Video proof of me struggling to breathe last night - UARS?

[MyronH]

Not to step on Fred's next post, I still don't see a problem, particularly UARS in your graphs.  That puts me in agreement with your sleep doctor, and very cautious about the PES testing.  I already posted and linked to side effects of high concern for your medication, and think all the rest of this is a distraction.

So last night I tried a regular pillow instead of ergonomic neck pillow. Wore my neck brace too. 

I woke up middle of night with chest feeling tired and burning sensation across my left side of chest. Checked Sleepy head results. It shows my Max IPAP increased to it's max of 18 after a couple of OA's and fluctuated several times up and down.

So it appears a regular pillow is out of the question for me unless I lay on my side. 

Since it was hitting max of 18, should I increase it to 20 to see where the machine wants to go?

Can increased pressure cause burning sensation or tired feeling in chest? 

Or is this UARS?

[MyronH]

Keep us updated. I do hope you get it resolved ASAP.

Well I had been doing okay for awhile. Though tonight, my webcam video showed I bent my knees up in the air again. I checked sleepyhead, and it was during the time of pressure increases. It lasted about an hour that I kept my knees in a bent position.

I woke up 2:35am and turned off machine to use bathroom. I didn't feel stressed out or that I was struggling to breathe like that one other time. But the video did show what sounded like some minor snoring or some type of obstructions going on. I am still on Multaq for afib, and haven't stopped it yet. 

My sleep doctor last time I showed them this, was not concerned about me bending knees at night, but had no answers. He also didnt seem concerned about that night on 11/5, where I had some major night sweats.

I recently had an echocardiogram and waiting on the results. Which is probably normal, since they didnt detain me after the test.

What should I do at this point?

[Sleeprider]

It appears to be unrelated to therapy. Your results are good at 1.1 AHI with minimal respiration artifacts. The kind of movement you describe is normal. If there is something related to therapy, Sleepyhead is not providing a clue.

[MyronH]

It appears to be unrelated to therapy.  Your results are good at 1.1 AHI with minimal respiration artifacts.  The kind of movement you describe is normal.  If there is something related to therapy, Sleepyhead is not providing a clue.

I went on this website "quora" where sometimes you get answers from doctors and retired nurses. I asked about my knees bent and night sweats, and someone replied, that it could be my body's attempt to help me breathe better. My body may be seeing I'm having trouble breathing, and then bends the knees up. 

They said if I'm getting night sweats associated with it, then I could be having breathing issues.

Unfortunately, i've already let me sleep doctor know about these symptoms and he said I'm "treated well" on my BI-LEVEL. If I go back to my primary care doctor or cardiologist, they just point me back to my sleep doctor.

So at this point, I'm still wondering if I should do a sleep test with the PES device.

[Stom]

So at this point, I'm still wondering if I should do a sleep test with the PES device.

UARS is treated with PAP therapy. You are already on an auto titrating type of PAP machine. What will doing an invasive PES test tell you? Will it change your therapy in any way?

Also, most cases of UARS can be diagnosed from regular PSG recordings and the PES test is only used in " in rare, doubtful cases":

These subjects presented repetitive short (“transient”) alpha electroencephalographic arousals lasting 3 to 14 seconds that regularly interrupted the abnormally high inspiratory efforts. Standard PSG recordings of these subjects evoked the diagnosis of UARS from the presence of these repetitive transient arousals, increases in snoring just before the arousal, and an increase in inspiratory time and a decrease in expiratory time, which were determined with the use of well-calibrated sensors. No significant change in Sao2 was seen, and the respiratory disturbance index was low (<5).

A nasal pressure cannula and, in rare, doubtful cases, esophageal pressure monitoring must be included in all sleep studies to confirm the diagnosis of UARS.

-Principles and Practice of Sleep Medicine, 6th ed.

[ardenum]

It appears to be unrelated to therapy.  Your results are good at 1.1 AHI with minimal respiration artifacts.  The kind of movement you describe is normal.  If there is something related to therapy, Sleepyhead is not providing a clue.

I went on this website "quora" where sometimes you get answers from doctors and retired nurses. I asked about my knees bent and night sweats, and someone replied, that it could be my body's attempt to help me breathe better. My body may be seeing I'm having trouble breathing, and then bends the knees up. 

They said if I'm getting night sweats associated with it, then I could be having breathing issues.

Unfortunately, i've already let me sleep doctor know about these symptoms and he said I'm "treated well" on my BI-LEVEL. If I go back to my primary care doctor or cardiologist, they just point me back to my sleep doctor.

So at this point, I'm still wondering if I should do a sleep test with the PES device.

Is sleeping with the knees bend such an unusual thing that its a problem to you? I always sleep with my knees bent, does it really matter why? Isn't it just more comfortable that way?

[MyronH]

Is sleeping with the knees bend such an unusual thing that its a problem to you? I always sleep with my knees bent, does it really matter why? Isn't it just more comfortable that way?

Last night, had the same thing happen. Legs bent at the knees. Happened for only a few minutes this time, not hours. But it happened during the time you see below, when I had some Hyponea and OA's.  I thought about PES testing, but like you said, we already know I have OSA, so the invasive PES testing won't change anything. 

Last night I had a 45sec OA and 30sec OA. This is while wearing my dental appliance too. 

So I'm thinking if I should move forward with some non-invasive procedures to open my throat and airway in the back?

A local ENT does Injection Snoreplasty, that says it lifts the palate up, and he cuts the uvula. Sometimes I think I feel my Uvula hanging down in my throat and maybe that is what is causing partial obstruction?

As you can see from the Sleepyhead chart, even during times of no events, it kept the pressure raised, so obviously there is some flow limitation of some type going on.