AEROPHAGIA (swallowing air)

[Sleeprider]

You have a tidal volume in the mid-500 range and your respiration rate, inspiratory time and expiratory time are all normal. Medication can contribute to central apnea and periodic breathing, particularly narcotics. What medication?

[jerry1967]

You have a tidal volume in the mid-500 range and your respiration rate, inspiratory time and expiratory time are all normal.  Medication can contribute to central apnea and periodic breathing, particularly narcotics.  What medication?

Dilantin and Phenobarbital for seizures -very small amount of Phenobarbital

Sotalol for heart rhythm (fights afib ) I am in afib right now.

Cartia  for heart rate ( keeps the heart rate normal)

Synthroid for thyroid

[Sleeprider]

Phenobarbital is a known contributor, Dilantin has possibilities, but I have not seen a connection there. Your problem is not life-threatening, but it is serious enough to discuss this matter with your doctors. Since anti-seizure medication is unlikely to be discontinued, the appropriate solution is an adaptive servo ventilator (ASV) like the Resmed Aircurve 10 ASV. The device is indistinguishable from a regular CPAP machine visually, but it monitors breathing on a breath by breath basis and can trigger a breath when a central apnea occurs. Opioid related central apnea is a well documented problem https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459205/ , and it is easily mitigated with ASV. That said, the condition is not particularly common, and relatively few physicians are experienced in this approach to treatment. I would start with your primary doctor that manages your medications, and let him see the charts of your sleep showing mixed / complex apnea. If you go to a sleep specialist for this, it has to be someone ready to deal with opioid related CA and not someone who thinks all apnea is obstructive.

[jerry1967]

Thanks sleeprider. My Dr. wants me to have another sleep study to test for centrals. Last time I talked with him he said I am getting to many of them . He said try the machine I have for another six weeks and then if they are still a problem I should have the test done .

I take it I have to go into the sleep center to have this done? I was hoping I could have it done at home.

[Sleeprider]

In order to cover your problem with insurance, you will be required to have a clinical polysomnograph and diagnosis. Your CA problem is intermittent, but should show up if you get some sleep. You should not change medications prior to the test. I would have a detailed discussion with your doctor about the contributing role of medication on this issue so he can specifically direct how the study is conducted. If possible, you may be able to expedite things if the clinic can diagnose the CA and titrate with ASV in the same study. This is a 2-part study and avoids the need to return for separate titration on ASV. Simple BiPAP will not solve your problem.

[jerry1967]

ok thanks

[jerry1967]

https://imgur.com/a/7IpD4

[jerry1967]

Could someone tell me what the graph in sleepyhead "TIME AT PRESSURE" means?

https://imgur.com/a/7Ljnd

[Walla Walla]

It just shows how long your machine operated at any one pressure during the night. I've never really found a useful need for that chart.

[jerry1967]

Ok thanks but if you go up above one and look at my sleepyhead for last night it shows time at pressure 8. I have my machine set at 11-20 so how could it record  time at pressure 8?