41m Cheyne Stokes headaches and acid reflux

Hello,

Thanks for looking at my charts and this wonderful data I did not know existed. Im 41 male non-smoker overall healthy apart from this apnea.

I have been using the Airsense Resmed since 2017 nightly with most AHI usually sitting around 5 (which i was told was generally good anything under 5) I was diagnosed at AHI 22 and some other details (I can grab the original study for that information and post also). I have changed the pressures over the years trying to find a better setting but stayed in the prescription threshold for the most part. I did try some other settings also over the years to test.

Recently I have been waking up with headache, acid reflux like and fatigue. I decided to take a look and found this forum along with sleepyhead software. I have posted the last 2 Fridays along with the yearly statistics to see if anyone with more experience has any ideas? I also upload Aug 30 that had no CSR statistics


I am also scheduled for an appointment in November but hoping someone may have any suggestions also prior to the appt.

IMGUR Links:

https://imgur.com/a/XarOeS0

Thanks again for any suggestions or even looking at my statistics.

There's some mess there, but need SleepHq to take a look. Open a free account, load your data there and post the link back here. July 30 looks like a good place to start.

Thank you for taking the time to respond.

Here is the uploaded data:

https://sleephq.com/public/d180bfbd-6a3 ... fe0ea8a1e1


Note: Im not sure why Aug 1 to Aug 17 is missing data. I wear the CPAP everyday for 5 years. Let me know if there are more dataes etc needed.

Here is 1 year also

https://sleephq.com/public/463535e7-130 ... 0e51d7f488


Looks like high leak rate so i have tightened the mask straps. Sometimes i tighten it and its too tight which hurts my neck/head. I also have tried many different masks. I have the amara view full mask, phillips gel, the dreamport nasal. I keep coming back to the f20 foam because of the comfort. Willing to try any

Sorry, I need to ne more clear.

We (I) need the complete data from individual nights, and post July 30th first.

Gotcha:

July 30:
https://sleephq.com/public/5e8d17ab-047 ... 79b721de8a

31:
https://sleephq.com/public/315143f7-d30 ... 05fe827eea

Hopefully this is what is needed. Sorry im new to all this data

Do you take any medications of any kind? Even OTC? If so, what are they? Names and dosage please.

Are you waking frequently during the night or sleeping soundly for the most part?

Any other physical or mental health issues that might be impacting sleep quality?

No medications, nothing OTC. No drugs or alcohol. Until recently I felt like I was sleeping all night but recently (within last month or so) Ive felt like I wake up with acid reflux and sometimes headaches. Thats when I started looking for more information. I was under the impression that AHI under or around 5 was/is the best outcome using CPAP so I never thought to look further until I found my original script from the sleep study. Those had reports of alot of centrals but the person noted that they felt like those were "obstructive in nature" Im male 41 225lbs 6'3. play softball in league and walk regularly.

I can provide the original sleep study if needed. The clinic has since shut down and the DR retired.

When i was a kid 7-8 I had my tonsils and adnoids removed because my mom said i would hold my breath and then gasp/release breath so she was worried. Im not sure at the time if cpap was a thing but i think i have had this my whole life

I did a very quick and cursory look at a those 2 reports on SleepHQ.
I am sorry but I don't have all that much time right now (family stuff) to really dig deep in those reports but from a quick glance the bulk of your flagged events appear to be post arousal....meaning for most of them you weren't sound asleep when they were flagged.

In other words the bulk of your flagged events may be symptoms of poor sleep quality rather than the cause of the poor sleep quality. Now why the frequent evidence of arousal breathing???? Million dollar question and we can't get the answer definitively from the data the machine offers.

I frequently see such arousal breathing evidence but then I already know my sleep quality isn't the greatest but it has nothing to do with my sleep apnea nor treatment. I have other health issues that mess with my sleep.

Figuring out the cause of the arousals and subsequent fixing of that cause......not an easy thing to get done.
I am still working on fixing mine and it's hit or miss (mostly miss) but to fix any problem we have to first identify the problem. Sometimes I win and sometimes the crappy sleep wins. And I know the cause.

Honestly i appreciate you even looking at this data. Could that be switching from left side to right side sleeping and i just dont remember? I know if i sleep on my back i have major events so i try to stay on my side. Thanks again

rizzo wrote: ↑

Mon Aug 21, 2023 12:35 pm

Could that be switching from left side to right side sleeping and i just dont remember?

Entirely possible. When we have arousals we don't always remember them when they are very brief but they still happen and we can see it on the flow rate graphs.

I have a few examples in this thread.
viewtopic/t186231/Examplesmouth-breathi ... gging.html
I call these post arousal flagged events as "false positives". A while back I had an AHI of 9.4....sounds horrible doesn't it but 90% of that AHI was false positive post arousal flagged events. I slept horribly that night and I wasn't surprised when I saw that AHI and looked further to see all the post arousal breathing stuff. I was a stupid old woman who did WAY too much in her garden one day and paid the price with lots of back/pelvic pain that night and I tossed and turned all night long and I remembered the tossing and turning. I have a hard enough problem with pain issues disturbing sleep without doing something stupid and making it worse.

When I don't sleep long enough or soundly enough I get headaches and feel like crap.
Wonder if your acid reflux is affecting your sleep quality much???? Wouldn't be impossible for it to be a factor.

Can you post the results of the sleep study?

Do you have a SleepHQ night with a nasal mask?

Can you post the SleepHQ of 2/26/23?

There's a LOT of flow limitation that the algorithm doesn't feel like scoring.

There's a significant amount of central stuff that is similarly ignored.

There's a huge amount of what appears to be palatal interference of both inhalation and exhalation:



IIWY I'd see a good ENT guy for evaluation and possible solutions.

That said, perhaps a pressure challenge and/or EPR might be thrown at it to see if it responds.

This is looks like sleep-transition stuff:



Fall asleep, subtle respiratory event, arousal from sleep:

Because of the associated FL, this a probably a REAR:

"Ideal" settings are affected by sleep stage, body position and sleep continuity, but this makes you wonder if <9.0 creates issues:



Grossly anyway, this sorta makes the case against APAP.

That said, all those pressure changes need to be looked at to figure out what was happening.

For example, here's a change from 7.0 cmH2O to 9.0 cmH2O:



There's some FL/palatal interference which the machine might have opted to address, but didn't (that's OK, probably right decision). Rather, it waited till arousal occurred and you threw a couple of central apneas (it says OA, but they're not. They're CAs) which should not have received a pressure increase, but did.

This is like, WTF man:

Ill post the original sleep study when I get home. I have not used the dreamport nasal or the phillips nasal in over a year because my mouth would come open and the air would blast out. I did try the mouth tape but didnt like the idea of closing it off.

Ive added 2-26 from sleepyhead:

https://imgur.com/a/XarOeS0


https://sleephq.com/public/abe60f5f-a32 ... 9ce045a98a


SleepHQ says i cant go that far back under the free account so ill look into costs for upgrade

Edit: Im kinda scared by the WTF comment