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Daytime sleepiness one year into ASV
#11
RE: Daytime sleepiness one year into ASV
ASV does not register central events because it prevents them from happening, so the closest to central that ASV registers is Hypopnea events.
That said, I am of the opinion that your daytime sleepiness has more to do with your 235mg? dose of prescription opioids every day than it does with your sleeping on CPAP , which according to your chart is going pretty well. 20 years on opioids is also a very long time.
I don't know which opioids you are taking but assuming that it is a prescription drug, it must be a synthetic form such as Codeine content like Tylenol family of codeines or another analgesic like the family of Oxycodone.
 Either case, synthetic opioids impact different people differently but their sedative effect on most, is a common thread as you may well be aware.
Reducing your dose to half over a short period of time would have an inverse effect on day time "yawning" and an urge to sleep during the day but then again I am not sure how long it took you to half your dose but if it was done over a period less than 6 months to a year, you could expect your daytime drowsiness to continue for a while (like a couple of years).
Generally synthetic opioids have  much more dramatic side-effects than organic forms that are OPIUM derived like Opium itself or its derivatives such as heroine (its pure and unadulterated form), but whether synthetic or organic, long term opioid use is an addiction which should not be taken lightly.
If being alert during the day is critical for you (like for your type of profession), then you should speak to your doctor about putting you on medication for it that will not counter the effect of your prescription opioids.
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#12
RE: Daytime sleepiness one year into ASV
"ASV does not register central events because it prevents them from happening, so the closest to central that ASV registers is Hypopnea events."

the asv is good but not perfect. it doesn't prevent all central (and obstructive) apnea but it does flag ua or unclassified apnea. a close look at the flow rate is necessary to attempt to determine whether a particular ua is ca or oa. same with hypopnea.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#13
RE: Daytime sleepiness one year into ASV
(08-28-2021, 10:00 PM)sheepless Wrote: the asv is good but not perfect. it doesn't prevent all central (and obstructive) apnea but it does flag ua or unclassified apnea. a close look at the flow rate is necessary to attempt to determine whether a particular ua is ca or oa. same with hypopnea.

According to the ResMed ASV Manual:
"AHI and Total AI: Central sleep apnea detection (CSAD) is not active in ASVAuto and ASV modes. The ASV algorithm eliminates central apneas. Therefore, any apneas reported by the device will be obstructive or indicative of a closed airway."


I admit that I have pondered this and wondered whether the centrals are truly gone (because I, too, started using ASV to fight central apneas). Apparently some hypopneas may morph from central events.

Also, like petemsw I’m experiencing daytime sleepiness (3 months in) even though I’ve adjusted the ASV settings for reasonable comfort and low AHI’s (always below 1.0)…. Sleep doctor visit scheduled.
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#14
RE: Daytime sleepiness one year into ASV
news to me and good to know. apparently I stand corrected.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#15
RE: Daytime sleepiness one year into ASV
there may be another thing. if you spent some time--perhaps years--sleepy in the afternoons, perhaps taking a nap--your body and mind become accustomed to that. it's habitual, or rather normal. So sometimes daytime sleepiness is just a matter of reverting to the habit--especially if you nap. Breaking the nap habit and establishing a new routine can be difficult. If this is the issue, pushing on through the daytime sleepiness and then seeing if you rebound later in the evening will tell you something. An evening rebound will suggest that you're getting enough sleep and jsut need to break the habit of daytime napping.

this may be entirely off base! I throw it out as one possibility.
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#16
RE: Daytime sleepiness one year into ASV
Just curious, but could you post or PM some 30 minute long close ups from Aug 4 chart from 00:00 to 00:30 and from 00:30 to 01:00? And, can you change the flow rate bounds to -90 to +90 which would make flow variations show more distinctly?

QAL
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