New Rx effects on overall sleep

[Beej]

I started a new Rx on November 30 and have been gradually increasing the dose per the instructions. It has a really long half life (the amount of time it takes for half the drug to be metabolized out of the body).

Looking at this graph, I believe I am seeing a slight increase in AHI. And I'm wondering if I should up the pressure to compensate for it.

[chill]

I find that the summary graphs are mostly good for pointing out when you should take a closer look at the daily ones. Try comparing recent nights with ones before you started the medication. Are you now bumping up against your top pressure? It kind of looks like it, but it is hard to tell. If so, raising the pressure should help. You probably want to bump your minimum too, so it does not have too far to run. Also take a look and see if flow limitations or snores have increased and if the OA/H/CA ratio is changing. Post some comparative daily graphs for comment.

[Sleeprider]

Obstructive events seem to be increased in the week after you started the new medication. A small increase in pressure should bring it back. What medication? BTW, good work with the summary graphs. I think you're reading the trend correctly.

[Beej]

I find that the summary graphs are mostly good for pointing out when you should take a closer look at the daily ones. ...

Exactly. Which is why I check the overview. I also tossed it into Excel and a 2nd degree trend line seems to fit the data. The Rx is lamogitrine and is used for epilepsy, bipolar disorder, and migraines with lots of aura (which I have, sans headache). You have to start low on the dose (25 mg) and increase gradually, so the liver can adjust to breaking it down. I'm up to 50 mg and going to 100 after week 4 is complete, though I think I'll ask about going to 75 mg first, as I'm beginning to have issues with insomnia. I'm also trying to figure out the best timing. I was taking it at bedtime until the insomnia hit; now I'm moving the time earlier to see if I can optimize the effects. Otherwise, I may have to stop the Rx, as sleep deprivation can be as detrimental as sleep apnea!

Also here are graphs of before getting heavily into the Rx and after a tad more than 3 weeks.
12/06/2016

12/21/2016

[chill]

Yep, looks like more pressure needed. I have ocular migraines too, they suck. Fortunately mine are not frequent enough to warrant medication. Hopefully the insomnia will go away after you adjust. Earlier this year I had a bad few weeks from starting some anti-depressants. I slept better after a month or so. I sure do miss being young and healthy!

[Beej]

My migraines usually consist of visual scotomas and gray outs. Over the last 6 years, though, I've had 2 serious attacks of vertigo where I went to the ER. They are currently identified as vestibular migraines, hence the lamotrigine. I'm fortunate that I don't get the headache which many migraine sufferers have.

I'll take the top pressure up to 12 cm and raise the lower pressure to 9 cm.

[chill]

This is what I get, also happily without any pain.
https://en.wikipedia.org/wiki/Scotoma#/m...cotoma.gif

[Beej]

Mine don't seem to be as thick lines. One time, it was as if a bucket of water had been splashed over the world and all the colors fuzzed into each other. I was functionally blind for nearly an hour.

Fortunately, my visual scotoma tend to be smaller and fairly short duration. The vertigo attacks vary in duration - the first one was 24+ hours, although they discharged me from the ER before 24 (after 24 hours, they admit you at Ohio State med center). The last one was perhaps 7-8 hours.

Another question: if you continue increasing the pressure, is there a point at which it makes the obstructive apneas worse? (last night the AHI went up to 9.91!)

[chill]

I don't think it will make the obstructive apneas worse, but it might cause you to have pressure-induced central apneas. If you did not sleep as well with the higher pressure that might also just be sleep/wake junk. When my AHI jumps around, I look in SH to see if I can correlate the events with when I think I was not soundly asleep.

[Beej]

Last night, I fell asleep pretty quickly and didn't get out of bed. I may have woken once in the night, maybe 4-ish, and went back to sleep. I almost never remember dreams and was not aware of any wakefulness.

This is what it looked like.

No snoring to speak of, just tons of OA.