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Newbie-Please look at my charts [Catathrenia]
RE: Newbie-Please look at my charts [Catathrenia]
(06-22-2019, 07:56 PM)SarcasticDave94 Wrote: esme17,

Welcome to the Apnea Board. I know this probably won’t help right now, but FWIW I’ll be keeping tabs on this thread as ASV was mentioned. Since I’ve got that device, if/when needed or otherwise appropriate I could give pointers on obtaining the ASV and share experience about it. Like sheepless I’ve never been aware of your particular medical issue prior to now.

Again welcome and best wishes on success.

Free bump thrown in... Coffee

Thank you for your support! I know who I will be asking for help if I get an ASV. Wink
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RE: Newbie-Please look at my charts [Catathrenia]
(06-23-2019, 08:58 AM)Sleeprider Wrote: Catathrenia is an issue that I have seen on the forum before, but have not researched for a cause or solution.

Catathrenia is rare and until recently most doctors and researchers thought of it as completely harmless, but with more recent studies they are finding it is not. They aren't sure why it exists or what the solution is. Most suggest PAP. 
It has only gotten worse for me as my sleep worsens as it's primarily stress based. I'll have 20+ events a night now vs. 3-5 only on a night when I was overly tired or stressed out. The last 3 years of lacking quality sleep due to what I assume is UARS is greatly taxing my body, mind and entire life; I feel like catathrenia is the least of my concerns. My thinking is if I can get better sleep by eliminating the apneas, snoring, sleep disordered breathing, teeth grinding, etc., it will calm my dysregulated nervous system way down, and the catathrenia will fade.

Quote:You are using a Vauto at 5.8 to 25 pressure and PS 3.  Based on the statistical median and 95% pressures, this seems like a reasonable range.   Have you tried adjusting cycle sensitivity?  My inclination would be to set Trigger to Very Sensitive, and  Cycle to normal.  Your Ti Min can be left at 0.3, and the Ti Max should be around 1.6.

When I first started using the machine (2 weeks ago) I adjusted it to a place that felt comfortable to me based on the settings recommended by user Bonjour: Ti min 1.0, Ti max 2.0, trigger and cycle medium. 
Based on your new recommendations I changed it to what felt most comfortable to me: Ti min 0.7, Ti max 1.6, trigger and cycle medium.

Quote:I think an in-clinic sleep study might be needed to confirm your self-diagnosis of Catatrenia. While your symptoms and experience may point to that, clinical observation could confirm this as a diagnostic that your doctor can act on.

I do have an official diagnosis of catathrenia, sleep disordered breathing (probably UARS), plus an "unspecified sleep disorder". Long story short... I had 2 in-home studies that showed enough interest (above average RI) to warrant an in-lab sleep study. However my insurance wouldn't cover it. The first sleep doctor I saw didn't know what catathrenia was at all (googled it on his phone while I was there!), and seemed very uninterested. I found a new doctor for a second opinion. He listened to my sleep recordings and looked at my in-home studies and thus diagnosed me with Catathrenia and sleep disordered breathing. I did the sleep study in his lab (which was not the greatest experience). For once I didn't snore, grind my teeth, have catathrenia, or do anything at all. The sleep study showed nothing. There was very little deep or REM sleep until I was on the titration portion. I slept slightly better, but not remarkably. Based on all that, the doctor still gave me an APAP (Resmed 10 AirSense) with a setting of 6. Without going into all my myriad of symptoms my sleep is very poor, restless and I am ridiculously tired during the day. The doctor thought the machine would help that, plus the catathrenia as some studies show. Unfortunately, I was not compliant due to lack of any interest on his part in helping me troubleshoot things. (Obviously I was unaware of wonderful forums like this one.) So I had to give the machine back. And continued to have worse and worse sleep. I recently learned I could buy a machine and do this myself, so here I am.

Quote:Without that, I tend to agree with Ajack that we need to treat this as conventional obstructive sleep apnea, and centrals, that is generally within efficacy limits for CPAP treatment.  With that said, my recommendation for now is to moved to a fixed bilevel pressure to eliminate the variability of auto pressure, and to keep pressure out of the range where you complain of aerophagia.  My suggestion is S Mode at 9.0 IPAP, 6.0 EPAP, Easybreathe On, or Vauto at IPAP max 9.0, EPAP min 6.0, PS 3.0.   I don't know that this will make things a lot better, but it should make it easier to identify the problems.

I tried the settings you suggested on VAUTO (as I felt those were a bit more comfortable than S mode). I slept okay/normal for me. The settings felt comfortable, easy to breathe and tolerate (felt like nothing!), and the aerophagia isn't gone, but lessened. (I have a weak LES and hiatal hernia so I think anything can be irritating to my system.) Here is the chart and some close-ups from last night with your suggested settings.
PS: 3
Ti Min: 0.7
Ti Max: 1.6
trigger: normal
cycle: normal

THANK YOU SO MUCH AGAIN! I really appreciate your help and wisdom. I'm so frustrated and tired, and this is all very difficult. You've inspired my husband to research and learn more about all this so he can help me. I'm usually pretty sharp, but the lack of sleep has affected my cognition.




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RE: Newbie-Please look at my charts [Catathrenia]
Interesting that the OA events are apparent breath holding. It starts with an inhhale, and I presume these may be the Catathrenia. The CA events generally are shorter and start after exhale. I don't see how higher pressure will help this, so if it helps with the aerophagia, this might be a good setting to get a few days of settings, then perhaps try just a bit less pressure and a little less EPR.

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