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Chronic Insomnia
#21
RE: Chronic Insomnia
The closeups reveal significant flow limitation ending in arousal and recovery breathing, and the variable breathing in your case appears to be alternating flow limitation and recovery. You have some leaks through the night that can stand improvement. The Vauto will resolve the flow limitations. RERA and variable breathing problems. VS2 is often flagged when vibration is detected in the airflow, and it can be from movement, the tube being dragged over an edge or hard surface and may even be real snores. We don't give it a lot of attention, but VS is a more significant event.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#22
RE: Chronic Insomnia
I am trying to get a better understanding as to what is going on with my sleep and how it is displayed on Oscar. So last night I left my machine on CPAP but lower the pressure down to 11.5 to see what would happen. I have attached a few charts for ya'll to look at. I guess I need to get a better understanding of terminologies first. On my Dreamstation, (I don't know how it will be called on the Resmed I plan to get)  it list Clear Airway Apneas, Obstructive Apneas and Hypopneas. What are the differences in those events?  

Clear Airway Apneas

For the month of December my Clear Airway Apnea's normally ran between 10-30 events a night with one night being 45 and they seem to be my biggest problem but I don't know what happens during one of these events and what to do to stop them. Hopefully the Resmed AirCurve VAuto will help these.  

Obstructive Apneas

For the month of December my OSA have run between 0-5 with a few nights going up to about 7 or 8. Strange thing is that when I switched from Autopap back to cpap my Clear Airway apneas almost went away. The first night back on cpap (Dec. 28) with pressure at 12, my Clear Airway apnea was 0 and OSA was 14. The second night on cpap (Dec. 29) with pressure at 13, my Clear Airway apneas were 2 and OSA was 11. Last night (Dec. 30) Clear Airway apnea was 7 and OSA was 30. 

Hypopneas  

For the month of December my Hypopneas ran between 0-15.

Periodic Breathing

I do not know what this means. Is this good or bad? For the month of December normally ran between 0-5 events a night.

Variable Breathing

I do not know what this means. Is this good or bad? For the month of December ran between 20-35.

Pressure Pulse

Another event I do not know what it means. For December up till the 28th it ran between 20-50 with one night being 83. Then on the 28th (cpap pressure 12) it was 2, the 29th (cpap pressure 13) it was 6 and then last night (cpap pressure 11.5) it was 17.

RERA

I know these are respiratory effort arousals which can not be a good thing. For the month of December up till the 28th, they ran between 5-15 a night. On the 28th (cpap pressure 12) there were 11, on the 29th (cpap pressure 13) there were 29 and last night (cpap pressure 11.5) there were 24.

If someone would just described what some of these events are so I have a better understanding of what is happening during my sleep so I can take action to hopefully get to sleeping and feeling better. I know some of you have mentioned the Resmed AirCurve 10 VAuto should help a lot.

I have posted a 3 charts from last night. The 3rd one is about the time I woke up around 2:00 and then had to take an Ambien to get back to sleep.

The company I was planning on ordering my machine from told me that I would need a new prescription showing Bipap and the required pressures. Now I am having to wait on the doctor to get back with me and hopefully send me a new prescription. This might take some time. Some doctors don't like patients doing there own thing and requesting equipment
which would show the doctor failed to do there job and recognized these problems I am having. I just saw her 2 months ago and all she said was, "Your using your machine every night and your AHI is below 5. You are doing great." And I had told here about the sleep problems I am having waking up several times during the night and not being able to get back to sleep. Oh well. 

Thanks,
Mark

It will not let me attach the 3rd chart. It says that I have met my attachment quota of 5.86mb.

Thanks,
Mark


Attached Files Thumbnail(s)
       
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#23
RE: Chronic Insomnia
Mark, I don't have a lot of help for you other than to say I'm kind of in the same boat.  I sleep in cycles.  I switched from a Resperonics avs to a Resmed aircurve 10 avs about a month ago to try and solve my issues.  The 30 day AHI average of my Resperonics was 3.31 -- the 30 day average of the ResMed is .73.   With the ResMed I have had sleep periods of 0.00, but I don't sleep through the night.  And I do take Ambien, which I hate doing.  I cut the 10 mg pill to 6 and 4 mg and take whichever part I want to try just to get me off this stuff.  Last night, I went to bed with no medications, and woke up a couple of hours later, then took  6 mg of Ambien, then after waking, got up and went around the house, ate pancakes, then went back to sleep.  The first portion of the sleep and the last portion of the sleep were 0.00.  So only the middle portion, the Ambien portion, kicked up the AHI.  I've noticed several websites that say sleeping medications are a cause of hypopneas.

