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[Diagnosis] Could Sleeping Pill During Test Cause False Apnea Diagnosis
#11
Love this thread...

Sleeping pills:

I've been on them for about 10 years. I was diagnosed with sleep apnea about 2 years ago. I changed to the sublingual (under tongue, Edular) method just before that. Is it possible the sleep meds, which cause the brain to "relax, also cause muscles to relax a little too much -- specifically those back-of-the-throat muscles? ...therefore worsening the cause of sleep apnea?

Amazingly, a few weeks ago -- after 10 years -- I seemed to have kicked the sleeping pills. I still wake up in the early morning, but now it's after about 4-5 hours of sleep (instead of 2-3). I don't fall back to sleep but just rest in bed for the next 2 hours. That, plus CPAP, seems to work for me in that I can survive nicely the rest of the day.

Coincidentally, my kicking the pills started with the recovery from an operation where I slept continuously day and night for perhaps one week. Perhaps this was a twist on the sleep deprivation therapy but from the opposite point of view! By sleeping all the time I really confused my sleep clock which allowed me to reset it???? Crazy. Anyway, I seem to be off pills for the first time in 10 years but I couldn't survive one day without CPAP.

Sleep Study with Sleeping Pills:

On my first sleep study, and later titration, I didn't sleep at all. Of course, the sleep doc said there was some sleep. I swore to myself I'd use sleep meds if I ever had that chance again. Two years later (a few weeks ago) I did! I took 1/2 a pill to sleep with all the wires. I might have even taken another 1/2 in the middle of the night, but I don't remember (sleeping pills is not great for one's memory).

The results were pretty much the same as two years ago with one exception... my O2 really plummeted at times with the pills. I even dipped to 85% for some periods. That's pretty bad I think. The lesson I guess is that sleeping pills might really contribute to one's early departure if they are misdiagnosed sleep apnea sufferers.
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#12
(09-17-2016, 09:50 PM)trish6hundred Wrote: Hi Violetskyye,
WELCOME! to the forum.!
I want to encourage you to stick with CPAP therapy and good luck finding a mask that works well for you.
Hang in there for more responses to your post and much success to you on your CPAP journey.

Thanks so much. This has been such a struggle for me, but I'll keep trying.
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#13
(09-19-2016, 06:55 PM)WakeUpTime Wrote: Love this thread...

Sleeping pills:

I've been on them for about 10 years. I was diagnosed with sleep apnea about 2 years ago. I changed to the sublingual (under tongue, Edular) method just before that. Is it possible the sleep meds, which cause the brain to "relax, also cause muscles to relax a little too much -- specifically those back-of-the-throat muscles? ...therefore worsening the cause of sleep apnea?

Amazingly, a few weeks ago -- after 10 years -- I seemed to have kicked the sleeping pills. I still wake up in the early morning, but now it's after about 4-5 hours of sleep (instead of 2-3). I don't fall back to sleep but just rest in bed for the next 2 hours. That, plus CPAP, seems to work for me in that I can survive nicely the rest of the day.

Coincidentally, my kicking the pills started with the recovery from an operation where I slept continuously day and night for perhaps one week. Perhaps this was a twist on the sleep deprivation therapy but from the opposite point of view! By sleeping all the time I really confused my sleep clock which allowed me to reset it???? Crazy. Anyway, I seem to be off pills for the first time in 10 years but I couldn't survive one day without CPAP.

Sleep Study with Sleeping Pills:

On my first sleep study, and later titration, I didn't sleep at all. Of course, the sleep doc said there was some sleep. I swore to myself I'd use sleep meds if I ever had that chance again. Two years later (a few weeks ago) I did! I took 1/2 a pill to sleep with all the wires. I might have even taken another 1/2 in the middle of the night, but I don't remember (sleeping pills is not great for one's memory).

