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[Treatment] 29 Years Old - AHI Under 5, PVCs, and Waking Up
#1
29 Years Old - AHI Under 5, PVCs, and Waking Up
Hello!

I wanted to thank you all in advance for any help you're able to provide me.  This forum is great and I've found a lot of helpful info in navigating this new APAP journey Smile.  

Brief background summary for context:

  • I'm 29 years old and historically very healthy (have always exercised and have never been overweight - I run a couple miles about 2-3 times per week).  
  • I never used to have any issues staying asleep at night (though I did used to nap a lot and feel tired).  However, around 3 years ago, I started having multiple awakenings during the night and noticed myself waking up gasping for air sometimes.  Around that time, I also started developing pretty hard PVCs on a daily basis, which have continued until this present moment.  These PVCs were to the point where it would almost be impossible for me to fall asleep some nights.  
  • I was diagnosed with Mild Sleep Apnea end of 2021 (redacted Home Sleep Study attached).  
  • I just started APAP two months ago and have been 100% compliant.  I will say this: since I started APAP my PVCs have decreased/been suppressed SIGNIFICANTLY, which is great so far!     
My Main Issues:
  • When I sleep, I often end waking up several times briefly throughout the night (sometimes 3-5 times that I'm aware of) during deep dreams.  Though it's less common, sometimes I also pop awake after only sleeping 4-5 hours and can't get back to sleep.  So I feel like I often don't get into a sustained deep sleep and this usually leaves me feeling fatigued and foggy headed (tired and wired), as opposed to being groggy.  
  • I've had some really good nights on APAP where I have felt great the next day (a couple days the best I have felt in years!).  However, I still seem to be in this weird consistent pattern of having maybe 3-4 great nights of sleep, followed randomly by a stretch of nights where I wake up briefly a lot during those nights and then I feel awful the next days (sleep deprived and wired).  So it's a similar pattern to what I've been experiencing pre-APAP over the past few years.   

My Questions:
  • I recently started using a Viatom Wellue ring pulse oximeter.  My resting heart rate is usually quite low when I'm awake, around 50-60 and sometimes even falling below 50 at times.  However, per the OSCAR charts attached, my pulse rate is jumping up higher than my normal awake rate (at some moments spiking to 100-120+).  Is this kind of pulse rate variability in these charts normal while sleeping?
  • My AHI has remained under 5 the entire time I've been on APAP.  I'm guessing the CAs are treatment emergent/SWJ, as I didn't have any in my Home Sleep Study.  My CAs tend to hover at 0.5-1.5/hr (these CAs were about the same if not higher even at a min pressure of 8 and without using EPR - the current settings have given me my best numbers to date, and I find I breathe better on a higher pressure).  I also have yet to really find a correlation on CAs affecting how I feel the next day.  In fact, even though my CAs/AHI on Night 8.13 were higher, I felt MUCH more well rested following that sleep, whereas after 8.14 Night I felt awful the next morning (which is today  Too-funny ).  Are there any changes you might suggest making or anything that sticks out?  
I realize, too, that I may just need to give it more time, but I thought it would be good to check with some experts ahead of time.  Please let me know if you need any close-up shots, more charts, etc.  Thanks in advance!

Thanks,

Wes





           
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#2
RE: 29 Years Old - AHI Under 5, PVCs, and Waking Up
Hi Wes,
Welcome to Apnea Board!

Your charts look very good. Low leak rate and low Flow Limitation. Your pressures seem steady throughout the night.
The Clear Airways are more than likely treatment emergent and will lessen in time.

Your pulse rate is a little up and down. That could be due to REM sleep. Some folk do report that dreams tend to cause them to wake up more frequently, but I can't say for sure that is why you wake up.

Unless someone else sees something on your chart that needs attention, I wouldn't make any changes for now, but give it more time.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: 29 Years Old - AHI Under 5, PVCs, and Waking Up
Thanks, OpalRose! Really appreciate the feedback and glad to hear everything looks on track. For the record, I saw some advice you had given on other threads and ended up turning on EPR and making some pressure adjustments, which has helped a TON, as I used to have quite a bit of flow limits that were making my pressure go all over the place. So thanks for the help Smile.

Side note: I feel great today and slept MUCH BETTER last night, so I will definitely continue to be patient and give it more time (great sign that maybe this pattern will continue to stabilize overtime since I used to go through weeks at a time of sleep deprivation pre-APAP). Will definitely circle back on this thread and keep you and the folks posted if problems persist in the future!
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#4
RE: 29 Years Old - AHI Under 5, PVCs, and Waking Up
Thanks!  Please keep us updated on your progress.   Smile
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#5
RE: 29 Years Old - AHI Under 5, PVCs, and Waking Up
Hi WHHP, could you describe what PVCs feel like. I suspect I may also have. I’ve had a few ecgs done, and echocardiogram and a stress test. All seems normal and nothing picked up. Next thing I might do is get a holter monitor. I feel my heart is constantly beating really hard. It’s like a bounding pulse, especially at night. Had it for almost 2 months now. Quite unpleasant.
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