TOTAL MAYHEM - need help

[slimjim]

It's a good thought about the magnesium, but I'm not sure.  I take a multivitamin daily, so it's unlikely i am deficient.   Last night's data seems to indicate it is mostly a positional issue, although some clear airway apneas remain.  I have fewer eye twitches today than prior days, so the twitching seems to come from the clear airway apneas. Not sure why the cervical collar did not help

[SarcasticDave94]

According to OSCAR most events now are Central. I'd suggest turning Flex down from 2 to 1 or off for a night if possible. See if the CA drop down or to see how the CA respond to lowering of pressure swings. If you do try it and it's not comfortable, just return it to comfortable therapy settings.

[slimjim]

ok, i'll try it tonight.  Thank you

[slimjim]

Last night's summary.   Interestingly, I woke up after several hours and checked my AHI.  It was something like 0.50, perhaps the lowest I have ever seen.  Amazing!  This is with sleeping on my side, edge of the pillow, with the PS fixed at 3 and FLEX turned off. 

Then I  had some difficulty getting back to sleep.  The summary appears to show lots of Central apneas in the middle of the night.  I don't recall if I was actually on my side at these points during the night.  I may have actually been awake for some of this time.

It seems that sleeping position is most important for me, along with these minor adjustments to pressure support and Flex.

[SarcasticDave94]

Given that there's lots of centrals cluttered at the beginning of the latter 2 sleep sessions, this could have been equal or similar to sleep wake junk (SWJ). There could have been frequent shifting of position and breath holds, that type of thing. Just one possibility of other possible scenarios.

You'll have good and bad sleep sessions so this is somewhat par for the course. Just keep at it, I think you'll have some sleep debt to pay off, you're still getting used to therapy as well. I'm thinking not changing settings unless there's a comfort aspect needing addressed.

[slimjim]

Thank you.  Sounds like good advice. I agree, some could be "sleep wake junk" as you say.  I actually feel pretty good today.  My brain does not feel quite as foggy as usual.  By the way, I have heard this concept of "sleep debt" before.  What does it really mean and how can i tell whether i have "paid it off" ?   I have been on CPAP for over 3 years now...

[SarcasticDave94]

As I understand it, there's several factors involved. I'll use myself and you plug in your equivalent in the appropriate areas.

I'm making a guess because it wasn't medically tested as diagnosed for many years, even so I'm guessing I suffered from Apnea causing insomnia for possibly 15 years but maybe even longer. Some medical issues all crashed in at once August 2014. I had months of heart health tests but eventually it was decided by my PCP to go to a pulmonary and sleep doc, sleep study and CPAP issued in 2015 but I couldn't use as it's straight 18 pressure. 2016 was prep to get bariatric surgery to drop weight from 300 down to 200 within a year, but sleep wasn't good still. Moving through sleep studies for BPAP onto ASV in '17 where finally I started sleeping better with ASV. It took me about a month where I started feeling more rested, just noticable in the beginning and picking up better feeling in steps per week it seemed. Incorrect therapy or settings times do not help paying the sleep debt. It does count when you're on the right PAP machine and settings are good enough to get consistent decent feeling after sleep. Now debt is being repaid.

Due to complications in my ASV therapy where my diagnosis has changed, I'm not in PAP therapy and it's reverting back to undo the gains therapy had given. So there is a penalty if therapy stops.

So basics is you have to be on the right machine and settings that's giving consistent good therapy and rest. That's when you're paying the sleep debt back.

[slimjim]

Fascinating stuff. I remember reading somewhere that it is a misconception that we can "make up" for lack of sleep or bad sleep in the past, since one cannot "undo" the past but it is possible to try to return to normal by getting good sleep from hereon out. I've noticed very slight dark circles under my eyes in the past decade (since my sleep problems began) and I've always had a gut feeling that it should be able be undone if I get enough truly good long term sleep, but I think it could take months or years to reverse the dark circles.

[DaveL]

As I understand it, there's several factors involved. I'll use myself and you plug in your equivalent in the appropriate areas.

I'm making a guess because it wasn't medically tested as diagnosed for many years, even so I'm guessing I suffered from Apnea causing insomnia for possibly 15 years but maybe even longer. Some medical issues all crashed in at once August 2014. I had months of heart health tests but eventually it was decided by my PCP to go to a pulmonary and sleep doc, sleep study and CPAP issued in 2015 but I couldn't use as it's straight 18 pressure. 2016 was prep to get bariatric surgery to drop weight from 300 down to 200 within a year, but sleep wasn't good still. Moving through sleep studies for BPAP onto ASV in '17 where finally I started sleeping better with ASV. It took me about a month where I started feeling more rested, just noticable in the beginning and picking up better feeling in steps per week it seemed. Incorrect therapy or settings times do not help paying the sleep debt. It does count when you're on the right PAP machine and settings are good enough to get consistent decent feeling after sleep. Now debt is being repaid.

Due to complications in my ASV therapy where my diagnosis has changed, I'm not in PAP therapy and it's reverting back to undo the gains therapy had given. So there is a penalty if therapy stops.

So basics is you have to be on the right machine and settings that's giving consistent good therapy and rest. That's when you're paying the sleep debt back.

Dave this is fascinating and an important lesson for me.  Thank you for writing it. 

DaveL

[SarcasticDave94]

Welcome Dave. More work in making Dave's look good.