Sleep aid & Apap?

Ambien is not harmless it's simply more tolerated than other medications and has a low physical dependency. For some Ambien is a total nightmare but that's the exception and not the rule. Only you can say if its working or not or if the side effects are worth the benefit or not.

So are there major risks to trying it? Doubtful if the doctor prescribed it and knows your history. Ambiens main complaints are related to its effect on memory mostly. If you drink and then take Ambien expect memory issues such as not remembering what happened before you went to sleep. For some this is very unsettling. Some users of Ambien have this problem even without alcohol. Do some research online and you will notice some mentioning "Ambien sex". For some this may be a huge problem. Many woman reporting having sex with no memory of the act in the morning. For the lucky its a long time partner telling them about the previous night but for the unfortunate they wake up next to someone they had no intention of having sex with. More disturbing is a lot of men online report the positives of this side effect either in their partner or worse in people they just wanted to have sex with. Men brag online of sexual activities with their wife that normally the wife would never do but on Ambien they do it and they have no memory of it. If you are going to use Ambien I would follow the directions to a tee. Make sure you are going to bed when taking it and have 8 hours of dedicated time for sleep, never drive and avoid alcohol. Make sure you trust who you share your bed with. I know this sounds like common sense but you know young people these days!

As far as dependency consider this. Most people here will tell you the best part of Ambien is its not habit forming and then post links to others on how to get off Ambien. This should tell you that in fact there is a dependency issue, if not you could just stop and long time users would not need a program to quit. More accurately you will not die if you suddenly stop taking the drug but dependency as most see it is referring to it being "habit forming". Ambien does the same type of dirty work as benzos without the chemical dependency which is true but the brain still compensates for this GABA blocking drug so when you stop you may have more trouble sleeping then you did before taking the drug. Because of this you may feel dependent on the drug to sleep. However if you are going to take a sleep aid over long periods of time Ambien is usually the safest bet. Coming off Ambien for me was very easy, coming off of tamazepam was a nightmare.

I have taken almost every sleep med there is and I agree Ambien seems to be one of the safest of the bunch but to paint the picture its harmless is not true. It has its risks and people tolerate it differently. In my personal experience it had unwanted sexual side effects so I stopped taking it. I would not be so worried trying Ambien but make sure you are in bed within 15 minutes of taking it and tell the doctor of any complaints you may have about the drug. Most people tolerate Ambien well and since it has little or no chemical dependency issues its the drug of choice for doctors to hand out. Tamazepam is far better at putting you to sleep and keeping you asleep but is very risky for chemical dependency (I would know).

In short you should use any drug with caution but Ambien is quite mild when comparing with other sleep aids on the market.

Giving me the scoop, or trying to scare me to death...

kaiya2465 wrote:Giving me the scoop, or trying to scare me to death...

I want that sexual side effect. 59 years old, menopausal with a husband who is gone all the time.
Why can't I ever have any side effects like that? Zero side effects. I lead a dull and boring life.

Mine says he likes that idea, At least I'll be with the right person if that side effect hits. I hope I remember to update this in the morning.

Well I feel like I went through the wringer last night...Don't know how to get the sleep I need, but it won't be with Ambien.

Call the sleep doc's office and let them know that the Ambien is not working for you and that you HAVE been taking it every night (if you've been taking it every night) for however many nights you've taken it. And that your AHI remains high according to the machine. And that you are feeling really lousy and are at your wits' end. Then ask the receptionist for a call back from the doc, a nurse or a PA as soon as one is available.

Since you are leery of sleep medicine to begin with, be sure to mention this to doc, nurse, or PA when you get a chance to talk with them. They may still push pills your way. But at least they will know you are not particularly happy about it. And so they'll be more likely to talk about a broader based approach to dealing with the insomnia including both some CBT as well as the sleep meds.

In light of the elevated AHI (which could be contributing to the insomnia) you may want to ask about a trial run on an APAP. Or at least a brief two week period of autotitration to see if the machine's 90% or 95% pressure level is significantly different than the titrated pressure that came out of your sleep study.

I am on Apap now, Ahi is still @ 7, leak is 3.0, & pressure is now @ range 9 - 12. Pressure may be going up to 10 low range number.

kaiya2465 wrote:leak is 3.0,

Please confirm leak. Where is decimal point?

