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+--- Thread: [Diagnosis] New Guy Needs a review - Treated but untreated. (/Thread-Diagnosis-New-Guy-Needs-a-review-Treated-but-untreated)
New Guy Needs a review - Treated but untreated. - Madapples - 07-26-2021
Hey everyone, new guy here. A little background: 42 Male, I think I've always had had sleep apnea or more likely central. As a kid, I was diagnosed with ADHD and I've pretty much have had GERD my entire life with frequent heartburn. I would describe myself as an annoying morning person who pops out of bed every day after 5-6 hours of sleep. Almost always feeling refreshed and energized for the day(thanks Air Force) Anyways, I remember an event in my 20's where I woke up gasping for air as if I was being choked and everything was going dark. caught my breath, scared to death having no idea what that was, something like that has never happened since. thankfully.
Occasionally I would ask my wife If I snored and her reply is "sometimes, its usually not loud but it can be loud occasionally but you definitely breathe funny"
Fast Forward to COVID things, I've put on some weight, GERD has come back, constant sinus issues, and now I have uncontrollable Anxiety and Panic attacks. So bad I'm now on Xanax a few times a week due to panic attacks. At bedtime, I would lay down for bedtime in constant worry. And now, I'm officially diagnosed with General Anxiety Disorder, Health OCD, PTSD, and Panic Attack Disorder! But, this constant worry started to take an effect on my sleep. I would notice as I'm falling asleep I was holding my breath and after a quick doze I would wake up, not gasping for air but would also take two quick reflexual breaths. This would happen 3+ times if not over and over again until I fall asleep. Once asleep I was always tossing and turning, ALWAYS waking up after 3 hours, only to do the same process again for another 2-3 hours. And occasionally, I would be lying there, suddenly I would slowly but suddenly awake and notice a pounding heartbeat. That was it! I knew I needed to get tested!
At the sleep study, I slept like utter crap, maybe 5 hours and since it was a 2 for 1, half-sleep study and half titillation but they said I had an AHI of 21, issued me a Phillips Dreamstation with a pressure setting of 8-20 a-flex 3. The first week my average AHI was 35-37ish, next week the same thing but I was getting the occasional 50 or 70 scores with 200+ centrals and then I'll get a few nights where my AHI is 8-12. I have yet to have a night where my AHI was under 5 since March. My current settings are 8-13, I have a chin strap, and a neck brace that I have used for extended periods of time but still nothing consistent.
Being the researcher I am, I found Reddit and this message board and started to mess with settings. First, changing from A-Flex to C-Flex, then taking it down to 2, then to 1, and then tested with it off. Messed with pressures, bumped up my lower limit to 9, then to 10, and I tried out 12 for a while. More of the same, AHI numbers in the 8-15 but then it all gets ruined by a bad night of 40+
BUT, even tho my numbers have been all over the place and I'm technically not treated I do feel better, My daytime sleepiness is only bad one or two days a week, no more waking up with a pounding heart but I am still having those events at the beginning of sleep where I hold my breath but I do feel my sleep is marginally better than it was without CPAP. Typically with one arousal where I wake up to adjust my mask but what I would give for a solid 8 hours of time travel, I mean sleep.
In closing, I have another sleep study scheduled in the next month or so(currently moving) where I expect to be bumped up to a BiPap but I'm going to push for an ASV if possible since I know my insurance (Tricare) won't cover it so I'll see if we can skip a step if CA is the real issue. I'm attaching one day of oscar of my lower AHI days and then a one from last night with a higher AHI, then I attached the settings page. Let me know if I need to reformat the pictures and I'll take care of that right away.
I apologize for the paragraphs but OCD remember? lol
[attachment=34133][attachment=34130][attachment=34132]
RE: New Guy Needs a review - Treated but untreated. - Madapples - 07-26-2021
Further research leads me to believe I most likely have Cheyne Respiratory Syndrome and I'm probably in heart failure....perfect.
[attachment=34139]
RE: New Guy Needs a review - Treated but untreated. - staceyburke - 07-26-2021
I'm not an expert on Cheyne Respiratory Syndrome, however here is a very recent post about the same thing. Check out page 2.
http://www.apneaboard.com/forums/Thread-CPAP-Newbie-to-CPAP-Therapy
He also has the same problem you have positional apnea. Positional apnea is when you sleep in a position that cuts off your own airway. (read the link and the same thing is said there) NO PRESSURE THE MACHINE can give will help you have to find a way to stay out of the position. Check out my link in my signature about a collar, it has help many people here.
RE: New Guy Needs a review - Treated but untreated. - Sleeprider - 07-26-2021
I think it is premature to conclude that cheyne-stokes respiration is present, but there is clearly some periodic breathing being flagged. It would be useful to zoom into some of those segments flagged as periodic breathing, and we can look at the flow rate graph and let you know what we see. Heart failure is diagnosed by a number of tests, but a low left ventricular ejection fraction is common with HF. I think this might be your anxiety kicking in, and before worrying too much, a diagnostic by a cardiologist would be more useful than anything else.
RE: New Guy Needs a review - Treated but untreated. - Madapples - 07-26-2021
Thanks for the quick replies
I've had two EKGs in the last year and both have been clear so I'm well aware it could be my anxiety as I've had anxiety longer than these sleep problems. and I'm aware I could be having panic attacks in my sleep. But here is a 10 min chunk of last night
As always, thanks again.
The site won't let me add another photo or add an imgur link yet so if anyone has a suggestion how to efficiently upload another picture I'm all ears. lol
RE: New Guy Needs a review - Treated but untreated. - Madapples - 07-26-2021
Okay, I think I figured it out, last night and a few days ago.
RE: New Guy Needs a review - Treated but untreated. - Shadowpup - 07-26-2021
I’m not qualified to comment about things apnea, but I’m blessed with TriCare. My ASV is covered by Medicare. TriCare picks up the entire copay. Best wishes.
RE: New Guy Needs a review - Treated but untreated. - Madapples - 07-26-2021
(07-26-2021, 01:58 PM)Shadowpup Wrote: I’m not qualified to comment about things apnea, but I’m blessed with TriCare. My ASV is covered by Medicare. TriCare picks up the entire copay. Best wishes.
Thanks for the reply!
According to Tricare, they don't cover ASV machines as they are still "experimental" But you were able to get Medicare to cover the initial costs, and then Tricare agreed to cover the leftovers?
RE: New Guy Needs a review - Treated but untreated. - Shadowpup - 07-26-2021
My doctors suppose sleep apnea caused my enlarged right ventricle. The ASV has delivered excellent treatment(AHI~1) over the last 11 months. So I’m hoping my next echocardiogram in two weeks will make me happy. With the kind of numbers you are putting up, perhaps consider discussing your heart with a doctor. Best wishes.
RE: New Guy Needs a review - Treated but untreated. - SarcasticDave94 - 07-26-2021
As I understand it, real CSR could come from heart or kidney issues, and some other things. None of which I'd believe it's where you're going to be sitting there not knowing a doctor hasn't talked with you on X health condition. The key is if you were sick with these things that cause CSR, you would know something's gone bad. You'd not need to guess.
This would be an acceptable sample chart with CSR I'd think.
[attachment=34143]