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Sleep Onset Issues
#1
Sleep Onset Issues
Hey guys - I know many people here have had sleep onset issues - and was told there is nothing to worry about. But do most people's O2 drop like this? This was an unusually hard night - I don't mean to double post stuff but I am really struggling with this. Does anyone else have more solutions / tips on what to do about this. The doctors don't seem to be concerned but I literally can't get to sleep half the time.  Posted this is other forums as well.  Just struggling.

I know I am not fully asleep - SWJ type stuff - but these seem and feel like a lot bigger issues than others have told me.

Attaching 3 graphs from last night.

   

   

   
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#2
RE: Sleep Onset Issues
You have what we call positional apnea or chin-tucking, and it cuts off your airway in a way pressure cannot resolve. The signature of this problem is when obstructive events occur in clusters. You are having very long OA events and it's important that we try to solve the problem. Start by reading these two wiki articles:
Positional Apnea: http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar: http://www.apneab oard.com/wiki/index.php/Soft_Cervical_Collar

Some people resolve this by changing pillows or being aware of sleep position, but the soft cervical collar is a tried and true solution. Note the tight clusters of OA in your charts, and compare that to the examples in the wikis. This problem is easily solved, but until it is, therapy is usually poor regardless of pressure.
Sleeprider
Apnea Board Moderator
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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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#3
RE: Sleep Onset Issues
Thanks sleep rider. I have a cpap specific pillow - and I have used a collar before but it hasn’t seemed to change much.

I do try to keep my chin up as I sleep and I only sleep on my side.

“ The airway obstruction or positional apnea from chin tucking is more acute when nasal breathing and is typically overcome through arousal and/or mouth breathing.”

This is from the article - does this mean I should try to breathe more with my mouth?

Also is there a chance the collar isn’t high enough? It’s a pretty big collar but I do have a little room under my chin.


Thank you!
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#4
RE: Sleep Onset Issues
Too funny!

I don't think they were recommending mouth breathing, just like they probably weren't recommending waking up.  Rather, I  think, they were saying that's what happens as a result. 

Nasal breathing is the preferred method of breathing.   Your nose is designed to breathe air in and out and offers protection to the body.
Sleep-well
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#5
RE: Sleep Onset Issues
Lolabove  What she said! Perfect.

The only thing I'll add is maybe your CPAP  pillow is stuffed too full or elevates your head too high. I use a down pillow that is very compressible.  I actually think some the therapy pillows  with memory foam or buckwheat husks are the worst for this problem.
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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#6
RE: Sleep Onset Issues
Gotcha I’ll try that. Do those look at all like central apneas (been told they do but I have no idea). Or does ASV work on transitional apneas?
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#7
RE: Sleep Onset Issues
I don't see anything in your charts that points to central apnea or ASV. I see positional obstructive apnea.
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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#8
RE: Sleep Onset Issues
How coincidental, I just posted a similar thread thread on a DME-owned forum and was going to post here as well shortly (I'd hinted at this in another thread but was a bit off topic so posted a new one!).

Have a look here:

http://www. a DME-owned forum .com/viewtopic.php?f=1&t=181551&p=1379021#p1379021

I'm currntly on ASV which gives me the best results - for me, the issue is the o2 plunges at sleep onset still occur though but over a longer period which I believe is due to the asv trying to compensate for the flow reduction as I drift off but not really being able to (as the algorithm works within only a 3 min moving window).  Without ASV I plummet much faster the second I enter light stage sleep.

While my AHI I practically now zero, I'm still having a lot of sleepiness which I atteibute to nights where my o2 levels are still lower than ideal for long periods... so not necessarily causing sleep arousals but still hypoxia starving the brain of oxygen.

Still looking for answers, finally got my next appointment in June so will hopefully be able to get some.
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#9
RE: Sleep Onset Issues
BTW on the positional apnea - they're good suggestions by sleeprider and in my case the neck collar did really help the first night but only in basal spo2... it didn't stop the sleep onset plunges for me, which I believe are (certainly in my case) a more 'central' hypopnea issue.. my breathing slowly gets shallower and shallower like I'm just giving up  Oh-jeez  

They happens EVERY time, like clockwork - doesn't matter what position I sleep in or other steps I take to prevent anything obstructive.. and again, my AHI is often 0.00 as far as my resmed S9 Adapt SV is concerned (before that I was using a DreamStation autoSV, that too wasn't flagging any OAs).  It doesn't tend to wake me, and my breathing does recover / tends to be not too bad after that - but the onset plunges do bother me as they shouldn't really be happening (mine can go as low as high 70s when not on PAP therapy - or high 80s on it), and it's a little disheartening the ASV doesn't seem to fully control it.

More co-incidentally still, it was searching the forum for 'nose breathing' that brought me to this thread - I'm largely a mouth breather (and always use full face masks), but after reading that nose breathing can improve blood oxygenation I've just bought some of the somnifix mouth strips and see if I can tolerate nose breathing only to see if there's any change whatsoever - if nothing else it'll help with my desert throat that always seems to wake me in the early hours!
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#10
RE: Sleep Onset Issues
Wow ChrisJ this is refreshing to hear. This sounds like my exact problem.

The biggest issue is I wake up right away when my O2 plummets - and it doesn’t what position I sleep in - back, sides, stomach or sitting.

Can you tell me how you got this diagnosed and got an ASV machine for this? If only I had a machine they let me sleep through this... the entire world would change for me.

Did this happened suddenly for you? Can you take me through your timeline?
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