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11-21-2024, 12:39 AM (This post was last modified: 11-21-2024, 12:41 AM by LanceDrG.)
UARS Waking up All night - pounding heart
I have been using my CPAP for 6 years now and my apnea has gotten worse over the last year or so. Keep waking up multiple times throughout the night.
It seems like I fall in to the category of Severe UARS with Mild Apnea. I had multiple sleep studies with AHI ranging from 5 to 15. The issue is my high RDI
I'm 42 yrs old, fit, use a cervical collar, sometimes mouth tape. I have tried laying on my side, supine very elevated, on stomach with pillow under hips with chin extended to open airway. Frustrated that nothing seems to help. After reading the forum I am curious to try BiLevel.
I practiced as a dentist and have pretty bad vertebral cervical (neck) degeneration with a reverse curve and herniated discs. According to some research studies I have read these neck issues seem to contribute to sleep apnea.
Oscar data from two nights and sleep study attached.. Any guidance would be appreciated.
Before switching to bilevel, it is worth testing the increased minimum pressure setting to 9 cm. It will give you a smoother pressure ride and can reduce the flow limits.
11-21-2024, 02:04 AM (This post was last modified: 11-21-2024, 02:16 AM by THEVGE.)
RE: UARS Waking up All night - pounding heart
I am in the same boat for 3,5 years like you. My story (summarized) may help you.
Me: mild OSA (7 not on my back, 14 on my back), self diagnosed UARS, Afib, pain in legs/cheeks, zero energy during the day.
CPAP/APAP: suppressed AHI to 0 even at a pressure 6, but introduced arousals (5 per hour). All typical OSA/UARS issues mentioned remained.
Bi-level: helped from the start, but effect gone very fast. Still better than CPAP, significantly less pain (only some days in my legs, no idea what causes it), probably the improvement is due to the PS which gives me much better flow rate. Arousals remain with same frequency, and like you I suffer from therapy induced CA which is not going away in my case. I also developed a huge SpO2 dip at sleep onset.
Yesterday I gave up on bi-level as well, now trying to start up therapy using ASV.
As for the heart issues you mention, as stated I suffer(ed) from Afib. I got rid of it not by my (ineffective) PAP therapy, but with simple breathing exercises that are focused on calming down your nervous system (no medicine). This made me believe stress is my main cause for the heart issues. I do believe badly treated UARS, obviously, is a stress factor that does not help. But I found my heart issues solved even with bad PAP therapy. Besides solving Afib I now get daily "morning wood" again, I completely forgot I did not have that for the last few years ;-).
So in short, I do believe bi-level will be better for you but I doubt if it will really help long term. I especially foresee even more CA's for you and very likely no change in arousals. Your data already looks pretty good by the way compared to me on CPAP.
All that being said, I agree with G. Szabo that you should try increasing your EPAP and maybe try EPR 2 iso EPR 3 as well to reduce therapy induced CA's. Don't change everything immediately, 1 setting at a time and try it a few days (advice easily given, hard to follow myself ;-)).
(11-21-2024, 02:04 AM)THEVGE Wrote: I am in the same boat for 3,5 years like you. My story (summarized) may help you.
Me: mild OSA (7 not on my back, 14 on my back), self diagnosed UARS, Afib, pain in legs/cheeks, zero energy during the day.
CPAP/APAP: suppressed AHI to 0 even at a pressure 6, but introduced arousals (5 per hour). All typical OSA/UARS issues mentioned remained.
Bi-level: helped from the start, but effect gone very fast. Still better than CPAP, significantly less pain (only some days in my legs, no idea what causes it), probably the improvement is due to the PS which gives me much better flow rate. Arousals remain with same frequency, and like you I suffer from therapy induced CA which is not going away in my case. I also developed a huge SpO2 dip at sleep onset.
Yesterday I gave up on bi-level as well, now trying to start up therapy using ASV.
As for the heart issues you mention, as stated I suffer(ed) from Afib. I got rid of it not by my (ineffective) PAP therapy, but with simple breathing exercises that are focused on calming down your nervous system (no medicine). This made me believe stress is my main cause for the heart issues. I do believe badly treated UARS, obviously, is a stress factor that does not help. But I found my heart issues solved even with bad PAP therapy. Besides solving Afib I now get daily "morning wood" again, I completely forgot I did not have that for the last few years ;-).
