+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: transitional/sleep onset apneas after years of PAP (/Thread-transitional-sleep-onset-apneas-after-years-of-PAP)
Pages:
1
2
transitional/sleep onset apneas after years of PAP - gaspsalot - 09-03-2024
Hi, all.
Longtime lurker, first-time poster.
About 18 months ago, I started waking up gasping for air with my heart racing and not breathing. This happened maybe 20 times a night for the first couple of nights, and it was torture. I borrowed some Ativan the next few nights and that seemed to nip it in the bud for a while. A few months later, the bolting-awake-while-falling-asleep thing returned for a few days and it has come and gone multiple times since. My sleep doctor says it's relatively common to have a high AHI/centrals in the transition sleep phase and said I may just have developed an anxiety or sensitivity to it. He prescribed Ambien to help me get tired enough to fall asleep when I have these spells. He adjusted my pressure but I can't go higher without getting aerophagia, so I got a dental appliance a couple months ago to do hybrid therapy. It hasn't seemed to do much, either, and I'm in the middle of a month or so of another Jolt Awake While Falling Asleep Because I Stop Breathing phase.
Other background: These spells tend to be correlated with periods of higher stress, and I have longstanding issues with anxiety/depression for which I've been on sertraline for many years. I've been tired most of my adult life and on CPAP since 2015 when I was diagnosed with moderate obstructive sleep apnea (my AHI was right at 15 on my sleep study then). People talk about what a difference CPAP makes, but it never really did with me. Most late mornings I will need an hour or hour and a half nap and at least 9 or 10 hours of sleep to feel somewhat refreshed. Three or four years ago, my sleep doctor put me on BiPAP because I had a lot of centrals in the first hour of sleeping/going to sleep. I'll note that when this gasping stuff first happened in early 2023, it was about two weeks after I got COVID for the first time, which I figure is probably a coincidence. I tried a pulse oximeter a few months ago and my readings went down into the mid-80s at times during the transitional apneas.
I'm wondering if anyone could take a glance at my Oscar data and see anything I or my doctor might be missing. I very often go downstairs to try to not wake my wife after having these incidents, so my PAP usage stats have gone way down, but I've included some screenshots from one of my recent full-usage nights.
Many, many thanks for any help/advice you can give me! I have already learned so much from this board!
RE: transitional/sleep onset apneas after years of PAP - Jay51 - 09-03-2024
On you leak chart (right hand side) is shows you are above the allowable leak maximum of 24L/min, but it is not registering on your "Large Leak" summary chart on the left hand side. Leaks can contribute to more CA's due to more CO2 escaping from your mask - which can washout more CO2 and decrease your drive to breathe.
Here are some tips to help stop leaks. Hopefully getting this under control with help your therapy. This is probably the 1st thing to try to work on right now.
Mask Primer
RE: transitional/sleep onset apneas after years of PAP - gaspsalot - 09-03-2024
Thank you! I'll try to fix that and see how it goes!
RE: transitional/sleep onset apneas after years of PAP - SeePak - 09-08-2024
https://www.youtube.com/watch?v=1kyZVJoK2dc
Breathwork is a MUST for anxiety/depression, and SDB, sleep disordered breathing, sleep apnea.
It's a breathing problem!
Check out the video, Patrick McKeown.
We need to breathe less!
CPAP can be helpful and necessary, however, if we use TOO MUCH AIR, we will more than likely increase ANXIETY during sleep!
Have you had a sleep study recently, if not, did you have one and what was the pressure prescription?
My suggestion, for the CPAP therapy, keep a narrow band of pressure FIRST and see if you get results.
No Auto until you find a zone.
There is an article somewhere, on this site, WIKI probably, that talks about APAP often causing more problems than it helps!
Kill 2 birds with one stone, lower max pressure, less wakeups/anxiety, less air leaks!
Just watch for the OA events.
RE: transitional/sleep onset apneas after years of PAP - gaspsalot - 09-11-2024
Hi,
I haven't had any luck getting my leaks down yet, but will try nasal pillows tonight to see if that's any different.
I'm wondering about this screen in OSCAR. It says I was above the leak threshhold for only 0.5% in the last 30 days and the leaks don't seem to coincide with the central apneas. Any thoughts on that?
Thanks for your help.
RE: transitional/sleep onset apneas after years of PAP - Jay51 - 09-11-2024
You may not be having too bad leaks then. I went by the green line above the 24L/Min red line in your 1st and 3rd OSCAR charts (the "LEAK RATE" chart plotted against time on the right hand side at the bottom) that you posted above. It is strange that your statistical summary (left hand side numerical data) showed 0.0 large leaks. Something is incorrect between the 2.
RE: transitional/sleep onset apneas after years of PAP - Deborah K. - 09-11-2024
I have seen huge leaks on the chart and 0.0 on the left panel on many Dreamstation reports. I think there is a big problem with the Dreamstations.
RE: transitional/sleep onset apneas after years of PAP - SeePak - 09-12-2024
The leak rate chart was only for about 12 minutes not sure how it looked for the rest of the night maybe you could show the leak rate chart for a whole night's worth of sleep?
If it was only for that short duration here and there statistically it probably gets averaged out
RE: transitional/sleep onset apneas after years of PAP - gaspsalot - 09-17-2024
Thanks for your reply. I got a pulse odometer and wore it last night. It went down to 77% at one point, and I woke up gasping. The average was 92%, which is low. I have mild asthma, but don’t smoke and am otherwise pretty healthy.
RE: transitional/sleep onset apneas after years of PAP - SarcasticDave94 - 09-18-2024
Note that one aspect about the Philips Respironics machines and leak rates, they show 2 trace lines on the leak chart as the PRs have intentional and unintentional leak values. Also the 24 L/Min leak redline I think is specific to ResMed.
There's definitely some issue if your oxygen level drops on occasion. You'll want to get that checked out due to Asthma. And from a guy with COPD/Asthma and Apnea, getting a correct machine is more important than with others.