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In anticipation of my BIPAP Re: New Thread
RE: In anticipation of my BIPAP Re: New Thread
(01-18-2020, 01:00 PM)ApneaQuestions Wrote: That single night's graph isn't telling me much about any magic silver bullet.

Poop.  Sigh. Okaayy.

Research requested:

(Btw, I forgot to mention my husband says I do these in addition to everything else:

OFTEN:  Sleep Talking - (Not anything to really worry about according to info I have read, just thought I'd mention I do it).

You may talk out loud during sleep. The subject matter is often loud and fairly nonsensical. By itself, sleep talking is very common and tends to be harmless. It may also be a feature of another sleep disorder such as REM sleep behavior disorder, sleepwalking, night terrors or sleep related eating disorder."
 

INFREQUENTLY:  Sleep Related Eating Disorder

This parasomnia is defined by repeated episodes where you rapidly binge eat and drink after you wake up in the night. These episodes are out of control and tend to occur when you are only partially awake. You may only have a slight memory or no memory of the binge. This may occur nightly. The food is often highly caloric and consumed in strange combinations. People with sleep related eating disorder might accidentally injure themselves by eating toxic substances, burning themselves or causing fires."
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STILL RESEARCHING MY SITTING UP relationship to Sleep Walking, I'm finding most mentions state "eyes" open which mine are not 99% of the time. - Gotta address this tonight or tomorrow here.

(THIS - PROBABLY WHY THERE WAS THOUGHT I WAS DEVELOPING DVT, ALTHOUGH TESTS SHOW OTHER VEIN ISSUES THAT SEEM TO HAVE LESSENED WITH PAP THERAPY:  "However, sleeping upright does present some concerns. First of all, sitting motionless with bent limbs for more than a couple of hours can lead to the development of deep vein thrombosis,...")

Google can be dangerous.

Speak to ya later.  PS. Sent you PM re: O2 meter

Have a great day!!
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Sleep Walking

Sleepwalking or somnambulism is probably the most well known arousal disorder. Sleep Walking is most commonly seen in children, although it can be seen in adults and the elderly. Boys are more likely to be sleepwalkers than girls are, and the disorder usually runs its course before the teen years. The rates of the occurrences can vary from person to person, some may only sleep walk once a month, while others may sleep walk nightly. The actions during a sleepwalking event can vary as well. *Some people may only sit up in bed, or walk around the room while others may walk around the house or leave the house. Other events during sleepwalking may include open eyes with a blank expression, **unintelligible talking, or use of language not typical to the person. While injury from sleepwalking is rare, they affected person can put them self in danger, like going outside in bed cloths during the winter. In most cases, no treatment is necessary for the sleepwalker, as the number of events will decrease as the child ages. As the sleepwalker is unaware of their environment there are some common sense steps one can take to insure safety for the sleepwalker. Be sure there no large objects near the bedside; make sure there is not anything on the floor that could be tripped over. If one is concerned the sleepwalker will try to go outside, close and lock bedroom windows at night and lock doors to the house. Despite popular myths, it is not dangerous to wake a sleepwalker. However, upon waking them, they will probably be confused or disoriented, so it is best to speak to them gently and encourage them to return to bed.

Quote from: From ASA; American Sleep Association


*Now I am trying to figure out if eyes are closed or not, if it matters if they are open or closed a % of the time.
** My husband says I usually sound like I'm speaking gibberish. 

Well, back to Google and trying to figure out the correct search terms/keywords.

Plmnb 
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Here ya go.... following your link one link deeper....
Check out sentence one of bullet 3
https://www.sleepassociation.org/sleep-d...rder-book/

3. Diagnosis of parasomnias
All parasomnias more commonly affect persons who have breathing disorders during sleep.

I rest my case your 'onor ... lock 'er up!! ;-)
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RE: In anticipation of my BIPAP Re: New Thread
I raised the issue of these sleep disorders because they seemed to fit certain events you have described, and it might be useful to talk to your doctor. Doing some research and trying to decide if this "fits", may be helpful. I was actually moving towards a discussion of some pharmaceutical approach to getting to sleep and staying asleep long enough to feel good, and perhaps suppress extra curricular problems. As far as getting to bed earlier, "that" extra curricular activity might be a good idea and result in more better sleep for both of you, and certainly beats late night television. Just trying to come up with practical approaches to therapy. Smile
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RE: In anticipation of my BIPAP Re: New Thread
Phoebe..
Can you remind me what your smoking status is these days? I seem to recall that you quit smoking. Did you restart or are you still on that journey too?
One of the side-effects of nicotine withdrawal is insomnia and sleep disruption. Apparently it can take some time for the nicotine receptors to calm down.

Also, you mentioned alcohol in passing some time ago. Where do you stand with that these days and how much how often?
That's another thing that affects sleep quality and apparently can affect throat muscle tone.

EDIT: There was also mention of taking a antihistamine too. Has that regimen changed at all?

