[Diagnosis] Good therapy at first, till the migraine came back

[SuperOuss]

Hi all,

Thank you all for the help you provide on this forum, that's a great source for information.

I was diagnosed with severe sleep apnea (30 Apnea events/hour) I started APAP therapy a month and a half ago with a Prisma smart machine.

At first, it was amazing, I was always at less than 5AHI/h, and I felt great during the day.  (min 4cmH20 - Max 12cmH20)

Two weeks ago, I started having morning migraines again, I changed the minimum pressure to 5cmH20, I felt better but still a bit of fatigue.

I've attached the signal report from last night (I use Lowenstein's proprietary software), some obstruction events don't trigger a pressure surge.

I've also attached my heart rate report from last night.

[SuperOuss]

Hey,

A bit of an update.

I turned EPR off, and I set the minimum pressure on 6 HPa, there has been a some improvement, but I still have a lot of RERA events and I wake up a lot during the night. If you have any advice on how I can improve my therapy, I'll be grateful.

[Sleepster]

It looks like you have a lot of what they call "obstructions" even though the number of obstructive apneas is low. I'm guessing that by "obstructions" they mean what other manufacturers call flow limitation.

Note that obstructive apneas aren't the only thing that causes pressure jumps. Flow limitation, judged somehow by the shape of the flow rate graph, can also do it.

I can't tell for sure if you're using ramp, but if you are try turning that off.

I would also turn the EPR back on to its maximum setting and also raise the minimum pressure some more.

[SuperOuss]

Thank you for your answer, I updated the settings with your recommendations. Will keep you posted on the therapy results.

[Sleepster]

Keep in mind that to get reliable feedback from your data you need to keep the settings the same for several days. It's okay to make a tweak if you want, just keep in mind that you need a several-day trend after that to be able to make any reliable judgments.

[bballkj7]

For the migraines: My doctor said Estrogen has proven to make them worse, and on the contrary, taking magnesium helps ( over 50% of people with migraines are deficient, and a higher percentage are helped by magnesium)

I recommend 500mg magnesium citrate a day. Cheap, low side effects if any (like a mild laxitive effect, you can start low if you're worried). It helped my apnea migraines, especially the throbbing ones that happen the day after a bad nights's sleep.

Look up the studies. magnesium is a no brainer if you have migraines. It helped me.

[SuperOuss]

Thank you both for your help, much appreciated.

I used to take magnesium every night, but never long enough to see if it helps. I'll get back to it.

I turned EPR back on. The issue I have with EPR is that it makes my mask move due to the pressure differential. The mask movement wakes me up at night (It took like 10 days at first for me get used to the movement).

I'll turn it on again and see how it evolves. Thank you again for the help