So in short, I do believe bi-level will be better for you but I doubt if it will really help long term. I especially foresee even more CA's for you and very likely no change in arousals. Your data already looks pretty good by the way compared to me on CPAP.
All that being said, I agree with G. Szabo that you should try increasing your EPAP and maybe try EPR 2 iso EPR 3 as well to reduce therapy induced CA's. Don't change everything immediately, 1 setting at a time and try it a few days (advice easily given, hard to follow myself ;-)).
Thank you for sharing your story!
OK so I increased my EPAP to 9 and I'll change the EPR to 2 tonight.. I'll give it a couple days and see.
You mentioned foreseeing even more CA's.. I'm a newbie reading these Oscar Charts. Where in the charts do you see CA's? I see that CA stands for Clear Airway with Apnea.. Do you just deduce it is a central apnea since there is a clear airway and not obstructive?
Sucks CPAP helps us but also induces central apneas. Those feel horrible since it's just a cessation of breathing with not much you can do it about it vs. OSA. Makes me wonder if I should have just used a combo of positional therapy and surgery from the start.
I have a heart monitor on currently for 2 weeks to see if it detects any abnormalities.. I need to get back in to deep breathing. I used to do it more consistently. There are so many things to include in to my daily routine with my chronic musculoskeletal spine degeneration and pain, overactive bladder, apnea, HBP.. ugh
Also.. I'm jealous of your morning wood... lol I miss those days. Hope to get it back as well.. I do notice a difference of course when I have a relatively better night.
11-21-2024, 08:06 PM (This post was last modified: 11-21-2024, 08:08 PM by churras.)
RE: UARS Waking up All night - pounding heart
(11-21-2024, 02:04 AM)THEVGE Wrote: I am in the same boat for 3,5 years like you. My story (summarized) may help you.
Me: mild OSA (7 not on my back, 14 on my back), self diagnosed UARS, Afib, pain in legs/cheeks, zero energy during the day.
CPAP/APAP: suppressed AHI to 0 even at a pressure 6, but introduced arousals (5 per hour). All typical OSA/UARS issues mentioned remained.
Bi-level: helped from the start, but effect gone very fast. Still better than CPAP, significantly less pain (only some days in my legs, no idea what causes it), probably the improvement is due to the PS which gives me much better flow rate. Arousals remain with same frequency, and like you I suffer from therapy induced CA which is not going away in my case. I also developed a huge SpO2 dip at sleep onset.
Yesterday I gave up on bi-level as well, now trying to start up therapy using ASV.
As for the heart issues you mention, as stated I suffer(ed) from Afib. I got rid of it not by my (ineffective) PAP therapy, but with simple breathing exercises that are focused on calming down your nervous system (no medicine). This made me believe stress is my main cause for the heart issues. I do believe badly treated UARS, obviously, is a stress factor that does not help. But I found my heart issues solved even with bad PAP therapy. Besides solving Afib I now get daily "morning wood" again, I completely forgot I did not have that for the last few years ;-).
So in short, I do believe bi-level will be better for you but I doubt if it will really help long term. I especially foresee even more CA's for you and very likely no change in arousals. Your data already looks pretty good by the way compared to me on CPAP.
All that being said, I agree with G. Szabo that you should try increasing your EPAP and maybe try EPR 2 iso EPR 3 as well to reduce therapy induced CA's. Don't change everything immediately, 1 setting at a time and try it a few days (advice easily given, hard to follow myself ;-)).
I have almost the same history ?
Gonna try maybe 6-7 more things in the bipap. Them will try ASV, hoping it will help.
Do you think you sleep better without anything? Or with the bipap?
When I sleep without anything, I will wake after 4/5 hours of sleep. 90% of the times feeling good and with a good brain for 2/3h. Never dizzy.
But then I will be miserable during the rest of the day.
With bipap I’m not so tired during the day, but my brain is worst all day. And in the last few night, I have been very dizzy.
(11-21-2024, 08:06 PM)churras Wrote: I have almost the same history ?
Gonna try maybe 6-7 more things in the bipap. Them will try ASV, hoping it will help.
