Which Therapy - CPAP or APAP Best Prevents Palpitations?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
ewriter
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Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ewriter » Fri Feb 03, 2023 2:08 pm

Hi,

I am not new to CPAP or APAP. I have used a Respironics machine (CPAP) for 12 years and, when that machine started having issues ("Call Support Displayed), I bought a ResMEd Aire10 AUtoset For Her. I have an issue with a "flutter". I have had some success (6 hours of sleep) using the Autoset in CPAP mode. But the success has not been perfect -- For the past month, I was unable to get more than a few hours' sleep on several ocassions. On Jan 25th, however, in CPAP mode using the AutoSet, I got 6 hours of reasonable sleep; and the "flutter" was not intense. However, I am not getting that at the moment and have had to start taking a sedative to help me sleep.

My greatest problem is the anxiety relating to the "flutter," which I am having investigated. Can anyone on this board help me understand which therapy (APAP or CPAP) is best for eliminating palpitations/flutter and/or preventing arrhythmias?

I have read that these therapies can actually reverse remodelling of the heart.

Any advice would be greatly appreciated!

Note: i am working with my family doctor but she doesn't have sleep medicine experience and here in Ontario it can take weeks to get a specialist referral and a Titration study. If anyone can name a private for-pay clinic that I can go to where they will do a sleep study right away and give me the results quickly, I would be extremely grateful!

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ChicagoGranny
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ChicagoGranny » Fri Feb 03, 2023 2:28 pm

ewriter wrote:
Fri Feb 03, 2023 2:08 pm
Can anyone on this board help me understand which therapy (APAP or CPAP) is best for eliminating palpitations/flutter and/or preventing arrhythmias?
Short answer: The therapy mode that treats your breathing and is comfortable enough to allow you to sleep restfully.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306230/

Are you using OSCAR or SleepHQ?

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chunkyfrog
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by chunkyfrog » Fri Feb 03, 2023 11:47 pm

If your palpitations are severe, call your doctor.
You may need a referral to a cardiologist.
If it is your heart, you need to get things rolling before it is too late.

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Miss Emerita
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by Miss Emerita » Sat Feb 04, 2023 11:02 am

Oh gosh, see a cardiologist! Or at the very least, see if your regular doctor will agree to have your heart monitored 24/7 for a period of days or weeks. A Holter monitor is annoying to use but does the job. Zio monitors are simpler to use.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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ChicagoGranny
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ChicagoGranny » Sat Feb 04, 2023 12:40 pm

ewriter wrote:
Fri Feb 03, 2023 2:08 pm

My greatest problem is the anxiety relating to the "flutter," which I am having investigated.

It seems she is already working with a doctor on the "heart" issue.

ewriter
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ewriter » Sat Feb 04, 2023 5:59 pm

Hi all,

Thanks for the informative feedback; especially for the encouraging article on sleep-apnea and arrhythmias. I hope others may contribute more.

I have seen improvement in my sleep after taking Seroquel (prescribed by the psychiatrist my doctor sent me to for anxiety relating to the "flutter").

Has anyone else on this Board experienced anything similar? How did you get rid of the problem?

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chunkyfrog
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by chunkyfrog » Sat Feb 04, 2023 7:24 pm

I used to wake up with palpitations.
Then I started cpap.
They were gone right away.
I wonder if your settings are still correct . . .

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ewriter
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ewriter » Sat Feb 04, 2023 8:59 pm

Hi,
That's great to hear. My problem is that i have to wait for a referral from my family doctor (who has no Sleep Medicine expertise) to see a Sleep Disorder Specialist and take a Sleep Study; it takes weeks to get this done and get the results. When i have the results, i can then set my CPAP or APAP to the correct settings. This is no way to build optimal health by getting prompt advice and treatment; but that's what we have in Ontario, Canada. In other countries like Singapore, private care is available around the corner. I am wondering if I should just use APAP and let the machine auto-titrate?

