[Treatment] Acceptable AHI with worrying minute ventilation / tidal volume

[gainerfull]

@McRiver - a lot of the "central apneas" you're showing in screenshots follow a position changes - it's completely normal to hold your breath after changing positions. Is there a reason you're tossing & turning so much while you sleep? Also, why do you go to bed so late? The first screenshot lets us know you're not starting therapy until 2AM.

[McRiver]

@McRiver - a lot of the "central apneas" you're showing in screenshots follow a position changes - it's completely normal to hold your breath after changing positions. Is there a reason you're tossing & turning so much while you sleep? Also, why do you go to bed so late? The first screenshot lets us know you're not starting therapy until 2AM.

No idea why I toss and turn so much. I always have, and I assumed when I got the apnea diagnosis it was probably my body reacting to the apnea.

As for the late nights... Combo of being a graduate student where it's normal to keep later hours than most people, and just, I feel awake in the evening and don't in the morning, even when I get to sleep at a normal person time? I'm trying to shift earlier but it's not like I struggle to stay up that late. I don't think it's a caffeine thing or anything, since I don't drink coffee after ~3.

[gainerfull]

No idea why I toss and turn so much. I always have, and I assumed when I got the apnea diagnosis it was probably my body reacting to the apnea.

As for the late nights... Combo of being a graduate student where it's normal to keep later hours than most people, and just, I feel awake in the evening and don't in the morning, even when I get to sleep at a normal person time? I'm trying to shift earlier but it's not like I struggle to stay up that late. I don't think it's a caffeine thing or anything, since I don't drink coffee after ~3.

Thanks for the reply, the subjective quality of your sleep will be better, the earlier your go to bed. It can also be enhanced by maintaining consistency between when you go to bed and when you awaken.

It would be interesting to see if you start measuring sp02 if the position change is due to a desaturation you're experiencing while sleeping on your back. Have you tried sleeping on a wedge pillow at all?

[Sleeprider]

The use of EPR did in crease the CA events and some periodic breathing is in there. This looks like therapy induced central sleep apnea, and EERS may be a good solution. The alternative with bilevel is to use a high trigger sensitivity to stimulate the breaths, but you are clearly sensitive to the use of pressure support/EPR. Tidal volume averaged 300 mL with the EPR, so you get better volume with the pressure support.

[ChadBSr]

Thinking about trying EERS - I've read the wiki entries on it, and it seems it does often have the effect of upping minute ventilation and tidal volume while dropping respiratory rate? Just nervous that it won't work and then I'll have ruined a mask elbow and bought the modification stuff for nothing.

Just tape over the the vents and the whisper swivel isn't super expensive. If you can find the tubing in short sections its really cheap. I had to buy a whole length for $11. Its a lot cheaper than a bipap.