Woke up Gasping

[BrassCat]

Hello the Forum,

Woke up early this morning, gasping, feelings of suffocating, no fun. Ripped the mask off, it was restricting my hyperventilating.
5:30AM? somewhere around that. Took 5 minutes to recover. Checked Sleepyhead. Also order an CM-50D Plus oximeter.

A pattern is developing. I am increasing in CAs. OA and Hypops are low. Posting screenshots.

[BrassCat]

I am adding a zoomed daily for just before I woke up. Seems like if one does not have much flow rate, then probably has low oxygen level.
I see a strange anomaly in the pressure graph in the statistics screen on the last day charted. Does not seem to reflect anything shown on the daily screenshot. ??

Stan

[quiescence at last]

Yeah, nothing worse than a machine that wants to be "restricting my hyperventilating." I need to hyperventilate.

uh. actually that would not be a good thing. hyperventilating can reduce your blood oxygen, and also reduce your CO2. no fun.

not taking the time to review your past results, if I were having night time like this I would back off min EPAP to 12, IPAP max to 17, and PS min of 0 and PS max of 5, and do a test run.

question - was you was dreaming when you woke up gasping?

ha ha. hope for much better night tonite!

QAL

[BrassCat]

Hello QAL,

Thanks for the response. I do not remember dreaming last night, certainly not when I woke.
I guess this post is just too intense.

I sent my Primary Care doctor a copy of the screen shots. He is getting a copy of my records
from the pulmonologist. Last time I saw the pulmonologist he informed my blood oxygen had
gone to 79%, and the bi-pap was not going to fix it. My last visit to that clinic, I was assigned
to a respiratory therapist, who left my settings the same, the pulmonology doctor would not see me.
She told me there was no record in my charts about low blood oxygen.

I will be emailing these screen shots to the clinic.

Stan

[CB91710]

Respiration rate is all over the place.
Interesting that it increases during the "cleaner" portions of the graph, which then leads into the cluster of events, and a drop in rate.

Keep in mind that the brain triggers us to take a breath not due to the lack of oxygen, but due to the concentration of CO2. Hyperventilation will flush CO2, and at that point I would expect to see CA events as the brain attempts to normalize the O2/CO2 balance, just as excessive pressure can tend to trigger CA events.

Personally, my respiration rate is very consistently 10-14, and I'm about 50 pounds overweight with HBP.

[ajack]

just an observation....when on a cpap/apap the CA tend to be less without flex or pressure relief, same EPAP/IPAP. I think because BPAP has even a greater difference between EPAP and IPAP, there may be a bigger difference on CA

to me it looks like you were awake for the last half hour of your chart and is inconsistent with the rest of the night and most of the month

[BrassCat]

Hello ajack, I like that full face mask.

ajack wrote: "to me it looks like you were awake for the last half hour of your chart and is inconsistent with the rest of the night"

I was definitely asleep. I see clusters of CA++ like this at other times throughout the night. Other nights also, but perhaps not over a 20 minute period. It seems to be a regular occurrence during my sleeping.

I will look into Cflex.

Thanks, Stan

[ajack]

Most of the month your total isn't too bad, but if they are coming in clusters, like the chart you have posted. Have you been to a cardiologist/respiratory? I'd get to a doctor, who may organise a home overnight ecg etc

are you on an opiate pain med?

[BrassCat]

Hello ajack, thanks for the response. I see that most of my apneas are central now. I did my last sleep lab last December.

I had Tylenol 3 (has codeine) end of Feb or so, I can see its effects in sleep lab. But that was two sets about 5 days each. Two tooth removals and infection. None since then.

I am getting much more assertive in this. Saw a cardiologist last year, did a stress test, some kind of injected radiation guck and photos, then ultrasound. My heart is in good shape. Just did lung x-rays two months ago, lungs are good.

I can have an AHI of 10 and then an AHI of 10, and the effects on me from those two nights can be very different. AHI value does not take into account apnea duration. Nor does AHI take into account how apneas are spaced out during the night; clustered or well spread out. The clusters will drop my blood oxygen more. Sometimes I wake up in such a stupor, and I see those clusters in the prior night. I just purchased the recommended recording oximeter for sleepyhead. they are on sale and very discounted.

I just got my 4th apnea machine, a Dream Station Auto Bi-PaP. Perhaps it should have been DreamStation BiPAP AutoSV.

Hears to a better night's sleep. Don't hold your breath!

Stan

[CB91710]

Excellent point on the spacing.

My wife tends to have her events clustered very tightly over a 1-2 hour span, so while she might log 10 hours and show an AHI of 1.5, it's actually an AHI of closer to 7-15.
Have you run oximetry while this is happening?