sleepmba wrote:... Do you ever try adjusting your pressure? Bumping the EPAP up may provide some interesting data. ...
I do both know how to adjust it and have in the past. I ended up at the same point that my titration reached. Higher does not seem to change this issue. It really does seem to be tied to stress in my life. I've talked this one through with my neurologist. My DME had set the EPAP pressure too low. But with it set to the titration value, it seems to do "okay" most of the time. But those "bad" nights are all too predictable. Under stress (of any sort), my body seems to conspire to make things worse. And I do mean
ANY sort of stress.
If I go see a movie with a lot of action scenes, I can barely walk out of the theater. Or if I travel via air (and thus have to deal with an airport). Or if I am at some sporting event. Or if I have a particularly bad day at work. Or if I have to go to an office and sit in the "hub ub" all day long. Or if... Problems that surface include problems with balance, coordination, speech, and vision. Balance is an inability to stand upright without falling over. I need to hold only things / use a walking staff to help orient myself. Coordination includes tremors, and things like the inability to reach for a door knob without feeling as if I had too much to drink. Speech issues include slurred speech. I'm often challenged at airports. Flight attendants think I had too much to drink. I have to explain that I have a neurological issue. It's one reason I use a medic alert bracelet. And vision is my most frustrating. My eyes start to jump around. It literally becomes hard for me to see things clearly. Under normal conditions (with no real stress) my eye (I only see out of one eye) with glasses should be correctable to 20/20. But due to nystagmus (due to the other eye having a scar at the focal point), it used to be correctable to 20/35. Unfortunately, due to increased neurological issues it can now only be corrected to 20/50. Oh, and a new trick is problems focusing my eye. As you might guess, due to all of this, I no longer drive.
Those are pretty standard conditions. When I am under stress, I start to develop problems with maintaining my O2 levels during the day and then have LOTS of central apneas at night. Trust me, this is a LOT of fun. I would not wish it on anyone.
So, I wish a bump of the EPAP would work. That would be a great thing. Instead I try to manage as best as possible. As I mentioned earlier, my neurologist cautioned me that involvement of the brain stem tends to cause ongoing sleep issues that are not easily treated.