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LabSpecimen - CPAP Therapy - LabSpecimen - 06-02-2024
I had been dealing with a myriad of symptoms I thought were consistent with OSA (sleeping >9 hours and feeling unrested and fatigued). A sleep study reveals only a few apneas/hypopnias (although REM AHI was ~5), however I had 144 spontaneous microarousals that seemed to impact my sleep staging. My doctor believes my results are consistent with early OSA/UARS and he is supportive of trying different treatment options. I was prescribed trazodone and this has provided a large benefit. I am now borrowing a Airsense 10 and trialing CPAP therapy. I feel like its had a noticeable positive effect (beyond just trazodone, still medicating) but I don't really trust my subjective experience (placebo/wishful thinking?).
Below I provide an overview/some highlights of OSCAR analysis of night two with CPAP (night one I was adjusting and didn't sleep well). One highlight is a region with several OSA events and the other is a region showing an example of what I think is flow limited breathing without an associated event (seen throughout). I tried to link out to Imgur but need more posts, so couldn't also show my sleep study results. Perhaps in a followup if necessary.
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I have a few questions and would be grateful if any of you could answer or provide insight. My doctor is giving my case time but I doubt he'll get into the fine details.
1) Do these results (both study and OSCAR flow rates) look consistent with UARS?
2) Is there any evidence that CPAP is having a positive effect
3) Does anyone have suggestions for next steps or questions/requests to bring to my doctor?
Thanks so much,
LabSpecimen
RE: Microarousals/CPAP trial -- possible UARS? - joeblough - 06-02-2024
the areas you have highlighted don't actually show the OA events. you need to expand the window so that it covers the blue markers.
it could be that the tops of the curves are not flat enough (second screenshot) for it to sense a flow limitation. how about comparing to areas where it has marked flow limitations?
how much traz are you taking? i have a friend that's been taking it for years and when he tried to stop he had serious insomnia. supposedly you can get a real cortisol rebound when you stop.
i think i am in the same boat as you - early sleep studies showed 70+ arousals not associated with any detectable respiratory events. but i guess that lab was not clued into UARS and so they didn't make that diagnosis. i've clearly progressed to more "true" apneas which a later study in a bigger clinic revealed. when i use the CPAP my AHIs are extremely low and flow limits are also extremely low, but i don't actually feel any better.
RE: Microarousals/CPAP trial -- possible UARS? - PeaceLoveAndPizza - 06-03-2024
I see some arousals, but not enough to call it anything greater than what we typically see. Without seeing the original test results, I would say that the machine is working well at managing events.
The pressure range is not optimal though. I suggest trying the following:
Min pressure 8
Max pressure 12
EPR 3 full-time
No ramp
I think that will smooth things out a bit and should be more comfortable over time.
You do have some minor leaking going on that appear around the wake-ups. Cause and effect? Maybe. Sometimes when leaks are managed wake-up frequency is reduced. Something to keep an eye on.
RE: Microarousals/CPAP trial -- possible UARS? - LabSpecimen - 06-03-2024
Thanks! Last night I increased the min pressure from 5 to 6 and noticed a significant decrease in flow limitations from .08 to .01 (95% stat). I'll continue to raise that and see how it goes.
RE: Microarousals/CPAP trial -- possible UARS? - PeaceLoveAndPizza - 06-03-2024
Excellent, that is a good approach. Add a wee bit of pressure over time and see how things work out.
RE: Microarousals/CPAP trial -- possible UARS? - Phaleronic - 06-03-2024
Hi LS-I responded over at the other site
Good advice here too!
Does central apnea event context offer insight? - LabSpecimen - 06-10-2024
I am only two weeks into trialing CPAP therapy but routinely get central apnea events in the second half of my sleep. Last night, I noticed two central apneas sandwiching a RERA. There are also a couple OA's intermixed with the CA's. Does this context offer any insight on the nature of these central apneas? I have my EPR down to 1 to try and manage these but my goal with CPAP therapy is to treat potential UARS. I'm also curious if central apneas would be as likely to negatively impact sleep as the other event types.
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RE: LabSpecimen - CPAP Therapy - Crimson Nape - 06-10-2024
LabSpecimen - I merged your 2 threads and renamed it to, "LabSpecimen - CPAP Therapy" to be inclusive. Please use this thread for all your therapy related posts. This provides the reader with your history so they have more information to base their help recommendations.
- Red
RE: LabSpecimen - CPAP Therapy - LabSpecimen - 06-11-2024
Hi all,
I'm currently trying to better understand the central apneas I'm getting (see my last post above). I.e., do other events clustered with CA's provide insight on the nature of the CA's? What is a reasonable baseline number of CA's (at what level should treatment aim to address them)? Do CA's impact sleep/health as much as OA's/flow limits?
Thanks,
LabSpecimen
RE: LabSpecimen - CPAP Therapy - joeblough - 06-11-2024
when i wear my iphone running SomoPose, i can clearly see that i get CAs when i change position, no matter the change in position. to me this means that when i wake up and fall back asleep, i have transitional apneas. based on my spo2 data, i can see that they are much worse when wearing the CPAP. as i understand it, the transitional CA is very common and is not really any cause for concern. the CPAP causes a bit of a feedback loop that increases the number of CAs seen which are kicked off by the transitional CA. this is caused by the cpap clearing out too much CO2 from your airway which causes your brain to think that you are breathing too much and so temporarily stops your breathing. eventually the CAs peter out. if you lower your EPR, this can combat the CAs, but then it's worse if your predominant problem is flow limitation.
in general sleep doctors consider any AHI < 5 "normal". so if your CAs result in a Central AHI < 5, i think you're probably OK, at least by the book.
you might try using Somnopose and see if your CAs correlate with position arousals.