Mild apnea/UARS/ASV (CPAP triggers centrals)

Yeah... I do know that it excludes CSA, but just kinda looking broadly around at my options and if my centrals are mild enough.

I was looking at my flow rate graph and compared it against a video you had sent earlier about interpreting sleepyhead and it doesn't appear to be CO2 buildup since it's very abruptly that I stop breathing. Central/complex apnea would make some sense if it's a genetic trait -my brother has similar symptoms with his sleep and general well-being but doesn't snore at all.

ophiuchus wrote: ↑

Mon Feb 21, 2022 10:35 am

would a device like the iNap suit me

For a quick experiment, I suggest you pick up a boil and bite mouthguard just to see whether you can even sleep with a mouthpiece.

I didn't buy the iNap because I wound up spitting out their mouthpiece.
Mouth taping may have prevented the spitting. But I didn't know about that option at the time.

Wearing it, I remembered wakeup events whereas I wasn't remembering wakeups without the appliance.

When I tried it, the trial period (~$60 for disposables) was only 2 weeks -> purchase for $2k+

Now they have a up to 3 month trial @$84/month -> purchase.

I actually gave up after one week so I probably didn't give the device a fair chance.
But I think even the 2 weeks wouldn't been enough time to see whether I could have acclimated.

YMMV

Bon Courage!

Sleep study company was basically a bust in the sense that my primary physician doesn’t specialize in sleep and the sleep physician offered a really basic interpretation of my results and I never got to see any data. Got diagnosed with mild OSA at 5.2 AI with 9 obstructives, 5 hypopneas, 14 centrals and 154 RERA in total with a 29/hr RDI.

I can’t help but feel like the obstructives are the least of my worries… but I’m just digging back into researching things. Conclusion of my results is with a 5.2 AI they don’t recommend cpap use or a sleep aid

So when did you have the sleep study?
And did you happen to stop cpap 3 or 4 nights before having the sleep study?

ophiuchus wrote: ↑

Tue Mar 22, 2022 8:07 am

154 RERA in total with a 29/hr RDI.

Now this statistic...it's worth looking at more closely.

Pugsy wrote: ↑

Tue Mar 22, 2022 8:21 am

So when did you have the sleep study?
And did you happen to stop cpap 3 or 4 nights before having the sleep study?

ophiuchus wrote: ↑

Tue Mar 22, 2022 8:07 am

154 RERA in total with a 29/hr RDI.

Now this statistic...it's worth looking at more closely.

That’s the one that I can’t help but notice, conclusion/diagnosis on the paper completely ignores it -though at least it mentions it in a different section.

I was off the cpap machine for a week+ and this study was about 17 days ago. Just got my results today but the sleep physician only just looked at results yesterday.

Good that you were off the cpap for a bit prior to the sleep study just in case there was any hold over effect causing the not so exciting AHI.

Now the RERA numbers .... Now bear in mind that I can't say for sure that this means UARS but it is where my mind goes to when I see those numbers and the other numbers aren't all that exciting. Upper Airway Resistance Syndrome. Google and start reading....
For a concrete diagnosis a sleep study done with the Pes device is needed and not a lot of place do that.

Here's the deal though...cpap is usually first line of defense in trying to deal with UARS but you can't really get much help from the data the cpap machine will give you. It was never designed for the subtle stuff that UARS brings.

Oh...meant to ask....any mention as to spontaneous arousal numbers on that report?

2 kinds of arousals...spontaneous which means we don't know what caused them
and Respiratory related (those RERAs) which means airway problems caused them

Pugsy wrote: ↑

Tue Mar 22, 2022 9:14 am

Oh...meant to ask....any mention as to spontaneous arousal numbers on that report?

2 kinds of arousals...spontaneous which means we don't know what caused them
and Respiratory related (those RERAs) which means airway problems caused them

“…23 arousals were associated with respiratory events…and 54 spontaneous for an arousal index of 17.7/hr.”

I can strike personal data from the report and share it if that’s allowed. Still trying to wake up so I’m not firing on all cylinders with interpreting it myself, thinking I might have to call around to find a sleep specialist out of my area for a professional’s insight since this is literally the only sleep medicine location near me and I can’t speak to their physician.

