Tips for improvement? Potentially Central Apnea?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
yeezuscrust
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Tips for improvement? Potentially Central Apnea?

Post by yeezuscrust » Sat Oct 16, 2021 4:28 pm

Hey all,

I'm new, so let me know if I am doing anything incorrectly here.

I did an at-home sleep study in August and the results implied severe apnea. I was sitting at about 35 AHI. I know, an actual sleep study and titration would be ideal, but unfortunately I do not have the means to do so right now.

I started using my CPAP about a month ago. I adapted to it fairly quickly except for leakage through the mouth. In the past few days I have been using a strap (head strap? mouth closer thing?) and have been seeing a lot more success. I still don't feel any improvements despite my AHI dropping. I know a lower AHI doesn't necessarily indicate success, or it could take time to feel better, but I am looking for advice from you, more knowledgable people, on how to improve. Is it possible that I have Central Apnea and need a BiPAP instead? That's what I'm getting from my charts. Unfortunately I need to make that decision shortly in order to get a refund and switch machines without paying for two.

Also! I have my EPR off and am using a Resmed N30i with my Resmed Airsense 10.

Let me know if you need anything else and thanks for your time!

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yeezuscrust
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Re: Tips for improvement? Potentially Central Apnea?

Post by yeezuscrust » Sat Oct 16, 2021 4:56 pm

More charts.

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Pugsy
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Re: Tips for improvement? Potentially Central Apnea?

Post by Pugsy » Sat Oct 16, 2021 5:48 pm

You aren't having enough centrals (even if all those flagged were for sure asleep centrals) to earn the central sleep apnea diagnosis.

Go here and watch the videos and take a crash course on identifying arousal/awake centrals from real asleep centrals.
http://freecpapadvice.com/sleepyhead-free-software
pay special attention to the bottom video

How's your sleep quality in general? Wake up during the night very often? Toss and turn a lot?
Takes any medications? If so what?
Exactly what symptoms are you having that you haven't seen any improvement on and want to see reduced?

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palerider
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Re: Tips for improvement? Potentially Central Apnea?

Post by palerider » Sat Oct 16, 2021 6:25 pm

yeezuscrust wrote:
Sat Oct 16, 2021 4:28 pm
I know, an actual sleep study and titration would be ideal,
Ideal for the profitability of the sleep lab... it's debatable whether it's ideal for the patient.
yeezuscrust wrote:
Sat Oct 16, 2021 4:28 pm
Is it possible that I have Central Apnea and need a BiPAP instead?
Nobody needs a "bipap", the company that makes those has recalled all of them.

I see no evidence that you have central apnea and need an ASV. A few (and what you have are a few) central apneas, quite possibly caused by the fact that your pressures are too low and your sleep is still disturbed.

I'm thinking you need a minimum closer to 13, just go ahead and set the max to 20 so it's out of the way, not that it looks like it'll ever get close to that.

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zonker
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Re: Tips for improvement? Potentially Central Apnea?

Post by zonker » Sat Oct 16, 2021 6:43 pm

palerider wrote:
Sat Oct 16, 2021 6:25 pm

Nobody needs a "bipap", the company that makes those has recalled all of them.

Image

to the OP: bipap is a model name for the philips resperonics version of a bilevel machine.
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yeezuscrust
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Re: Tips for improvement? Potentially Central Apnea?

Post by yeezuscrust » Sat Oct 16, 2021 6:57 pm

zonker wrote:
Sat Oct 16, 2021 6:43 pm
palerider wrote:
Sat Oct 16, 2021 6:25 pm

Nobody needs a "bipap", the company that makes those has recalled all of them.

Image

to the OP: bipap is a model name for the philips resperonics version of a bilevel machine.
Ooop. My bad. I'm new to this! But you know what I mean.

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Re: Tips for improvement? Potentially Central Apnea?

Post by yeezuscrust » Sat Oct 16, 2021 6:59 pm

Pugsy wrote:
Sat Oct 16, 2021 5:48 pm

How's your sleep quality in general? Wake up during the night very often? Toss and turn a lot?
Takes any medications? If so what?
Exactly what symptoms are you having that you haven't seen any improvement on and want to see reduced?
My sleep quality has never been well. I am an extremely light sleeper and I wake up at least once a night. Toss and turn a ton. I've been on Prozac for a few years, though my sleep was the same before it.

I just don't feel more rested than before. I still could sleep 12 hours if I let myself.

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Re: Tips for improvement? Potentially Central Apnea?

Post by yeezuscrust » Sat Oct 16, 2021 7:01 pm

palerider wrote:
Sat Oct 16, 2021 6:25 pm
yeezuscrust wrote:
Sat Oct 16, 2021 4:28 pm

I'm thinking you need a minimum closer to 13, just go ahead and set the max to 20 so it's out of the way, not that it looks like it'll ever get close to that.
Thanks! I'll try that out ASAP.

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Re: Tips for improvement? Potentially Central Apnea?

Post by palerider » Sat Oct 16, 2021 7:06 pm

yeezuscrust wrote:
Sat Oct 16, 2021 6:59 pm
Pugsy wrote:
Sat Oct 16, 2021 5:48 pm

How's your sleep quality in general? Wake up during the night very often? Toss and turn a lot?
Takes any medications? If so what?
Exactly what symptoms are you having that you haven't seen any improvement on and want to see reduced?
My sleep quality has never been well. I am an extremely light sleeper and I wake up at least once a night.
It's actually normal to wake up every 1.5-2 hours, or very almost wake up, but we normally just start another sleep cycle and don't remember the brief wakeup.

You may find that you wake up more with cpap, but you'll be sleeping better in between times, once it's adjusted optimally.

Also, sometimes the improvement sneaks up on you over time.

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Pugsy
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Re: Tips for improvement? Potentially Central Apnea?

Post by Pugsy » Sat Oct 16, 2021 7:32 pm

Read up on Prozac side effects....google it and look at multiple sources
here's one
https://www.drugs.com/prozac.html

Also google "SSRIs and sleep" and start reading. They are well known to mess with sleep stages particularly deep and REM sleep so that a person doesn't get all the needed percentages they need for the restorative powers of sleep to work its magic.
Prozac belongs to the drug classification group SSRI.... https://www.drugs.com/drug-class/ssri-a ... sants.html

From what I have read (and some very limited experience with SSRIs)...they tend to cause us to be "light sleepers"...wake easily and frequently during the night and we may or may not remember the awakening...but the awakening can still mess with the normal progression of the sleep stages that we need. It ends up causing a form of what we call sleep maintenance insomnia (google it as well).

Those awakenings could also be a factor in your centrals....either a false positive or simply causing more chances for a sleep onset central to happen and sleep onset centrals are normal.

Most mood medications come with these sort of side effects (what I call baggage) and we are obviously damned if we do and damned if we don't with some of this stuff. Something to maybe have a chat with your doctor about if you continue to have nice low numbers and don't seem to feel any better at all.

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