting to move and I still lack motivation. (i have a regular sleep pattern, 9 hrs or so)
3) My AHI index is around 1.5 most days. I am aware that this is in the normal range.
4) Most of my apnoea are now central, often for more than 30 seconds.

Some other details: I don't drink or smoke, i am fit and not overweight, and exercise regularly.

So my question is, seeing as I don't feel rested in the morning, Is it possible that my central apnoea need to be addressed? Without CPAP i feel terrible so its doing something, however, do I need to take a step to deal with the central ones?

Has anyone been in this situation and could maybe offer some advice?

Many thanks in advance

Bob

[Pugsy]

I don't think that the doctors would do anything about centrals even if all your AHI was central and if all of the centrals were real centrals. Never minding that some of those centrals probably are normal centrals anyway. We all have them from time to time. Sleep onset centrals are normal.

Sometimes the machine flags awake/semi awake breathing irregularities as "centrals". In a sleep lab they wouldn't be counted.

I think you would need to see 5 per hour or more before they would start getting excited about the presence of a few centrals.

Now as to why not feeling rested in the AM?? We like to blame all our problems on sleep apnea and expect the machine to fix them but sometimes it isn't sleep apnea that is to blame.

What does your flow limitation graph look like? Can you post an image of a typical night's report?
Is your sleep fragmented by a lot of wake ups for some reason or other?
How many hours of sleep are you getting on average?
Take any meds even OTC stuff?
General health issues...thyroid...Vitamin D levels...blood pressure (and/or meds for bp)...etc?
Pain?
Bed comfort?
Trouble falling asleep or staying asleep?
And the list goes on....

[CactusRoper]

I believe that I have the same problem as you. I had CA’s and OA’s, which have responded very favorably to my only sleeping on my side. Once I started sleeping only on my side, most nights I have zero CA’s and OA’s. My AHI is always less that two and these are due to hypopnea’s, flow limitations and variable snores. My problem is PLMD and I have a very many of them each night. The result of this is that I am not able to reach REM sleep very often and am tired during the day.

There is a dearth of studies relating on how to treat this problem and almost all of the studies of this malady have been done on individuals with both PLMD and RLS. They have had some success with using Ropinirole, I was on this drug for about one month and stopped taking it as I was not seeing any benefits and also there have not been any long term studies as to the possible negative effects of taking a dopaminergic drug. There has been one very small study of that involved patients with PLMD and without RLS, which is my case. They were given 3 mg of Melatonin a night and seven of the nine patients demonstrated a significant reduction in movement.

I have started on this regime two nights ago , so I do not know whether this is going to help me or not.

The biggest problem I have is not being able to measure my PLM. I don’t want to have a sleep study every month, and this simple country boy can not afford the over $3000 for a machine that will measure PLM, so I am in the process of setting up a camera do take time lapse video so I can see if the Melatonin can ameliorate my problem.

[chiefs]

Thanks for the replies.

I generally have good sleep hygene, no blood pressure or any other of the problems you mentioned. Maybe my bed is not tip top comfy, but that would be it. What I will do is get a reading of a typical nights sleep. Unfortunately my card reader is not handy at the moment so it will be a few days. Would be good to know more about what else is bothering my sleep.

I will report back once I have the information.

Thanks

[Sir NoddinOff]

What does your flow limitation graph look like? Can you post an image of a typical night's report?
Is your sleep fragmented by a lot of wake ups for some reason or other?
How many hours of sleep are you getting on average?
Take any meds even OTC stuff?
General health issues...thyroid...Vitamin D levels...blood pressure (and/or meds for bp)...etc?
Pain?
Bed comfort?
Trouble falling asleep or staying asleep?
And the list goes on....

I agree with all of the above issue. These things can be complicated. Please use Photobucket or whatever photo hosting site you like to put some waveform images up for people to examine. As I recall Pugsy has all that info in her signature line.