Going down a rabbit hole!

[richcrab]

Hey everyone, after about 6-9 months of being in the zone and having good quality sleep w/ my ResMed AirSense 10, I am trying to figure out why things seem to be deteriorating.  During that "good" period, my AHI was typically in a range of 1.0 to 2.0 (Obstructions 0.5-1.0 and Clear Airways 0.5-1.0; pressure 12-15).  I felt fairly well rested.

Several months ago, something seemed to change.  AHI became more variable night to night (1.5-3.5 or so) but what was more concerning was that I didn't feel as well rested in the mornings.  Machine and mask remained the same, with leaks well controlled, and I don't think I was doing anything different re sleeping position.  I had gained a little weight, however.  Ultimately, I bumped up the pressure a bit and tightened the range a bit (from 12-15 to 14-16).

This did not seem to help much.  I then potentially complicated things by starting 20mg daily of prozac.  Almost immediately, I began to see more deterioration in the numbers, with AHI moving into a range of 3-6 with increases in both obstructions (1.5-3.0) and clear airways (1.5-3.0).  I have read that SSRIs like prozac can impact REM sleep and make breathing more shallow, possibly creating more clear airway events.  

I feel like I have gone down a rabbit hole here, constantly looking at SleepyHead and trying to figure out why I am not feeling as rested (even prior to prozac) and what can be done.  Has anyone found themselves in a similar situation?  What did you do?  Am I right on how SSRIs can impact #s?  Should I go back in for a sleep study to rebaseline things?  Or in the big picture are these numbers ok and I am worrying too much?

Thanks for any help - I don't have access to SleepyHead at the moment, but can post images later of helpful.

[OpalRose]

If you would post some data from #SleepyHead, we might see something in your graphs and be able to advise.

Follow the tutorials in my signature line, and post a screenshot or two here.

As far as using Prozac or any medicines, you can count on it affecting your numbers.

[richcrab]

Absolutely OpalRose, thanks.  Below I am linking two time series:
The first is from just last night (8/2/17) when my AHI was 6 with a pressure range of 14-16 and EPR 2.
The second is from March 2017 when I was consistently getting AHI ranges of 1.5-2.5 or so at pressures of 12-15 and EPR of 2.  

Any help is appreciated!

[OpalRose]

Mabye go back to the pressure range that gave the best results.

One thing that may help with the Clear Airways is to lower the EPR to 1, and eventually off.

I do see the increase in CA's and obstructives, which may have increased due to the Prozac. I'm no doctor, but just assuming.

[richcrab]

Thanks, in the first graph does the way the pressure bumps up against 16 suggest that I should actually be at a higher figure?  Like 17?

[Sleepster]

This did not seem to help much.  I then potentially complicated things by starting 20mg daily of prozac.  Almost immediately, I began to see more deterioration in the numbers, with AHI moving into a range of 3-6 with increases in both obstructions (1.5-3.0) and clear airways (1.5-3.0).  I have read that SSRIs like prozac can impact REM sleep and make breathing more shallow, possibly creating more clear airway events.  

It could be that something else changed that caused you to start taking prozac. Whatever that thing was, it could be responsible for you not feeling as rested. Anything like that can have an affect on your AHI.

Then when you started taking the prozac, things went further south. I would talk to your doctor about an alternative to the prozac. Emphasize that it makes you feel less rested when you take it.

[OpalRose]

Normally, I would say yes. The pressure bumped up to the max in response to obstructives, but then lowered probably due to the CA's.

If you keep raising the pressure, you could experience more CA's. I would first try reducing the EPR setting.

[richcrab]

Thanks guys, I will tweak and see what I can do

[richcrab]

Here is last night's results, reducing the ERP from 2 to 1.  I noticed the difference in terms of exhalation, but reducing the ERP did seem to have a + effect as overall AHI reduced from 6 the night before to 3.  Of course, I realize one night is not a trend.  Anyone see anything notable in the graphs?  Thanks again.

[Sleeprider]

So far the only consistent trend I see is that AHI is worse with higher pressure. EPR does not seem to be a problem. Your results in March were with a pressure of 12-15, EPR 2. The increase to 14-16 does not seem to have been particularly helpful. The results for 8/3 actually has a slightly lower median pressure than August 2.

I think the setting changes are occurring too fast here to establish a trend, but I'm curious why the increase in pressure from your March baseline which appears to be better in terms of results?