maybe hypothetical question

[DariaVader]

Have you tried your EPR to 3? I like that setting myself.

I just use the EPR on ramp, it's at 3, do you think I should try it all night??

Storywizard

Thought you had EPR on previously and took it out to see if it would help with pressure related CA. I don't have an issue with clear airway events.... so take my advice with a grain of salt If they are caused by pressure, then according to what I have read, the variance and amount of pressures are implicated - so that EPR should be reduced or eliminated to keep the pressure steady. Seems it is first pressure that is varied causing the body to react by holding breath, and second the amount of pressure is implicated with greater issues at higher pressures. When this happens, sometimes the body gets used to the pressures over some time... your best option might be to stick with the best plan you have with osa needs vs ca needs and let your body acclimatize. I have had different issues with my therapy, and its only now after > 5mo that I feel like I am getting the sleep I need --- I went without for far longer. It sometimes just takes time and persistence.

[TyroneShoes]

"Comorbidity" is a pretty scary word; it seems like it is overstating the case a bit. As if it meant "two things conspiring together to murder you". Technically, I guess it can actually mean that, but it really only means two symptoms having coincidence, and possibly aggravating each other. Also not good, just not as life-threatening as it sounds. I'd suggest retiring the word, but most docs need to sound smart, so they would never agree with that.

Z-drugs can cause fugue states by their very nature. They put you to sleep by depressing the central nervous system, and they have a particular sinister ability to put your higher brain functions to sleep which hopefully coincides with putting your lower, reptile-brain functions to sleep as well, but the risk is in your reptile brain waking up and acting out, without your higher brain functions becoming cognizent enough to keep a tight leash on the potentially irrational actions of the reptile brain.

That is something that has nearly a 100% chance of not happening without the drug, but a slightly lower chance of not happening with it. This explains a lot of odd behavior, including people in their underwear peeing in busy intersections at 2 AM, awakening to find you have eaten everything in the refrigerator, wrong-way driving arrests, and more. This is how a Kennedy drove into a barrier at the capitol at midnight, and how Robert Downey gave a rambling early-morning interview to a radio show. Not that this will happen, but also not that it won't happen. Basically, you can not fully "wake up" for a time and be quite literally, out of your mind for that period of time. Never bodes well for your wellbeing. Its a tiny risk, but one I won't be taking, that is for sure.

But from a simple viewpoint, it would seem that since CA events are basically the CNS being just under the borderline of triggering the respiration feedback system to tell you when to breathe, and that something depressing it would aggravate CAs rather than lessen them, so this is a very interesting paradoxical reaction.

Please let us know what your PSG reveals.