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[CPAP] Am I worse because of CSA?
#1
Am I worse because of CSA?
I started a thread in Oct of 2021 - WHY DO I FEEL WORSE?  I was complaining then that I was soooo tired after starting CPAP therapy.  Well that gradually improved so that by Nov I was feeling pretty good.  But, then I gradually started to go down hill again.  Gradually I began to have more sleep issues and anxiety. I have been waking up more in the night without being able to go back to sleep because of anxiety. My anxiety has gotten so bad that I have had to resort to using Ativan. Also got my Covid booster at the end of Nov so at first I thought maybe that had caused a flareup in my chronic health issues. I suffer from Hyperandrenergic POTS (HyperPOTS) which causes my body to put out too much norephedrine so at first I thought I was having a flareup with that issue from the booster. When I first started CPAP a lot of my issues with HyperPOTS improved. I also get what I call crashes were my energy just suddenly depletes, I get a sore throat, ache all over and generally feel like I am getting the flu (which has been very unnerving during the pandemic) but I never get sick.  Sometimes I can feel this way in the afternoon and by the evening I am fine.  My crashes have gradually gotten worse as well. Then I realized I hadn't looked at my data from my CPAP machine for awhile.  So downloaded a big chunk and started looking.  It seems like I have had an increase in Central Sleep Apnea (CSA) which I am now think is probably what is causing the increase in issues.  I am aware that often new CPAP users will have an increase in CSA which usually improves over time. Am uploading some screen shoots from OSCAR to see if others concur with my suspicions about the CSA and if you have any suggestions on machine settings that might help. SO APPRECIATE EVERYONE'S HELP!

   

         
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#2
RE: Am I worse because of CSA?
I was going to post a few more OSCAR screenshots but I guess I am only allotted 3 at a time. Let me know if what I uploaded is enough for evaluation or if you want to see more.
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#3
RE: Am I worse because of CSA?
3 questions:
You've been on PAP since about September?
Are you using Ramp, and what settings if you are?
Are the CA enough of a negative issue to take on a fight to get ASV?

I think your history shows now CA are the biggest possible problem, other than maybe other health related issues. You should build a sleep diary that includes all symptoms and complaints including CA concerns.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Am I worse because of CSA?
(01-05-2022, 01:03 PM)SarcasticDave94 Wrote: 3 questions:
You've been on PAP since about September?
Are you using Ramp, and what settings if you are?
Are the CA enough of a negative issue to take on a fight to get ASV?

I think your history shows now CA are the biggest possible problem, other than maybe other health related issues. You should build a sleep diary that includes all symptoms and complaints including CA concerns.

   

1, Yes been on CPAP since September of 2021
2. Yes using ramp. Attached screenshot of my machine settings.
3. Issues are bad and having hard time distinguishing what is causing what. Is it CSA, slight hyperthyroidism (am going to have to adjust thyroid meds soon), Hyperandrenergic POTS, combo of all three or something else? Can I take on fighting for ASV. Guess I need to take care of thyroid first and see how I feel after that. I might just buy my own ASV like I did with my CPAP machine and then have my insurance company cover the supplies.
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#5
RE: Am I worse because of CSA?
Hi! Fellow dysautonomia person here, though I have primary central apnea (and honestly, I'm semi sure that the central apnea is directly linked to the dysautonomia, though I'm not sure what caused what, or if there's a third thing linked to both).

If you've been using the CPAP constantly since then, it's probably unlikely that the centrals will just go away. It's worth looking at them and considering if those could be related to awakenings or not - especially if you zoom in closer to them and see a big breath taken in before the apnea.

The hyperadrenergic side is the worst - it's like being anxious without being able to do anything about it because there's no brain worry half the time, and if there is, it's a horrible vicious cycle.

The only thing I could suggest is maybe to turn off the EPR, but the problem is that what helps obstructive events and flow limits tends to worsen centrals and vice versa. It's a balancing act with CPAP. That said, PoTS is freaking exhausting at the best of times, so you may well be feeling rotten just because of that, not necessarily because of the centrals. Looking at your averages, it's only this week that the CAs seem a little higher than in the previous weeks, but that could have been from a couple of restless nights.
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#6
RE: Am I worse because of CSA?
Suggestion to help the CA with editing Ramp settings as you see fit. Maybe shorten it less than 30 minutes and above 4 cmH2O, ideal for CA would be off, but you're dealing with other concerns too so comfort first.

Disregard if the CA diminish on their own, as they might. Central Apnea are notoriously consistently inconsistent.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Am I worse because of CSA?
(01-05-2022, 01:51 PM)Ratchick Wrote: Hi! Fellow dysautonomia person here, though I have primary central apnea (and honestly, I'm semi sure that the central apnea is directly linked to the dysautonomia, though I'm not sure what caused what, or if there's a third thing linked to both).

If you've been using the CPAP constantly since then, it's probably unlikely that the centrals will just go away. It's worth looking at them and considering if those could be related to awakenings or not - especially if you zoom in closer to them and see a big breath taken in before the apnea.

The hyperadrenergic side is the worst - it's like being anxious without being able to do anything about it because there's no brain worry half the time, and if there is, it's a horrible vicious cycle.

The only thing I could suggest is maybe to turn off the EPR, but the problem is that what helps obstructive events and flow limits tends to worsen centrals and vice versa. It's a balancing act with CPAP. That said, PoTS is freaking exhausting at the best of times, so you may well be feeling rotten just because of that, not necessarily because of the centrals. Looking at your averages, it's only this week that the CAs seem a little higher than in the previous weeks, but that could have been from a couple of restless nights.

Hi! Yes, very nice to meet a fellow dysautonomia person on here! Thanks so much for your feedback. And yes, POTS is freaking exhausting! So sorry you/both of us have to put up with it!
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