S8 machines report leak in L/sec. The line in the sand for this model machine is 0.4 L/sec. to get this to see how it compares with the 24 L/min where Resmed says all bets are off..we multiply by 60 seconds to get L/min.
As with S9 machines the S8 machines report excess leak because it subtracts vent rate before reporting.

It is the 95th percentile that is 3.0 I have no clue if that is good or bad. Sure wish I knew what I was doing.

kaiya2465 wrote:It is the 95th percentile that is 3.0 I have no clue if that is good or bad. Sure wish I knew what I was doing.

Is that 3.0 off the machine's LCD? Or is it in ResScan?

As Pugsy points out the units are critical.

If that 3.0 is the 95% off the machine's LCD, it represents 3.0 L/sec, which is VERY, VERY, VERY BAD since leak above 0.4 L/sec is BAD on the S8 models.

If that 3.0 is coming from the ResScan software, it's important to look for the UNITS by the number (or on the y-axis of the graph. Do the units say L/min or L/sec.

Note: the conversion between the two units is based directly on the conversion between minutes and seconds. Since 60 seconds = 1 minute, we have:

1.0 L/sec = 60 L/min

So if that 3.0 figure is a L/sec figure coming off the S8 LCD, you have a 95% unintentional leak rate in L/min computed as follows:

3.0 L/sec = 3 * (1.0 L/sec) = 3 * (60 L/min) = 180 L/min

And Resmed says all bets are off as far as quality of treatment and accuracy of AHI data when there are leaks AT or ABOVE 24 L/min for any length of time. Note: 24 L/min = (24/60) L/sec = 0.4 L/sec. So you really want that S8 LCD 95% leak rate number to be below 0.4 on a consistent basis if possible.

So kaiya, can you please clarify exactly from where you are getting that 3.0 leak rate number: The machine or the software?

Once I know where you're getting that number from, I'll try to dig up one of my old posts that explains 95% numbers for you.

The info I am putting on here now is from the machine itself Pressure range 9 - 12, leak is 0.0 l/min, Ahi is 9. I don't know what it all means, I guess that's why I am here... Sorry just learning how to get into everything & know have to figure how to interpret the data.

Kaiya doesn't have ResScan because she needs that darn card reader.

Leak off the machine shows 0.0 ???? that is L/sec and that is quite good. Leak of 3.0 that you previously mentioned is quite horrible.. to the point you might as well not even be using the machine.

AHI of 9....too high and high enough to be strongly messing with your sleep architecture even if you didn't have your other problems. That alone is enough to wake you up and mess with how you feel.

Does your machine show on the LCD screen a 95% pressure?

Sure wish we had software for you. Is there anyway you can get your DME to either use their card reader to get you a hard copy of the full detailed reports or let you trial a S9 Autoset so we can use the SD card to get the reports?

AHI of 9.... no leaks of huge proportions noted and APAP range of 9 to 12 ...without any additional data points to the pressures not preventing the events. Specifically the minimum of 9... it isn't enough to get to where it needs to go quickly enough.

Is there a breakdown available on screen as to the apneas and hyponeas hourly indexes?

kaiya2465 wrote:The info I am putting on here now is from the machine itself Pressure range 9 - 12, leak is 0.0 l/min, Ahi is 9. I don't know what it all means, I guess that's why I am here...

My understanding is that the leak number on the S8 (which you have in your signature) is in L/sec and NOT L/min.

Since you are using an S8, you've got that crappy "can't find a card reader for the proprietary card" problem so you can't easily download and read your data in Resscan yourself.

Since you are having so many problems all at the same time, it's worth asking the DME or the sleep docs office to download all the detailed data on the card and make some printouts for you of the detailed data. You won't have waveforms because you've got an S8. But the detailed data will still show whether your events are clustering together and what your unintentional leak line really looks like.

If your LCD leaks are bouncing around from 0.0 (good) to 3.0 (very bad on an S8 even though it's quite decent on an S9), you need to know when the leaking is happening so you can figure out what to do about it instead of just taking potshots at it in the dark.

I have asked my DME for some copies of the dl results which the last one was done on Sept. 13th, he stated that he would mail me the latest on. I also asked him if I sent the card to him if he wouls send that info to, but he said it was to soon...My DME in my opinion likes to be in control. Still waiting on a return call from the Dr..

Another question, don't remember if you mentioned it in your other posts so forgive me if you have and I missed or forgot.

Did any of your previous sleep studies ever mention central apneas?
With your history of brain injury makes me wonder.