Mostly Centrals

[sheepless]

if you feel reasonably well, looking pretty darn good! I think you can safely consider that a 0.0 ahi night.

[Sleeprider]

Tidal volume is trending towards normal and events are controlled. Looks good.

[zzzzk]

Tidal volume is trending towards normal and events are controlled. Looks good.

Ok, thank you.  A couple of questions:
1.   How long does it take to recover from sleep apnea after it has been corrected?  For example, I feel better in the morning, but I still get very sleepy and tired late afternoon (I know my AHI has only been down 2 days...).  Also, I was much clearer in thought and speed before apnea.  Does that tend to come back?
2.  Can you recommend a book, pdf, etc., on how to read sleephead data, apnea terms, general knowledge of apnea, etc., so I can do some analyzing myself.  (I will still use you guys and am grateful).  I'm a computer guy, so it can be technical.  Thank you

[Sleeprider]

1. You're ahead of the curve. Time varies, but since you have been around a while I'm sure you have realistic expectations...2-days is not enough.

2. I have not written the book yet, but I did a lot of work to update the wiki started by Roby Sue: http://www.apneaboard.com/wiki/index.php...SleepyHead

[Apnea Infant]

1.   How long does it take to recover from sleep apnea after it has been corrected?  For example, I feel better in the morning, but I still get very sleepy and tired late afternoon (I know my AHI has only been down 2 days...).  Also, I was much clearer in thought and speed before apnea.  Does that tend to come back?

I have seen somewhere, probably on the internet, MRI images of the part of the brain controlling memory highlighted, pre CPAP and post CPAP therapy. After a period of about 6 months with therapy that part of the brain had increased in area which led to the conclusion that yes it does come back.

Personally my memory has improved as well but currently I could not say it is as good as 5 years ago probably as my sleep is still fragmented despite the success of PAP therapy. This is probably due to other health issues which I am trying to get to the bottom of with my doctor and other health consultants.

I believe it does take a bit of time to repay that sleep debt and for myself it came on by degrees which were imperceptible. I did not get that enlightenment on the road to Damascus which others had.

[zzzzk]

zzzzk, the charts show that your EPAP min is pretty good, with a median at 6.7 and 95% at 7.5.  The pressure support is active, and the maximum PS is probably being used to counter CA events.  Obviously you kept breathing and did not experience any pauses that counted as apnea, so obstruction is treated as well.  If you're comfortable with this, I don't see any need to change settings, and in time you will adapt to the pressure changes and sleep better.  I'm impressed with the tidal volume, and expect that it should reduce to a more normal level for you as you adapt.  Great start, and good luck as you continue.

I'm happy the apnea is corrected, but the lack of decent continuous sleep is killing me.  Any suggestions?  Attached are two screenshots, one show ahi, the other the broken sleep.  Suggestions?  Settings changes?  Thank you.

[Sleeprider]

I can't begin to guess why you break your sleep into five or more sessions followed by breaks of 10 minutes to 2+ hours. That is a sleep hygiene issue, not therapy. I think it would be helpful for you to focus on the problem as being the issue, rather than trying to tie it to PAP/ASV therapy.

[zzzzk]

I can't begin to guess why you break your sleep into five or more sessions followed by breaks of 10 minutes to 2+ hours.  That is a sleep hygiene issue, not therapy.  I think it would be helpful for you to focus on the problem as being the issue, rather than trying to tie it to PAP/ASV therapy.

Thank you, however, with the change in machine, I have the change in continuous sleep.  I may be wrong, but it seems to me there is a cause and effect.  While my old machines did not correct the central apnea, I did not have such an extreme cut in continuous sleep.  I also wake up usually only after an hour.  This has been the same for about 2 weeks, so it is definitely a pattern.  

I have a partial theory.  Now that my centrals are corrected, I wake up less exhausted, so I don't back to sleep as quickly.  

Also, what do you mean a "sleep hygiene issue"?  