The results were pretty much the same as two years ago with one exception... my O2 really plummeted at times with the pills. I even dipped to 85% for some periods. That's pretty bad I think. The lesson I guess is that sleeping pills might really contribute to one's early departure if they are misdiagnosed sleep apnea sufferers.

Thanks. I guess in order to get the full picture of with and without pills, one would need a full sleep study without the pills and a full sleep study with. Unfortunately: (1) my insurance won't pay for so many studies; and (2) I don't sleep that many hours with or without the pills. I'm thinking once I'm more used to the machine, I'll go a night or two without the pills, and see if the machine records as many apneas, but it still seems like a futile experiment.

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#14
My Air Fit P10 Full Face arrived yesterday, and I tried it last night. Good and bad. It wasn't as uncomfortable or bulky as I expected. I set my min up from 4 to 5, and fell asleep okay, but woke up a couple hours later with the pressure up to 11, and the bottom part of the mask leaking and making loud farting-type noises against my face. I tightened it, and the leak was better, but the mask felt too tight.

On the measuring, I feel like I have a small face, and the measuring card showed I was right at the edge between a small and a medium. Since I don't want it right in my eyes, I got a small, but wonder if it's a scooch too small. The bottom is under my bottom lip,and the top is not quite at the top of my nose. Maybe I'll try a medium, since I have free return insurance.

Anyway, at 11 pressure, I really couldn't go back to sleep very well, and ended up wearing it just over 4 hours total, which a lot of that awake. AHI 5.54. I'll try again tonight. The funny part is that I got the full face due to mouth breathing, but it seems like I ended up breathing through my nose most of the time anyway, so maybe I'll go back to the Eson nasal, which I kinda like. Sheesh, it really is hit and miss with this stuff.

Thanks for the help.
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#15
My experience with sleeping pills is this: I was on ambien for a couple of years and it was working fairly well, although I never really felt rested. Then last year I started waking up and not feeling rested, then over the course of the day I would have intense fatigue and chest pain and various other side effects of extreme fatigue. Put up with this for about 3 weeks and then got off the ambien and onto trazodone. My fatigue cleared up and I was feeling pretty OK for about a month. Then it came back with a vengence and I spent all of January going insane with fatigue - waking up feeling not rested an a little off, and then it would ramp up to going out of my mind at night. Started back on the ambien and various other types of pills to try and get rested. Had a sleep study that put my AHI at 8.5 (on pills). Was thinking about getting onto CPAP but then decided to just get off all pills completely. Cold turkey, 2 days of not sleeping and crawling out of my skin, and then the clouds parted and I went 6 months feeling good. I assumed my fatigue was based on daytime withdrawl from the sleeping pills.

The fatigue came back a month ago and I immediately got a cpap machine and scheduled an appointment with the sleep specialist. AHI was at 13 and I can't get it under 4-5 but I'm working on it. I still feel like crap but not even close to as bad as I was in January. My assumption was that the pills were making the sleep apnea worse because of the muscle relaxant effect. But I don't know. The specialist wasn't even positive that my issue is sleep apnea, but I figure I need to get my AHI down for a while and see how I feel. I recommend getting off the pills if you can and see what it does.
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#16
Hi, I'm back to check in. Wow, I tried my new Air Fit F10 full face, and, on the third night, last night, kept it on for 6.5 hours, which is a first for me. My AHI was 5.4, with mostly Central, which is worrisome, but I'll figure it out. The bridge of my nose is killing me. The sizing guide put me right between a small and a medium, and I went w/ small, because I'm 5' and 100 pounds, so I'm always a small in everything, but I'm gonna try a medium w/ return insurance.

I am so pleased though that I was able to keep a mask on all night, which is huge for me, even though I have a ways to go. I took your advice and raised both the ramp pressure and the min to 5.5, so increases not so jarring. I still woke up every time the pressure went above 9, but I'll keep toughing it out.

