New user looking for input on data

[Jmack91]

I’m a 30 yo active male diet and gym regularly. 6 ft 180 no known health issues diagnosed with an ahi 30.9. I have absolutely no idea how to interpret my first few nights worth of data and if I should be worried with the csr. If anyone with knowledge could weigh in would be much appreciated thanks.

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Sorry I cannot figure out how to post more than one picture at a time

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Let me know if anything else is needed

[Jmack91]

Also would like to add I do take methadone daily and understand that could have effects.

[Jmack91]

Adding these of the csr these might be a better view.

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Sorry for all the extra posts to add screen shots I cannot add more than photo to my replies?

[Brazen]

Did you have a full in-lab sleep study?
Do you have the results?  Post if you have, minus any identifying details.
Any central apnea noted in your sleep study?
Do you have other medical conditions besides OSA?

The cpap machines sometimes flag rhythmic breathing as CSR.

Check out the links in my signature about how to post your OSCAR charts.

[Jmack91]

Thanks for the reply . I only had the watchpat one home study. Can it catch centrals ? If it does they never mentioned I had any the results they sent don’t show that much detail. I can post what they do show it’s mostly ahi,rdi,saturation,pulse,time in sleep stages. Saturation and pulse were in good range but ahi was 30.9 and rdi 34.8. If I have any health condition I’m unaware . My step father is my family Dr and see him a few times a year nothing has ever come up in tests or blood work. I take the methadone from a different doctor for non pain reasons.

[Brazen]

I doubt the accuracy of the WatchPAT studies as they are not nearly as comprehensive as an in-lab polysomnography. 
But, I do think the WatchPAT was able to record enough data to suggest the need for a full polysomnography.  Talk to your doctor about ordering one.

Methadone can effect your body's respiratory drive. I.e: reduces the signal from your brain that tells you to take a breath.
That respiratory drive is the difference between central and obstructive apnea. In obstructive apnea there is an airway obstruction preventing air getting into the lungs - central is a lack of signal from the brain.
Methadone can also increase airway resistance. 

It is common for new cpap users to experience central apnea because the machine clears more CO2 then that body has gotten used to so the signal to the brain is slower to react.  No way to know if that's your case or the Methadone effect without a full sleep study.

It might also be worth discussing alternatives to the methadone with your doctor. It's likely significantly affecting your sleep breathing.

[quiescence at last]

I did a brief review of methadone and its effects on the central nervous system (CNS) and I could not find anything that suggested that methadone is a CNS depressant, unlike opioid usage. I see no reason to believe the apneas scored as CA in your chart were caused by suppression of the normal CNS feedback. Also, I looked at the breathing before and after each CA and believe mostly these were occurring during sleep. we often advise that "sleep wake junk (SWJ)" or transitioning from wake to sleep and sleep to wake can sometimes kick off a few CAs but that those can be discounted as far as sleep apnea is concerned.

In your case, most of the CAs are internal to sleep periods, and therefore may be related to your body's attempts to control CO2 levels in your lungs, and that feedback feature is overreacting and then alternately taking too long to trigger the breaths. So, you over-breathe for 5 or 6 breaths, and then under-breathe (or stop breathing) for maybe 6 to 10 breaths worth - cycling back and forth.

rarely, on this forum, is the positive effect of rebreathing and CO2 retention spoken of. But, i think you could ask your "family" doctor to weigh in on an approach to increase volume of breathed air. Have him or your helpful researcher check studies on controlling or resetting "CO2 apneic threshold." Have them search for "CO2 apneic threshold NIH" which will filter out those sites which may be pseudo-science guru sites.

QAL

[Brazen]

Qal is definitely more experienced than me at reading and interpreting OSCAR charts and I would never discount their recommendations.

But, there is research suggesting a connection between methadone and sleep disordered breathing, specifically central apnea. Methadone is an opioid, and of course effects are dose dependent. 

https://pubmed.ncbi.nlm.nih.gov/16162728/

https://www.ncbi.nlm.nih.gov/pmc/article...po=1.02041


Just my 2 cents that it's something worth discussing with your doctor.

[Jmack91]

Appreciate the replies I will speak with my doctor about it . My number of centrals seem to go way down if I took a lower dose that day or my dose was taken early morning . Lowering or switching might be the next step. Thanks