I'm just trying to make sure we have the "big picture" right.
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RE: In anticipation of my BIPAP Re: New Thread
Good afternoon Sleeprider.  I am so glad you did mention the other sleep disorders.  I will certainly have a comprehensive book binder of notes and visual aids for my doctor.  I definitely will be addressing these other situations with him.

I have NOOOO problem getting to sleep, lol.  It is strictly the staying that way that is the issue.  I have tried prescription sleep medication in the past, a few different types, and nothing worked.  I also tried Melatonin, not a bit of help.

I do often work until 11:00PM so getting to bed by midnight is impossible.  (I will be asking the doc about why I can go to bed early or late and still wake up early).

I was thinking about posting a visual showing the way I sit up and also, something I never knew until watching the videos, there is this weird way, when laying down, that my legs are raised up with my feet either planted flat on the bed, as well as very often one of my feet and legs pointed out to the right while raised up.  If I can censor it enough I will do so.

I took a break this morning from posting charts and may do so tonight.  I was doing some creative editing on them and ran late for work.

Speak to ya soon,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Howdy do ApneaQuestions.

My smoking is back and forth.  I KNOW this isn't helping.  It wasn't an obvious issue in the past, but one day at a time with this struggle.  I did quit for an entire year once, but can't recall if it was before, during, or after my previous attempt at PAP therapy and I don't remember what effect if any the not smoking had on my apnea.  I do know that all these things I am experiencing these past few years do happen whether or not I am smoking or not smoking.

As far as alcohol, I don't remember talking about it.  Probably because I quit drinking entirely about 10 years ago,  I wasn't a heavy drinker, just a few drinks when I would go out to play poker.  I gave it up because the bipolar meds I had started taking mixed with alcohol consumption would have been deadly.

Btw, I haven't taken bipolar medications in about a year and a half.  I am curious if taking them again would be beneficial.  I briefly came across an article that talks about possible connections between bipolar and sleep apnea.  Another thing to talk to the dr. about.

Regarding the antihistamine, it was just recently prescribed for me due to an issue with my eustachian tubes.  I took it a few times but didn't notice any appreciable difference, so I haven't taken any in a about a week or two.

I have been taking blood pressure medicine for the first time in my life.  My blood pressure was running very high, which according to my research can be due to sleep apnea.  As to if they are maybe the cause of my other sleep situations, I had all my sleep issues prior to taking the medicine.

I don't exercise, I don't like it until I do do it.  Being 66 pounds overweight it would be a darn good idea to do so though.  And before anyone says, well there you go, she's overweight...I had sleep apnea back when I weighed 127 pounds over 40 years ago.

In the belief that this is a non-judgemental community I will say, I do smoke pot.  Not a lot, but a few times a week.  I do seem to sleep better, or at least longer when it is REALLY good quality.  (I did start some research on marijuana use and sleep apnea).

Do we need to know anything else that might be helpful?

Best Wishes,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
I've been really curious if anyone else here is doing this: (I was trying to post a shot of myself, but I couldn't censor it sufficiently, so this will have to do).


[attachment=19169]

This is pretty much exactly me doing one of the two strange things I do.  I was viewing video to see if this happens only if I fall asleep without the mask.  It does not.  The shot I was going to post shows me sleeping with the mask, then sitting up, then taking off the mask, and doing the above.

My husband says I do it for sometimes an hour or more at a time.

Yesss, I'm going to show the doctor my videos Smile

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Thanks for the answers Phoebe.  I just wanted to refresh my memory regarding the highly complex set of variables that are in play here.

As we look at the sleep data in OSCAR, we are basically treating you and the VAuto taken collectively as a single "system" that we are trying to control by using just a few levers.

Those three levers have labels on them..
a) PS
b) MinEPAP
c) MaxIPAP

One other "option" at our disposal is to switch out half of the "system" by replacing the VAuto with an ASV

However, that simplified way of thinking does not take into consideration the possibility that the "system" is potentially being impacted simultaneously by things like nicotine withdrawal, CBD, THC, caffeine, a thousand other chemicals in Marijuana, stress, anxiety, high blood pressure, low blood pressure, antihistamines, good thinking, bad thinking, straight neck, chin tucking, etc etc.

If we go back to the simplified view, then we have a clear idea of how to help with the flow limitations and what to do about it.  
Those choices are..
1) Keep bumping PS looking for better flow and trying to avoid too many CAs or discomfort
2) Switch to an ASV if we max out the capabilities of the VAuto and need to get better control

After that, the other things that may help are..
3) Prevent any blatant positional issues if or when they become apparent.
3a) Use a video looking for clues
3b) Use neck brace for chin tucking if that is in play (but results have been unconvincing so far)
3c) Fix pillows if that is an issue (but results have been inconclusive to date)

Finally we are left with basic sleep hygiene considerations
4) Go to bed at regular repeatable times
5) Optimize the chances of getting a sufficient duration of sleep by getting to bed early enough and/or rising late enough
6) Optimize the quality of sleep by keeping the mask and machine in play to give consistent therapy
7) Avoid anything that is known to have negative impact on sleep quality or sleep continuity.   (various drug impacts and/or drug-withdrawal effects).

