New to BPAP and very anxious/concerned about 02 drops and Central Events

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 9:07 pm

To those that can help,

I have attached a couple of images of some resent reports from my therapy sessions and have been growing very concerned about the Central Events and the drop to 78% oxygen experienced on a particularly bad night. I am hoping someone here can provide me some relief as I suffer from pretty severe health anxiety and this new road from being diagnosed with Sleep Apnea on an in lab sleep study has really got me down.

Things were going well as I was using the Dreamstation Auto CPAP, but have changed to the Resmed AirCurve 10 Vauto. I asked for the change because the continuous pressure was really bothering me and for the last few weeks I have been feeling very bloated and "breathless" having to frequently take deep breaths during the day and what not. Not sure if this is aerophagia, but something definitely seems off. I was diagnosed on the sleep study with 22.6 AHI mostly Obstructive with very few Central events. But since I have switched machines I have clocked in 20-49 events central events on a couple of nights and am SUPER worried I am going to die in my sleep or something. I am 36, I am in pretty good physical health all things considered. I dont have high blood pressure, recent ECHO was all clear, recent Pulmonary Angiogram all clear, etc. I am sure my anxiety is playing a part in some of this mission for me, but I was hoping someone could bring me up to speed and let me know if these readings are seriously bad and what not.

I have a hard time getting in touch with my sleep doc and am growing desperate for some peace of mind that if I truly am developing Central Sleep Apnea, that I can manage it and live a good life. I know this is a lot, but I have been watching my children every day for the last few weeks wondering how much time I have left with them and my wife. I am currently working out every day and my daily 02 levels stay good between 96-99%. I am also on Zoloft for anxiety which I have recently started about two weeks ago. I also have functional Dyspepsia, if that means anything to anyone. Anyway. Maybe I can get some help on tweaking my device to good settings to try and get rid of the central events along with some positive reinforcment that if I truly do have central sleep apnea, it is NOT a death sentence.

Thanks and best Regards!

Pugsy · Post by **Pugsy** » Sun Jun 20, 2021 9:39 pm

Calm down. Take a deep breath. I know this is scary but trust me....this is nothing compared to what it could be.
This person has real central sleep apnea...and he is still alive and kicking even with some congestive heart failure contributions.
And this was one of his "good" nights...he had some much, much worse than this...like AHI of 40 something and all centrals.

For now...some questions about your sleep quality.
Any chance you were awake when the cluster of centrals were flagged?
Any other meds besides the zoloft?
Are you waking often during the night?
Can you import your pulse ox data into the OSCAR software? Can't tell if the drops in O2 levels correspond to the clusters of events or not from these pictures. Any chance the pulse ox device lost some contact...came loose? Which device are you using?

Assuming you were sound asleep when the centrals were flagged...
Try limiting IPAP max to 10 and lets see if you get many centrals...sometimes pressures over a certain amount will trigger centrals.
Then if that doesn't help lets try reducing PS and see if that does anything.

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 9:52 pm

PUGSY,

Here are some answers to your questions.

Any chance you were awake when the cluster of centrals were flagged? I am not completely sure if I was awake to be honest. My wife says our daughter woke up and I asked if everything was ok, I don't quite remember. My daughter had a rough night that night 6-19-21. She is 3.

Any other meds besides the zoloft? I have been taking a very low dose of lorazepam occasionally, .5mg - 1mg but if I ever take it, I don't take it right before bed. Usually it is mid day to control panic attacks/anxiety or about 2-3 hours before bed.

Are you waking often during the night? I don't feel as though I am waking often during the night. I feel like I am getting at least 5-6 hours where I don't wake up, but I have waxed and waned with my use of CPAP/BPAP and have struggled with different masks over the last few months. Diagnosed January this year, used Dreamstation up until June 11th.

Can you import your pulse ox data into the OSCAR software? Can't tell if the drops in O2 levels correspond to the clusters of events or not from these pictures. Any chance the pulse ox device lost some contact...came loose? Which device are you using? I am using the Wellue02RING and no way it came loose. It fits on my finger very snug. IT seems when I zoom into the data from the Wellue02Ring app, it is pretty close in correlation to the Central events, but it doesn't seem to want to link up to OSCAR. I have tried a few different times.

Pugsy · Post by **Pugsy** » Sun Jun 20, 2021 10:10 pm

I don't think the Wellue device is OSCAR compatible. Too bad.

Normal O2 drops aren't as sudden and recovery isn't so abrupt unless they are lost of contact artifacts...so while your desats don't look entirely normal...they don't look entirely abnormal either. Makes it hard to know for sure if the desats are real for one thing and the other thing is if they are real...are they related to the centrals or not.

At any rate...it hurts nothing to assume that they might be real and there are a few things we can try to see if we get lucky and reduce the number of centrals.

Limiting the pressure is one thing....reducing pressure support (difference between inhale and exhale) is another thing.
It's really about all we can do with this machine.

Are you in the USA? In the US docs don't get too worked up over centrals until they see higher central index and they see ugly clusters all night long....or a sizable chunk of the night.

I assume you didn't have much of a mention as to centrals during the diagnostic sleep study without cpap?

You probably should take a crash course in figuring out if you were asleep or not. The centrals could be arousal related and you may or may not remember the arousal.
http://freecpapadvice.com/sleepyhead-free-software
If you weren't asleep they don't count.