https://www.webmd.com/sleep-disorders/sl...a-overview


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#24
RE: Chronic Insomnia
Rich have you tried Melatonin to see if it might help you get to sleep? I take an Extended Release that is suppose to help me sleep longer throughout the night. It is a lot safer than the Ambien because it is only supplementing what our bodies quit producing enough of as we get older. My doctor put me on Trazodone which is a relative safe drug that is not addictive but on long term use you would have to wean off of it like I am doing now. I do really think than sedatives like Trazodone, Ambien and the Benzo's like Valium, Xanux etc help to get to sleep but also effect our sleep apnea in a negative way. I think it relaxes the throat muscles enough to cause apneas and flow limitation problems. But I am no doctor either. Just my assumption.
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#25
RE: Chronic Insomnia
All of those terms can be searched in the wiki and you will find articles or at least definitions. Take the time to read it, and I'll be glad to answer any questions that remain and perhaps clarify the wiki articles.

In the zoomed image you provided, we see severe airway restriction that appears like flow limitation, that terminates in arousal and recovery breathing. This is followed by an obstructive apnea event because the flow has dropped to less than 10% of the preceding recovery breathing, but in other circumstances it might be flagged as hypopnea. This is followed by arousal and more recovery breathing. My best guess is that you may have positional apnea that is obstructing your airway. You may want to read the wiki on positional apnea and the soft cervical collar. We may have missed that you are having clusters of obstruction that are causing a lot of your problems including the variable or periodic breathing. The chart shows some pretty high leak rates as well.

[Image: attachment.php?aid=28973]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#26
RE: Chronic Insomnia
Yeah I will read the wiki. I think I am done experimenting with different pressures and will go back to Autopap till I can get the Resmed.

Thanks,
Mark
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#27
RE: Chronic Insomnia
A little exercise really help me sleep better, I started of with walking a mile now I’m at 4 miles a day. About 20min a mile. Now I know if I don’t walk, I’m probably not going to sleep good.
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#28
RE: Chronic Insomnia
Yes Mark, I did try the 10 mg extended release melatonin, and no other medication. -- for 3 nights in a row.  I can fall asleep ok, I just can't stay asleep, including with the Melatonin.  I'll be giving it another try soon.   I wake up after about an hour and a half, or two hours.   No choice but to keep on trying something.  I see my sleep doctor next week, I'm going to have to ask her if my lung issues are the cause, or ?? (she's also my lung doctor). If you come up with any solutions, please post them.  I've been watching this thread since the start.
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#29
RE: Chronic Insomnia
Like I mentioned at the beginning of the thread, it has taken me a while to figure out what was causing my sleep problem. I had decided it had to be hyperthyroidism because I had about 8 of the many symptoms for it. Even my regular doctor thought I probably had it but the test was negative. So I decided maybe it was my adrenal gland producing too much cortisol due to many stressful events I had going on. That test was negative. I was about ready to go to a alternative doctor to have all my hormones tested and to see whether I might be deficient in something. That was until I downloaded Oscar and started looking at my cpap data and getting the wonderful folks on here to help figure out what was going on. It seems that even though I was taking enough sleep medicine to put a horse to sleep, I am having problems with flow limitations and other things causing arousals throughout the night causing me to wake up. Now if I can just fixed that problem (switching to a Resmed Bipap machine) and keep weaning myself off the Trazodone and having to quit using the Ambien, I might feel like a new man. Time will tell.

Mark
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#30
RE: Chronic Insomnia
I am a little confused. I know it has been recommended to me that a Resmed Aircurve 10 VAuto would be best for my problem but I keep noticing that when someone has a lot of Central Apneas/Clear Airway Apneas that a ASV is suggested. I seem to be having a lot of CA's and last night I had 35. One night in December I had 45 of them and seem to average between 15-30 a night. Since I am in the process of purchasing a new machine I was wondering if that would be what I need to get or do I stick with the VAuto? I just don't want to spend the money on a VAuto and it not help my CA problem. I look to you guys for advice since ya'll are experienced at all of this.

Thanks,
Mark
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