Seeing more UA and CA - due to being sick or AFIB med?

[Walla Walla]

Are you doing anything different due to the cold? Something like raising the back of your head up a little with an extra pillow? The way the clusters are it looks like your airway is getting cut off. Since you normally don't have this problem I'm wondering if there's a reason why your chin might be tucking into your windpipe?

[MyronH]

My head is raised just the same amount as it always has been now. I tried raising it earlier, but that didnt help. So I put it back to normal height. My bed has an adjustable frame, that adjusts feet and head height. So I just put it back to where i had it.

[Walla Walla]

You might try taking a small pillow and wedging it under your chin. That it'll keep your chin from dropping. Not sure if this will help but it's worth a try.

[Sleeprider]

I see a tendency to the positional apnea Walla is referring to. When your chin drops toward your chest it can cut-off the airway. You can simulate this sitting in a chair and just fully relax letting your chin drop. If you feel increased resistance to breathing, that is the same thing that can happen at night. It causes micro-arousals and we shift position, and it repeats each time we relax. A soft cervical collar can completely prevent it. Your chart shows hours of no-problem, but clusters of severe obstructive apnea. This pattern is classic for positional apnea. You can try to set pressure high enough to prevent it, but it might be more comfortable to just prevent it using a lightweight, short foam cervical collar. For most people a 2-3 inch tall collar that allows a loose fit is enough to prevent the apnea and the leaks that often go with them.

[ajack]

I really haven't changed my thoughts, either leave it alone till you are well or I think you need more max pressure and the min needs raising
your median is 11.5, the 95% is 12.94 and max is 13. The machine really does want to go higher. min 11 and max 15 is what you could have. I would even put the max to 20 and see what the machine wants to go to.

[MyronH]

ok thanks. I bought a cervical neck support I'm going to try tonight. I know sometimes my chin slips forward, so that may be one thing blocking airway. 

My dentist, who is also getting into sleep apnea business, told me last year my tongue is one problem. It's rather large for my mouth and he thinks it is slipping back to close my throat when i lay on my back. He recommended I get a dental appliance to move my jaw forward. But instead of going that route, I went with the CPAP machine first to try. But looks like I may now need to get a dental appliance too.

I'm going to bed soon. If this neck support doesn't work, and I wake up with the same tachycardia and high blood pressure, I'll be going tonight to the hospital. I can't go another night like last night. My resting heart rate has been 84-90 all day, when a month ago, it was always 55-70.

[Sleeprider]

Let us know how the c-collar works out before resigning yourself to an oral appliance. Many people find the collar provides a gentle push forward on the back of the jaw which solves the problem, even when they sleep on their back. This same gentle push also helps avoid leaks.

[MyronH]

Well the collar somewhat helped, I think. Didnt have to use my chin strap to hold my mouth closed. I also changed max pressure to 13.8, but it looks like I may need to increase to 15 at least. I have doctor appt tomorrow, so can discuss with doctor. I hear that going to high, can aggravate CA events.

 I went to bed 11:45am, first OA (26sec) followed by a group of others, then last OA (39sec). Had a couple short CA (15sec), but then no events from 1:45am-5am or so when i woke up. 

But I did wake up once with my heart racing. My max HR hit 146bpm. Not sure how long, since my watch doesn't record that. But that is what I consider high.

So I'm trying to understand a few things....
1. Do other people with sleep apnea experience racing heart/palpitations that wake them up?
2. Other people would be happy with AHI <5 like me, but how can anyone else stand it? Is it because their events are more split out throughout the night, unlike mine grouped together?

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[Sleeprider]

You just need more time with the therapy. When we look at this session, most of the events occur in a 5 minute cluster, and my impression is your chin slipped under the collar or something like that. It would be more interesting to see how the event began, than what it looked like as it ended here. Amazing how it ends as quickly and completely as it started. The breathing pattern is very disrupted with abrupt exhales, almost like blowing out air. I don't think increasing pressure is necessarily the answer. Your median pressure is 7.5 and 95% pressure is 11.5 which leaves you 2-cm above that to max pressure. I think your pressure is fine, and this event was positional.

[MyronH]

Here is a screenshot of beginning. Also I'm wondering if it is my tongue blocking the airway in back of my throat? My dentist last year did a 3D scan of my head/neck, and showed how there wasn't much room between tongue and back of my airway. So if my tongue moves back, maybe the pressure just cant move it out of the way?

"Being positional"...When i woke up i was in the same position, laying on my back, with my head in same position too. Unless my head moved left/right during the night without me knowing.

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