I have the EPR set for 2 out of three full time, and am wondering, based on some research, if the EPR is what is causing so many central [or open airway] apneas, since my obstructives were only 2 in 7 hours last night. I guess I'll keep tweaking it till I get it right, but after 8 years on and off fighting with various pieces of equipment, I'm encouraged.
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#17
Interesting. I'm going to keep taking the pills for a bit, and try to adjust to using the CPAP. Then, I plan to do an experiment and titrate down off the Ambien, and keep using the machine. Obviously if it shows no events or less events without the pills, then the pills are causing or worsening the apnea, though it's going to take time and patience to know for sure.

I know I should get off sleep meds, but I have had insomnia, lying awake hour upon hour, since I was a little kid, and at 60, it doesn't seem like that's going to change. I have done meditation, sleep hygiene, melatonin, bananas and milk, staying up 36 hours until I'm exhausted. The only thing that works: popping one Ambien, and I'm out w/ in 15 minutes, so you can see why doing without it would be tough. I know it probably makes my concentration bad, and makes me a little groggy. Also, who knows what it may be doing to my brain, but doing without it is so dang hard.
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#18
Hi Violetskye,
It
s great to hear that you are going to keep trying with your CPAP therapy, I know it can be difficult to get used to.
Its great that you are finally getting used to the AirFit F10.
Keep up the good work.
trish6hundred
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#19
(09-22-2016, 03:23 PM)Violetskyye Wrote: Hi, I'm back to check in. Wow, I tried my new Air Fit F10 full face, and, on the third night, last night, kept it on for 6.5 hours, which is a first for me. My AHI was 5.4, with mostly Central, which is worrisome, but I'll figure it out. The bridge of my nose is killing me. The sizing guide put me right between a small and a medium, and I went w/ small, because I'm 5' and 100 pounds, so I'm always a small in everything, but I'm gonna try a medium w/ return insurance.

I am so pleased though that I was able to keep a mask on all night, which is huge for me, even though I have a ways to go. I took your advice and raised both the ramp pressure and the min to 5.5, so increases not so jarring. I still woke up every time the pressure went above 9, but I'll keep toughing it out.

I have the EPR set for 2 out of three full time, and am wondering, based on some research, if the EPR is what is causing so many central [or open airway] apneas, since my obstructives were only 2 in 7 hours last night. I guess I'll keep tweaking it till I get it right, but after 8 years on and off fighting with various pieces of equipment, I'm encouraged.

Violetskye, a couple suggestions...since you are not experiencing obstructive apnea events, I think you may be okay to reduce the maximum pressures. You are probably having some flow limitations or snores that is driving up pressure (hard to say without seeing data), but try limiting the maximum to 9.0 for now and see if you sleep better, or if it allows obstructive events to come through.

Secondly, EPR can cause centrals in some people. If you find the pressure change from inhale/exhale pressures to be comfortable, stick with it, and it will probably pass. For the time being choose whether you want to try a lower maximum pressure or lower EPR setting, but don't do both at once. Give any changes at least a few days to settle out before you decide to keep or reject the change; or before making additional changes.
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#20
Thanks so much. For last night, I set if for EPR during ramp only. Guess what! I kept he mask on over 5 hours [which for me is very good], and for the first time had an AHI of just 1.7. No obstructive again, just a handful of centrals and one RERA. You advice sounds good. Per Sleepyhead, the pattern is my flow will show I'm asleep for about 90 minutes, then an event, which sends the pressure up. Pretty shortly after the pressure goes up I wake up, eventually reset the machine back to ramp, take a bit to fall asleep, till the next event.

I think it is a good idea to set a smaller range to see what happens. I also may at some point try a good old fashioned continuous pressure of 7, which is what I was prescribed way back when. I'm a light sleeper, and maybe the pressure going up and down is not the best for me.

My nose bridge is so sore from the mask, so I'll have to nail that down too [not literally], but I never thought a full face would be so much better for me. I should have tried one years ago.
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