Do you think you sleep better without anything? Or with the bipap?
When I sleep without anything, I will wake after 4/5 hours of sleep. 90% of the times feeling good and with a good brain for 2/3h. Never dizzy.
But then I will be miserable during the rest of the day.
With bipap I’m not so tired during the day, but my brain is worst all day. And in the last few night, I have been very dizzy.
@lance, do you have thoses symptoms too?
You said you were going to try 6-7 more things with the BiPaP.. It looks like you have the Resmed Airsense 10.. I thought that was APAP or CPAP
I get a little dizzy with CPAP yes. I mostly feel tired/moody all morning until like 2PM.. Then the cycle starts all over again. I honestly don't know how I sleep better. Sometimes better with CPAP and sometimes better without it.. But when I don't use it, I get a sore throat from snoring.
Hope you will learn something from your new settings, good luck. It is really new for me to see a guy being jealous on that subject, hahaha. That being said, I do believe not having that is a serious red flag for a guy. As for CA's, I generally follow what OSCAR tells me. But people more experienced than me reading OSCAR charts are able to tell if it is a real one or not. Never forget that a Resmed device is dumb as "fill in something very dumb". Just show examples in your thread if you doubt them or want to learn doing it yourself. Just 2 nights in ASV so not able to say much yet as the settings are clearly not good yet, and in full honestly I went out with a friend yesterday for the first time in weeks and I went a bit overboard with the craft beers so I have no idea but I did sleep for 7 hours and the headache is not therapy induced ;-). But at least with ASV you will never have CA's, and another thing I like is that you can only set pressure and pressure support so a lot less variables and this ASV is the least dumb Resmed algorithm.
@churras:
I tried sleeping without device but I had to give up after a few hours (however, afternoon half hour naps are fine without device, how weird). I will get huge sleep onset SpO2 dips, and I feel the stress flowing through my body. Nowadays it feels way more horrible than years back before my diagnosis, I guess the PAP therapy changed my body and/or how my body responds. There is no way back for me. I learned for myself that when I have "tiredness around the eyes", my pressure was too low even when OSCAR tells me I have great numbers. My brain never really suffered as I often read here, or I am to tired and inactive to notice....I do not know.
11-24-2024, 06:58 PM (This post was last modified: 11-24-2024, 06:59 PM by Apex45.)
RE: UARS Waking up All night - pounding heart
(11-21-2024, 02:04 AM)THEVGE Wrote: I am in the same boat for 3,5 years like you. My story (summarized) may help you.
Me: mild OSA (7 not on my back, 14 on my back), self diagnosed UARS, Afib, pain in legs/cheeks, zero energy during the day.
CPAP/APAP: suppressed AHI to 0 even at a pressure 6, but introduced arousals (5 per hour). All typical OSA/UARS issues mentioned remained.
Bi-level: helped from the start, but effect gone very fast. Still better than CPAP, significantly less pain (only some days in my legs, no idea what causes it), probably the improvement is due to the PS which gives me much better flow rate. Arousals remain with same frequency, and like you I suffer from therapy induced CA which is not going away in my case. I also developed a huge SpO2 dip at sleep onset.
Yesterday I gave up on bi-level as well, now trying to start up therapy using ASV.
As for the heart issues you mention, as stated I suffer(ed) from Afib. I got rid of it not by my (ineffective) PAP therapy, but with simple breathing exercises that are focused on calming down your nervous system (no medicine). This made me believe stress is my main cause for the heart issues. I do believe badly treated UARS, obviously, is a stress factor that does not help. But I found my heart issues solved even with bad PAP therapy. Besides solving Afib I now get daily "morning wood" again, I completely forgot I did not have that for the last few years ;-).
So in short, I do believe bi-level will be better for you but I doubt if it will really help long term. I especially foresee even more CA's for you and very likely no change in arousals. Your data already looks pretty good by the way compared to me on CPAP.
All that being said, I agree with G. Szabo that you should try increasing your EPAP and maybe try EPR 2 iso EPR 3 as well to reduce therapy induced CA's. Don't change everything immediately, 1 setting at a time and try it a few days (advice easily given, hard to follow myself ;-)).
May I ask what breathing exercises you did to get rid of a-fib?
