[Symptoms] Heart rate, ICD and sleep

[edgnoj]

Because of heart failure (LVEF about 25%), I have a synchronization ICD.  It is set to a minimum heart rate of 60 beats per minute. My own heart rate is around 50 beats per minute. So the ICD is pacing continuously.

During sleep, the heart rate should drop below 60, but of course it won't because of the pacing.

My Huawei Smartwatch also indicates this by means of a lot of spikes in the transition area between light and deep sleep. Could this be the reason why it is so difficult for me to fall into deep sleep state? As soon as I feel that I am falling into deep sleep it is as if I am hitting a wall and bounce back to a lighter sleep state.

Could this have something to do with my ICD?

[Gideon]

Before looking at the ICD as a cause I would want to see your OSCAR charts and see if there is a respiratory cause.

[edgnoj]

No problem, here is an Oscar Chart of feb 5 and some breathing charts of that night.

By the way, I have regular panic attacks. Then wake up feeling like I'm suffocating. On Feb 05, I also had this at 06:02. On the Oscar Chart of that night I can't find out what causes this. The heart rhythm did shoot up a bit, but I can't discover anything about the breathing.

[Gideon]

Set the flow rate scale to +/-60 to get better resolution.
Nin pressure up.
Just before you had. Panic attack you had a flow limitations but that wouldn't cause that.

Assuming those are more or less representative you still have a significant number of flow limitations. Try bumping

[edgnoj]

Here is a chart with Flow Rate at 60-60.

I tried higher min-pressure before at 9.6 but that didn't do anything about the Flow Limits.

Flow Limits at 95 and 99.5% looking good I think?

And yes, those respiratories are more or less representative

[Gideon]

My preferred choice would be to try a higher EPR/PS.

Flow Limits are obstructive, your remaining choice is to increase you pressure.

Get a VAuto? But no guarantees there either.

[edgnoj]

Last night I increased the pressure from 7-12 to 9-12. See the Oscar chart for this and some snapshots of the Flow. Maybe it's a matter of getting used to, but my lungs feel a little tired now. It felt like my lungs were fighting the higher inhalation pressure. I don't know if that is a result of my heart failure and noted slight ventilation/perfusion mismatch or if I just need to get used to sleeping with higher pressure.

Further, I don't know in what ways higher pressure poses risks to my heart. What would be a maximum safe pressure in heart failure?

And my first question regarding the pacing of the icd and not dropping the heart rate in sleep? Is there anything to say about that?

By the way, I had a consultation with my primary care physician yesterday and he is going to try to get me further examined at a sleep expertise center. A clinic for complicated sleep problems. Maybe they can get me to try out a VAuto.