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Poor Sleep in the Early AM
#1
Poor Sleep in the Early AM
I woke up 6am this morning, out of breath and had to remove my nose pillow immediately because I felt my breathing was completely out-of-sync with the Airsense 10 CPAP.  I was trying to take deep breath and the machine was pulsing every 1 second or so.  What is happening ?  Can the software in the CPAP go bad ? Why does CPAP never get software update or firmware refresh?

Or maybe it is my health issue?   I have HBP, anxiety in the past, allergy, age 76.   I always have trouble sleeping after 3am and this poor sleep cycle occurs maybe 3 times a week or so lately. Attached is my data for the last 3 nights.


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#2
RE: Poor Sleep in the Early AM
Attached is expanded view on data before I got out of bed this morning because I can't breath.


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#3
How can I tell if CPAP Working Properly
How do I tell if my CPAP is working properly?   Maybe I need a Bilevel machine like the Aircurve 10.
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#4
RE: Poor Sleep in the Early AM
How long have you been on PAP therapy? New users sometimes have centrals, which may go away when the body gets used to cpap. If you have been on for a while , say 6 months, chat with your doc about an ASV machine.
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#5
RE: Poor Sleep in the Early AM
Because of the pattern of events, they may be more positional apnea. Usually centrals (the pap decides what type of apnea) are NOT positional but the way they come in groups then none makes me wonder if they really are centrals.

Positional apnea is when you get into a position that cuts off your own airway. Think of it like a kink in a garden hose. No matter the pressure the air will not flow until you get rid of the kink.

Sleeping on your back can be a problem but it is anytime your chin tucks down to your sternum cutting off your own airway.

Many people have found a collar has helped a great deal. I have a link on collars in my signature. It shows people without collars and the same people with collars / huge difference.

Again, centrals usually are not positional but I think it would be something to look at.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: Poor Sleep in the Early AM
Thank you for your replies. I have been on CPAP since I was 62; Now, I am 76. Started on Resmed S9 for a few years and been on Airsense 10 APAP for the last 8 years.  CPAP therapy was never perfect for me & I have always struggled with it. A week ago, I found out about Oscar through Youtube and this forum, so, I have been experimenting with pillows, changing EPR.  I bought a collar from Amazon, but have not try to sleep with it (too warm to sleep with). I am a back sleeper. Went from 2 pillows to 1 pillow to 1 & half pillow (use a small microbead type pillow).   I try to straighten out my neck and make sure I don't tuck my chin in when I sleep. I use saline nose spray to clear my nose, gargle salt water to clear my throat.  I stop using corticol steroid nose spray because I get rebound effect from daily use. Regarding EPR, I tried 3, 2, 1.  Not sure if I should go back to 2 or turn it off completely. The thing is, the first part of my sleep from 10pm to 2:30am is fine. The second section is sometimes a challenge. Not every night...driving me cracy.  ( I am not overweight & I eat a light heavy dinner & no food after 7pm.   COV 19 reduced my exercise routine to just walking & less sports) I know there is no silver bullet, but I have tried pretty much everything except the implant.  (I tried the mouth guard...very uncomfortable & did not work). Thanks for listening to me rant. I have an appointment with a new doctor (pulmonary) 7/13/22.  Will see what he say.
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#7
RE: Poor Sleep in the Early AM
Slam, are you by any chance in A-fib? Your respiration rate is reading over 40 and is extremely unstable. I think you should consider being checked out.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Poor Sleep in the Early AM
Sleeprider,

I looked up A-Fib.
an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart.  
I don't think I have heart skip beat, or heart beat racing in the day time.  I can hear my heart beat when it is racing , usually when sleeping,  and I can make it disappear by doing deep exhale. My GP checked me out and gave up EKG and the readings were normal  (that's when I complaint of tight chess and dull pain on left arm.) That went away... starting last winter, my hands & feet are particularly cold...that I figure is old age and arteriosclerosis...so, regular exercise & baby asperin..   

I though flow rate measures the air flow from the machine and does not necessarily represents the patience breathing rate...does it?    When I have difficulties breathing, my heart beat do start to race...and that contributes to my high blood pressure.     That is why I need to get my breathing taken care of first, so as not to stress my heart out.  I am only on calcium channel blocker & no other heart medication. ....At my age, I am always concerned about heart attack or stroke.  Thanks for bring this up
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#9
RE: Poor Sleep in the Early AM
The machine counts breaths per minute and charts that through the night. While sometimes irregular breathing is misinterpreted as rapid breathing, you actually are panting, or showing "Tachypenea". In this most recent chart, you have 5 breaths between 06:03:40 and 06:04 with many irregularities.  Counting only the major peaks that is 1-breath every 3.4 seconds or about 17 BPM.  The reminder of the chart is tachypenea at a rate of about 66 BPM.  This results in very low tidal volume, but high minute vent.  It is extraordinarily ineffecient, and you really need to get to the bottom of it.  A pulmonologist is a great start, but you may also need to look at cardiology.   There is not setting in CPAP we can recommend to resolve this extreme breathing rate or explain why it is occurring.  You should show this cart and other examples to your pulmonologist to kick off a conversation.  To read this chart the red-line represents zero flow. Each breath cycle is peak to peak, and this chart with 5-second x-axis is very easy to interpret the breaths per minute. This is an example at the extreme end of the night when you are likely awake or awakening. It would be interesting and helpful to look at representative samples of the respiratory rate through the night. In your case, including charts for Flow Rate, Mask Pressure, Respiration Rate, Tidal Volume and Minute vent (See Oscar View menu, advanced view) would be more helpful than the standard view. Post some charts so we can see if this is an exception, or typical condition.

My previous question about A-fib was because this unusual pattern is more frequently seen in individuals experiencing an irregular cardiac pace. Many BP machines, watches and other devices detect irregular heartbeat, and report it. The most helpful suggestion I can make is, when you become aware of being unable to breathe normally in the morning, you appear to have a panic attach with associated tachypenea. Focus on taking measured, slow breaths. Fill your lungs and exhale. Focus on your breathing and stop the panting.


[Image: attachment.php?aid=43081]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Poor Sleep in the Early AM
Sleeprider,

Thank you so much for your analyze. I will show this to my Pulmonary Dr..

I did much better last night...I took off the ramp, change EPR from 1 to 2, change Auto to Manual start, and raised humidity from 2 to 3  (I think higher humidity make my nose less stuffy, esp my left nostril due to mild deviated septum)

Most of my CA is after 5am. That's when my AHI goes up to 11. My wife gets up at 5:30am; so I was semi awake & AHI climbed to 16 until I got out of bed. Maybe I should get up the same time my wife gets up in the future. 9:30pm to 5:30am is 8 hrs of sleep.

Sam


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