I think at this point you have a good understanding of what to look for in OSCAR data and how to respond to it.
I also think you'll know when we've exhausted our options with the VAuto and how to pursue the possibililty of an ASV with the Doc and with or without insurance.

So.... where does this leave us?  What do you want to do next?

All I can see in my crystal ball is..

a) A couple more PS bumps squeezing the last drops out of the VAuto
b) maybe a tweak on the MinEPAP floor to tidy up any rogue OAs
c) Switch to ASV if still needed.
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RE: In anticipation of my BIPAP Re: New Thread
Crying-into-tissue


Not really, but I feel like it.



Thanks so much ApneaQuestions for trying so hard to help me, and I really am trying to keep my spirits up for this quest of decent, (I don't even mind not perfect), but at LEAST decent sleep.

I'm nervous that my sleep doctor appointment will be disappointing.  I did ask the doctor's medical assistant to try to schedule me enough time to go over everything with my doctor...you know not the typical 5-15 minute appointment.  I have only met him once so far, but he seemed to be a better fit for me than the previous doctor in the practice that was referred to by others here as a duck.

I also have an appointment at the end of the month with a psychiatrist for my bipolar.  I need to see if taking bipolar meds again will help.  It has been a couple of years and I don't remember if my apnea was affected in any way by them, for the better or worse...or maybe things were the same.

I'll admit it, my sleep hygiene is pretty poor.  I have no idea what to do about a consistent bed time.  My work schedule, as I have mentioned previously, is all over the place.  11-7,  
11-8, 1-9, 12-9, 3-11...I can have these various times all in one week.  For the first time in a year and a half I was scheduled 7AM - 3PM...that was fun, not.  I know my employer would work with me regarding a more consistent schedule if they could, but it just isn't possible due to the demands of the job and the other employees needs.

On top of my work schedule issues, there is my husband's schedule.  Again, previously mentioned but perhaps lost in all the posts I have written, he works a late shift, not getting home until after 11:00PM or often later.  As a newly married couple, it is very important for us to spend time together.  As it is I usually am passed out when he gets home.

So if anyone has any suggestions about a more consistent sleep-work-relationship schedule, please....let me know.

In regards to getting an acceptable duration of sleep, I wonder how many hours would be good for me?  It doesn't matter if I go to bed early or late.  I just naturally wake up anywhere between 5AM - 7AM,  (Even 4 AM at times, which sucks since when I don't go to sleep until 2:00AM at times).  If 7 or 8 hours is optimum and what I need, I just don't see how it is possible. Between such poor getting to bed hygiene and the apnea, I swear it is a wonder I can still function at all.

I'd love to give up smoking, it is said it is the most difficult vice to quit, although I have heard of may people who have done it, even cold turkey.  I was prescribed Wellbutrin many years ago as a non smoking aide, but after a couple of days I broke out in humongous welts and I couldn't sleep at all.  Doctor told me to stop taking it.  But after I stopped taking it I did not smoke for a year.  There is a drug named Chantix, (I think this is how it is spelled), but my primary doctor will not prescribe it for me due to my bipolar.  I think I'll ask at my psych doctor appointment. I have been trying the Florida Quit Now Program with little success.

Compared to my first experience with PAP therapy, I am 1000000% more compliant.  Besides a single day, I have put the mask on every night before I turn in.  And unlike the first experience, the majority of the time the mask is still on me when I finally wake up.  I do take it off when I wake up in the middle of my sleep, and I unknowingly remove it when I do my sitting up thing, but somehow it ends up back on 99.99% of the time.

I gave the neck brace another chance last night.  I slept with it on until I woke up in the middle of the night and kept it off when I went back to sleep.  I have compiled some interesting data and am going to post my findings when I finish the charts I am working on.

I also tried sleeping on my side AND my back last night, I am trying to correlate the video and the OSCAR charts for this in addition to the neck brace.  With the initial sleep lab study showing I actually did better on my back than on my left side, which apparently is counter to what the sleep experts say, and the fact that my bipap titration sleep study showed me sleeping better on my right side vs. my back, I'm a little confused.

Pillows, an area I have not done much with.  I did recently buy one of those bed pillows that people use to recline against.  I have read on here that for some, sleeping in a recliner has helped.  Not wanting to sleep in a chair, I thought this would do the trick.  Yeah, NO.  Someone mentioned a buckwheat pillow, I may try that next.  I hope it isn't too thick because my
experiments with pillow height have not gone well.

I am starting to find that my prescription usage is increasing.  I have gone from not taking anything except over the counter pain relievers for the apnea headaches, to taking what will soon be at least a handful of medication.

SOOOO, ApneaQuestions.... 

In addition to addressing all the above, there is this:


"All I can see in my crystal ball is..

a) A couple more PS bumps squeezing the last drops out of the VAuto
b) maybe a tweak on the MinEPAP floor to tidy up any rogue OAs
c) Switch to ASV if still needed."

Speak to you all again soon.

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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