High Centrals, Bad Sleep Quality, Next Steps?

Hello my friends:

I've posted before, all in varying states of sleeplessness. Things have improved with your support, and with the support of a sleep tech that met with me once a week to help debug. I can now at least sleep with my CPAP on for a full night (between 6 and 9 hours). I settled on an AirSense P30i mask - the nasal pillows. It hurts my nostrils something fierce, but it's better than the alternatives that I've experimented with (including the cushions, which do not form a seal properly). I have heard whispers of a more comfortable now-discontinued Resperonics gel mask, but have yet to chase that down. Anyone have any experience with that?

Anyway, to the matter at hand. When I left off with my sleep tech, she mentioned that I should seek out my sleep doctor again. My sleep doctor is not super helpful. Mostly he just wants to get off the phone. Its a shame. He viewed my data and said that most of my apneas were non-obstructive, and that treatment had therefore been effective and that he was no longer needed. The trouble is that my sleep quality has only marginally improved, and I'm still mostly having light sleep with dreams that indicates that I am not really fully going into deep sleep. I fantasize about what an score of 5 might feel like. At least my wife does not have to hear me snore anymore.

Your help interpreting my OSCAR data, and suggesting next steps to getting my score down would be kindly appreciated. I'm at a bit of a loss.

Your sleep doctor is a jerk. Can you find another one?

A few questions: What medications do you take? Do you live at a high altitude? Do you have any pulmonary problems that you know of?

I take a fairly large dosage of an SSRI called Sertraline, 150mg, and a chaser drug called Buspirone, which amplifies the effect. I have PTSD. I don't live at high altitude or have respiratory problems that I know of!

Working on finding a new sleep doctor, but wait times in the years..

You most likely need a different machine that can deal with the centrals because your current machine cannot treat centrals or prevent them.

So you also need a new doctor since your current doctor is an idiot and apparently doesn't understand that central apneas can be dealt with but not with your current machine. Just because someone isn't having a truck load of obstructive apneas doesn't mean that there isn't an apnea problem.
I also wonder about those hyponeas....I wonder if they are more central in nature or if they are obstructive in nature.

There isn't any sort of setting available on your current machine that will be much help with those centrals and after 2 years it's a pretty safe assumption that they won't go away with time.

If you do live at altitude (common cause for some central apneas) you might try going down to a lower altitude and see if the centrals reduce at all.
If you already live at a lower altitude then we can't blame your centrals on altitude.

BTW both your medications mess with overall sleep quality especially REM stage sleep.
Look up the side effects.
I understand why you take them but they come with some hefty baggage affecting both sleep and how you feel during the day.

Also...you can dream in any sleep stage and it isn't limited to just REM stage.

Got it. Is it necessary to engage another doctor before I go the route of tracking down a BiPAP (is that it?)? Well aware that these drugs mess with my sleep, and the baggage of side effects that comes with it is much preferable to the underlying illness. I suspect I'll be on this medication for the rest of my life. So, I must adapt.

sleepmouse wrote: ↑

Fri Jan 03, 2025 5:17 pm

Is it necessary to engage another doctor before I go the route of tracking down a BiPAP (is that it?)?

You most likely need a very special kind of Bilevel (bipap) machine called an ASV bilevel machine and yes...you most likely need another doctor to get it done and a doctor that is familiar with using those special machines for central apneas.

I don't advise trying to DIY this yourself without input from a doctor who knows what they are doing.

sleepmouse wrote: ↑

Fri Jan 03, 2025 5:17 pm

I suspect I'll be on this medication for the rest of my life.

There is some hope. Sleep apnea is know to cause major depression and anxiety.

“Snorting, gasping or stopping breathing while asleep was associated with nearly all depression symptoms, including feeling hopeless and feeling like a failure,”

https://aasm.org/cdc-study-forges-link- ... eep-apnea/

Of course, sleep apnea needs to be well controlled.

Alright let's see what the private medical system can do for me. Hm.

Thank you! The PTSD is well treated.