Possible Cheyne Stokes?

[mu50256]

I am having severe sleep issues.  My sleep patterns are incredibly messed up.  I am up all night and sleeping all day.  Some days I barely get any actual sleep no matter how hard I try.  I have tried things like melatonin, magnesium, etc.  My doctor prescribed trazadone and I am still barely getting any actual sleep.  I am in a constant state of exhaustion.  I get confused easily.  I have light headed spells.  I've always had sleep issues, but this is the worst I've ever been. 

I have severe GERD so I am supposed to sleep with my head elevated.  I have an adjustable bed.  I was doing that, but till having issues with potential positional apnea so I have lowered it to where I am only slightly elevated.  It's a catch 22.  I do get more reflux symptoms at night, but my AHI and O2 improved a bit.  I did try a cervical collar, but I found it to be incredibly uncomfortable and I had a harder time falling asleep so I am not using it.

This week has been especially bad.  I have not slept much at all.  I went to bed at 3:00 a.m. last night, but did not fall asleep until nearly 1:00 this afternoon.  When I plugged my card in, I see this breathing pattern throughout my sleep that has me concerned.  Please see attachments. 

I use the Wellvue O2 Insight Pro watch, but I have found inconsistencies with it so I don't fully trust the numbers.  Sometimes it will say my 02 has dropped drastically while I am awake and watching TV.  

Last night I had lowest O2 of 82 and a high O2 of 105.  I had 1 minute and 36 seconds under 90%.   For a while my O2 wasn't dropping below 90 and my AHI was staying below 5.  I don't know why this week has been so bad.  My AHI has been between 5 and 10.  My O2 is dropping into the 80's every night.  My sleep is very fractured.  I wake up a lot throughout my sleep.  

Does this sleep pattern look like Cheyne Stokes?  It was mentioned on my last sleep study that I do have severe sleep apnea with fractured sleep and decreased slow wave sleep and I never reached Stage 4 or REM sleep.  It was pretty bad.  I am on Auto settings, but my prescribed settings are 17 ipap/10 epap. 

Thanks. 

   
   
   

[Jay51]

IMO it isn't Cheyne Stokes.  Why?  Several clues.  1.  Doesn't look like classic CSR with crescendo- decrescendo symmetrical pattern - like some tennis balls or footballs connected by a string.  2.  No CA's involved.  CA's have to be involved in the chain for it to be real CSR.  3.  You have a H right before this, and a cluster of H's right after this.  4.  Your flow limitations rise in almost perfect unison with your breathing pattern.  

Looks like you had a hypopnea.  Cleared your airway a little bit, but not completely.  Then, the airway begins to get more compromised as the H cluster starts.  You only have 4 CA's in the chart.  And all happen way after this particular event (and in the "Sleep-Wake Junk" portion of a chart - beginning and ending). 

I hope this helps.

[Dormeo]

I agree that that isn't CS breathing. It was a period of unstable breathing with repeated arousals followed by a dwindling flow rate. Not restful, but not CS.

Have you looked into cognitive behavioral therapy for insomnia (CBTi)? There's more information here:

https://www.sleepfoundation.org/insomnia...y-insomnia

Yes, you're in a Catch-22 with the GERD and the apnea. I wonder whether your collar was the right size and fit. There's some information that might help you here:

https://www.apneaboard.com/wiki/index.ph...cal_Collar

The next time you post a chart, would you include one that covers the whole night, for context? And would you close the calendar and the pie chart and provide the following graphs in one screenshot:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.