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 10:53 pm

Pugsy,

Thank you so much for taking the time to reply to me so quick. I have been very worried and concerned. I set my IPAP to 10 and my EPAP to 4 and my PS to 3. I will give that a shot. Yes, I am in the US and my overnight sleep study without cpap didnt reveal Central Apnea at all. I think in 6-7 hours of sleep I had 9 total central events and my doctor said that is nothing to be alarmed about. My AHI was 22.6 with my lowest 02 dropping to 86%, but my average oxygen has always stayed pretty high 95-98% during sleep, even with the Wellue02RIng.

In your honest opinion, if this was Central Apnea or the beginning of treatment emergent central apnea, is this something that can be controlled for the long haul. Like do you think I can live a normal life with central sleep apnea as far as lifespan. I know that I am in for a modification in sleeping habits and effort to overcome these issues with therapy and what not, but as far as lifespan, I can live a long life right?

Thanks again.

Pugsy · Post by **Pugsy** » Sun Jun 20, 2021 11:03 pm

Yes...even if this were the beginnings of central apnea for any reason...it can be dealt with and actually fairly easily.
People with much, much worse very real central apnea can easily have it taken care of.
I know this seems really bad from your perspective....but it really isn't. Take a deep breath.....you aren't going to croak anytime soon..at least due to this stuff.

Put that worry aside. If you were my son (I am old enough to be your mom) I would be telling you the exact same thing..

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 11:09 pm

Pugsy,

Thank you so much for the positive advice and the kind words. I am trying to deal with this and get through the treatment but with all the stress in my life right now, it has been a big adjustment. I am going to try the new settings i sent to you and see what happens. I believe I have an appointment with my sleep doc in a week or two so, hopefully I can get some better results. Thank you so much. Any advice is MUCH appreciated!

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 11:18 pm

Pugsy,

This is a closer look at last nights events 6-19-21. This is what the pattern looked like. Not sure if this gives you a better impression or not to provide any more detail on if I should be worried.

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 11:21 pm

If you look at the time on the bottom of the 02 readings.....the drops occured within the same time as the central events. Both between :42 - :56

BoostedSoop · Post by **BoostedSoop** » Sun Jun 20, 2021 11:26 pm

This is a closer look at the central clusters from 6-14-21, but I dont have corresponding 02 reading from that night as the sensor is relatively new and didnt have it on for that nights therapy.

Pugsy · Post by **Pugsy** » Mon Jun 21, 2021 12:12 am

There may be some unstable breathing going on but it's not Cheyne Stokes Respiration which is the big one we worry about.
Some of the flags look real asleep and a few look more like arousals which doesn't surprise me because the event itself could cause an arousal.

Let's see the centrals happen with the pressure limited.
For years we thought that the 10 cm line was where centrals could be triggered. Actually they can be triggered at any pressure but for some people...10 is the magic line...or above 10.
We have now learned more about what can trigger centrals and there is more to it but it hurts nothing to try simple and easy first.
Limit the pressure.
If that doesn't work we reduce or turn off EPR (pressure support).
If that doesn't work then we do what the docs say....give it time.
Because....sometimes the centrals will go away or reduce on their own with consistent cpap use given a bit of time.
If that doesn't work you talk to your doctor about just how much of a problem this is and what your options might be.
It's normal to have a few centrals....but if you are having enough to be a problem and we can't reduce them to a non problem level there are machines that will deal with centrals and obstructives and all you need is a different machine.

Right now...it's not proven that they are a problem and your insurance wouldn't pay for that very expensive machine until you have exhausted all other options anyway...so that's what we are doing now....ruling out options.

GrumpyHere · Post by **GrumpyHere** » Mon Jun 21, 2021 12:51 am

O2Ring's data can be imported into OSCAR.

With the usb cable use 02 Insights Pro from Wellue to download the data into your PC.
Then within Oscar you go to Data -> Import Viatom Data
http://www.apneaboard.com/forums/Thread ... car-Import

Alternatively with Android phone.
http://www.apneaboard.com/forums/Thread ... d-to-OSCAR

BoostedSoop · Post by **BoostedSoop** » Mon Jun 21, 2021 8:29 am

Thank you for the support on the 02 Ring Data transfer to OSCAR....i was able to figure it out this morning.

Miss Emerita · Post by **Miss Emerita** » Mon Jun 21, 2021 11:08 am

Just to echo one of Pugsy's points: treatment-induced central apnea often goes away on its own with time as the body adjusts to PAP treatment. That certainly happened for me. I think you'll see improvement with capping the max and/or lowering pressure support, plus additional improvement with time.

BoostedSoop · Post by **BoostedSoop** » Mon Jun 21, 2021 7:12 pm

Pugsy,

Last night I decided to use my dreamstation for some reason and my 02 went down to 74% at one point while falling asleep. I have been a WRECK all day worrying about my oxygen levels dropping into the 70s the last few nights and am terrified that I am simply not going to wake up. The last few weeks I have felt tons of bloating and an increased need to take deeper breaths pretty frequently during the day although my daily saturation stays above 95% for the whole day (actually never really below 97%). Can anyone give me some peace of mind that these lower levels of 02 drops aren't a death sentence or a reason to be scared to go to sleep. I feel helpless and am very worried. These drops seem to be happening right when I am falling asleep and then they seem to stabilize for the rest of the night. Please help. Im just looking for some peace of mind here. Thanks kindly for any advice.

New to BPAP and very anxious/concerned about 02 drops and Central Events

New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events

Re: New to BPAP and very anxious/concerned about 02 drops and Central Events