Did a bit of forum research and experimented with EPR to... Pretty poor results honestly. Finally found a sleep doc locally that I'm seeing tomorrow.

I need advice…ENT gave me a clean bill of health throat/nose wise but said my RERA’s are concerning and I should see a sleep doc. Sleep doc told me that RERA’s aren’t a concern and don’t effect a person’s sleep significantly, my ahi is so low that she doesn’t recommend a cpap since it can cause me central apnea’s. She recommended Modafinil for daytime tiredness and to just continue on as is or see a psych about a stimulant.

I’m kinda at the end of my rope here, I feel awful.

ophiuchus wrote: ↑

Thu Mar 31, 2022 11:45 am

Sleep doc told me that RERA’s aren’t a concern and don’t effect a person’s sleep significantly,

So, being waked up and having bad sleep doesn't affect sleep 'significantly'?

ophiuchus wrote: ↑

Thu Mar 31, 2022 11:45 am

my ahi is so low that she doesn’t recommend a cpap since it can cause me central apnea’s.

It's *possible* in a low percentage of people, but that's a *STUPID* reason not to treat breathing disorders.

Your sleep doctor is incompetent.

First time seeing her, only one in town. Arguing logistics of being awakened several times an hour only got me a passive aggressive after visit summary reiterating the importance of AHI as the only important factor.

ophiuchus wrote: ↑

Thu Mar 31, 2022 12:18 pm

Arguing logistics of being awakened several times an hour only got me a passive aggressive after visit summary reiterating the importance of AHI as the only important factor.

AHI doesn't mean squat except the OSA is well taken care of.
There's a lot more to getting and feeling good sleep quality besides apnea events though.

I am a prime case in point....always have had stellar AHI numbers but still felt like crap and slept like crap because of other health issues unrelated to apnea.

Lots of people have crappy sleep quality and feel like crap and don't even have airway issues to blame it on.
That's why the "get sleep" industry is a multi billion dollar industry because people everywhere have sleep problems besides OSA.

I don't know what to tell you except keep looking for a doctor that isn't so lazy and quick to pooh pooh you off.
Look up UARS Upper Airway Resistance Syndrome. It comes with a lot of RERAs and not all that remarkable AHI numbers. Now I don't know that is what you have but it is possible. Unfortunately the go to treatment for UARS is cpap and it does seem like cpap may be an issue with you and the central apneas.
You are going to need someone who can think outside the box to maybe help you.
Not a lazy doctor who pooh poohs your complaints off and won't listen.

Further talking with the sleep specialist got me to where she didn't recommend, but could order the other half of the sleep study in the form of a CPAP titration, would really only help me out if I respond to BIPAP or BIPAP ST without centrals as they don't trial ASV in lab. Looking around at other options and doctors near me (to no avail so far) that at least use RDI as a scale and acknowledge UARS if that is what I could be suffering with.

I know that they're kinda frowned upon to OSA sufferers, but in the case of this being a mild apnea with borderline obstruction causing lots of wakeups with little drop in O2 I also set up a couple of free consultations for alternative therapies such as a MAD, the iNAP and ExciteOSA. Sucky thing there is that my quality of sleep improvement would be subjective since I'd have no data, but on paper they really only help with a mild apnea and by my understanding UARS is 'mild' in obstruction and could see improvement despite the impact it has on sleep.

Still feeling things out. Probably going to resell my Autoset or try flashing the BIPAP firmware if I can't find a doc, not like it cost me all that much in the first place.

Haven’t really had any luck with finding a sleep doc with my insurance, probably going to have to go out of pocket and settle with telemedicine and just base my treatment off my current results. Been having some really awful nights of sleep lately that seem to be taking a big toll on my day-to-day and working memory.

I’m in the middle of titrating out the iNap device since the trial wasn’t too expensive, but at stock settings (for which I need another prescription to adjust the pressure) it just makes my sleeping worse by blocking off my mouth. At the very least they’ve offered me some advice on telehealth providers if their treatment doesn’t work out.

Are ASV and Bipap all that different when it comes to treatment? Read some conflicting info that says that bipap or bipap/st can actually serve some people better than ASV in certain circumstances. Will probably end up flipping my CPAP and seeing how far towards another device I can get.