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Central Sleep Apnea Treated But Still Feeling Bad
RE: Central Sleep Apnea Treated But Still Feeling Bad
(12-01-2019, 11:48 AM)Chequebook Wrote: If I doze on my back without the Aircurve I wake up with a start feeling as If I'm suffocating.

This may be out from left field, but it may not be a central apnea issue, at least not now after your ASV.  Go get a soft cervical collar.

I've been wearing one since 2014.  When I did my ASV titration I told myself I was not going to wear one and let the machine take care of everything and then I will be rid of wearing a cervical collar for good.  I have obstructive and central sleep apnea.  I aced it with 0.0 of any apneas and and AHI of 0.6.  I slept lousy and felt horrible the next day.

First day at home with my ASV I really aced it with over 8 hours of sleep, 0.0 apneas, and an AHI of 0.3.  I felt equally lousy.  The next night I went halfway through the night and said forget this and put my cervical collar back on.  I slept great and have ever since with the collar.

In reading this it occurred to me that you will only get an event if it is 10 seconds long.  I have no data to support having 9 seconds or less events without my collar, but does that one second really matter?  I chalk it up to the super quick response of my machine to head off an event before it becomes one, but it doesn't really stop a sleep disruption.  I have not spent enough time getting into Rescan/OSCAR charts, except for the obvious and I don't know if there are any anomalies to show these sub 10 seconds events.

The reality is the 10 second rule may be just an arbitrary value that is not reflective of the threshold for a sleep disruption.  I don't know how it was established years ago.  It might reflect a medical threshold that the "average" person can absorb, but if you doze on your back and start feeling like you are suffocating, my gut says it is not a central apnea issue.

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RE: Central Sleep Apnea Treated But Still Feeling Bad
Yesterday my sleep specialist doc changed me to Pregabalin.  My first night, on 100mg, gave me undisturbed sleep, an early-ish wake up and a relatively good day.  That's promising, but I've been through so many false dawns that I'm careful over hanging anything on it.
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RE: Central Sleep Apnea Treated But Still Feeling Bad
As a quick update, more for anyone finding this at a later date rather than an expectation of finding that Eureka moment, I've been on Pramipexole and then Pregabalin for some time on each.  My wife says that my limb movements have decreased but I've noticed no long-term improvement to how I feel during the day.  I've also upped my exercise to some 45 mins to an hour jogging each morning, which seems to have reduced my instances of RLS without any noticeable change in my PLMS or the struggles I face during the day.
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RE: Central Sleep Apnea Treated But Still Feeling Bad
I believe Magnesium and Melatonin can be good for RLS. Melatonin can be tricky, you'd have to play around with the doses. Can range from 300mcg to 10grams.
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RE: Central Sleep Apnea Treated But Still Feeling Bad
I have mixed apnea best treated with asv but the way the asv quickly & dramatically raises & lowers pressure support in response to the non-passive flow limitations that follow my plm leaves me exhausted. the problem is that asv max pressure support can't be less than 5cmw higher than min pressure support.

I feel so much better using vauto, despite higher ahi, because I can cap max ps, effectivelly keeping epap & ipap pressures stable. I have trigger sensitivity set to very high to help keep centrals down.

I tried gabapentin for restless legs but felt it made it worse. recently I've been taking ropinirole for plm. now that I know what my plm looks like in my flow rate, I can say the ropinirole helps with plm (reduces but doesn't eliminate it) but my subjective sense is that it too makes my before bed rls worse.

for me, plm is very disturbing to sleep even though I'm completely unaware of it. partial relief with ropinirole & capping max pressure support leave me feeling the best I have felt in more than 3 years of apap, asv & vauto.
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