Thank you for your help.

[sheepless]

if it's any consolation, all your events, all hypopnea, occurred at the beginning of sleep sessions so they were probably not real and you probably really had a 0.0 ahi!

as for the fragmented sleep: it's not hard to believe that years and years of untreated apnea leave us conditioned to wake up a lot. IDK how to overcome that except to hope it eases in time.

meanwhile, my intuition is that after treatment we may still be sensitive to respiratory and other sleep disturbances. apnea may no longer be waking us up but other disturbances might. Sleeprider knows a heck of a lot more than me but I do not subscribe to his belief that therapy can't help. even with low ahi's I continue to see residual ragged breathing, snores, flow limitations and 'mini' apneas (look like apnea but less than 10 seconds). maybe periodic leg movement or palatal collapse, too. I have been slowly increasing my min epap to try to resolve residual disordered breathing. with this comes more leaks and aerophagia. on the plus side, lately I believe I'm getting incremental but visible reductions in these residual non-apnea respiratory 'events'. in addition, I'm starting to see an increase in my max sleep duration from about 1.5 hours to more frequent 2 and even 3+ hour sessions. not near enough yet but I'm hoping it's a trend.

I totally sympathize with how debilitating fragmented sleep is. sleep hygiene is probably the first and easiest thing to work on. scroll through the last few minutes of each of your sleep sessions to see if anything that might cause an arousal jumps out. keep a journal about what's going on each time you awake. maybe same with regard to daily activities like naps and medications and what you eat and drink. maybe like Apnea Infant, there are other health issues in play. take the complaint to your GP to test for and rule out things they think might affect sleep.

I wish I had a better answer, for both our sakes, but I wish you good luck in finding a way to sleep through the night.

[zzzzk]

if it's any consolation, all your events, all hypopnea, occurred at the beginning of sleep sessions so they were probably not real and you probably really had a 0.0 ahi!  

as for the fragmented sleep: it's not hard to believe that years and years of untreated apnea leave us conditioned to wake up a lot.  IDK how to overcome that except to hope it eases in time.  

meanwhile, my intuition is that after treatment we may still be sensitive to respiratory and other sleep disturbances.  apnea may no longer be waking us up but other disturbances might.  Sleeprider knows a heck of a lot more than me but I do not subscribe to his belief that therapy can't help.  even with low ahi's I continue to see residual ragged breathing, snores, flow limitations and 'mini' apneas (look like apnea but less than 10 seconds).  maybe periodic leg movement or palatal collapse, too.  I have been slowly increasing my min epap to try to resolve residual disordered breathing.  with this comes more leaks and aerophagia.  on the plus side, lately I believe I'm getting incremental but visible reductions in these residual non-apnea respiratory 'events'.  in addition, I'm starting to see an increase in my max sleep duration from about 1.5 hours to more frequent 2 and even 3+ hour sessions. not near enough yet but I'm hoping it's a trend.  

I totally sympathize with how debilitating fragmented sleep is.  sleep hygiene is probably the first and easiest thing to work on.  scroll through the last few minutes of each of your sleep sessions to see if anything that might cause an arousal jumps out.  keep a journal about what's going on each time you awake.  maybe same with regard to daily activities like naps and medications and what you eat and drink.  maybe like Apnea Infant, there are other health issues in play.  take the complaint to your GP to test for and rule out things they think might affect sleep.  

I wish I had a better answer, for both our sakes, but I wish you good luck in finding a way to sleep through the night.

Thank you for your insights.  Yes, I agree, it concerns me that there has been damage done for so many years left untreated properly.  (the tech is new, anyway).  I look at other people who are treated for apnea and their breathing, etc., looks perfectly in rhythm on the graph...  Mine still does not...  I'll let you know if anything makes it improve.

Also, you said "I have been slowly increasing my min epap"  what increments are you using?  What is your current level?  I'll compare with mine...