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ChicagoGranny
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ChicagoGranny » Sun Feb 05, 2023 6:01 am

ewriter wrote:
Sat Feb 04, 2023 8:59 pm
it takes weeks to get this done and get the results. When i have the results, i can then set my CPAP or APAP to the correct settings.
Most of the regular members of this forum find their own optimal settings and totally control their therapy. You can do a better optimization than your sleep professionals. You are going to be using CPAP for many years. It's best to look out for your own interests instead of relying on a doctor, even in Singapore.
ewriter wrote:
Sat Feb 04, 2023 8:59 pm
I am wondering if I should just use APAP and let the machine auto-titrate?
Read the first two announcements at the top of the index page. OSCAR (or SleepHQ for the less computer-minded) is the number one tool for patient-optimization of CPAP settings. You can fine-tune your machine settings better than a doctor. APAP settings of minimum pressure 7.0/maximum pressure 20.0 is a good place to start with the optimization process.

As you proceed, please stick to this one thread so that people helping you can easily see your history.

BTW, Gramps reminded me he had a little "heartbeat skipping" when he was under physical stress. After he started CPAP, this ended.

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Miss Emerita
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by Miss Emerita » Sun Feb 05, 2023 11:37 am

Is it the flutter or the anxiety that you're having investigated?

Great advice from Chicago Granny! You can find your optimal settings by using Oscar or Sleep HQ and posting your chart here. There are people with a lot of experience who can advise you about the changes you might want to try.

You have an excellent machine, by the way.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

ewriter
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ewriter » Sun Feb 05, 2023 4:14 pm

Hi,

Thanks for the helpful feedback. Attached are the latest dataset. I have highlighted two results (Insp Time, Resp Time and Minute Vent) which seems to show I had a 40-minute period of low breathing (but I might be reading this incorrectly); the Insp Time is almost flat, vs the Resp Rate and Minute Vent. What does this imply?

I ran a cardiac stress test about a week ago and was only able to get to level 4 and a heart rate of 133 for a few minutes, before I got winded. Are my settings for the CPAP optimal?

I am thinking of switching to the APAP mode but I was using CPAP at 12.5-13 for most of the nine years between 2011-2020 and then the Aire10 at Autoset for Her for the next three years (set at Autoset for Her and, more recently, on CPAP mode as I was having trouble breathing on the Autoset (probably because i may have set the EPR value too low e.g. 1 vs 3).

Any suggestions?

https://imgur.com/a/97BSizx

Thanks!

Paul
Last edited by ewriter on Sun Feb 05, 2023 8:05 pm, edited 2 times in total.

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ChicagoGranny
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ChicagoGranny » Sun Feb 05, 2023 5:47 pm

You forgot to post the screenshot. Please use the format specified - wiki/index.php/Oscar:organize

You may upload the screenshot to your account at imgur.com.

ewriter
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ewriter » Sun Feb 05, 2023 9:03 pm

Hi Chicago Granny,

I have added the link. Please could you have a look?

I highlighted two sections that look "unusual" but I don't know if they are or not.

Thanks for your help I appreciate it very much!

Paul

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ChicagoGranny
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ChicagoGranny » Mon Feb 06, 2023 7:40 am

Can you use the format in the wiki? At first post, we only need to see, in this order,

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limit

In your case, add the Respiratory Rate.

At first glance, I would guess you were awake during the highlighted period. But I would like to see the reformatted graph.

It would appear you had some beautiful sleep early in the night and then again late morning.

ewriter
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Re: Which Therapy - CPAP or APAP Best Prevents Palpitations?

Post by ewriter » Mon Feb 06, 2023 2:59 pm

Hi Chicago Granny,

Thanks for the reply. It appears you could be right: I am woken up in the middle of my sleep and it takes awhile to get back to sleep.

What i am concerned about is the long pauses (some appear to be 1 minute long) in the following charts:

https://imgur.com/a/ANzH81r


I don't know if I am reading these wrong? How can you have an OSA of 90 seconds? Does that mean I "stopped breathing" (or had a very low breathing rate) for 90 seconds? Or is it something else?