Pokey49 - Therapy Thread

[Pokey49]

Here are 2 shots hopefully as requested. One showing pretty much the whole night. I only had my cpap mask on from approximately 10:15 to a little after midnight. The other showing a zoomed view the last few minutes before taking off my mask. I hope I have manipulated it correctly. Its noted at one point my pressure bumped up to 10.4, highest for the period

[super7pilot]

Pokey, I agree with jdougc. I have moderated my position on just keeping the max setting really high. But your pressure never even hit 11.
The only thing I can think of is the weaning off of that drug you were on for so long. As that is a drug that is a brain chemical antagonist/agonist. And coupled with your admitted CPAP anxiety. It 'could' be some sort of cumulative thing.

Our fears no matter if they are founded in reality or not, can have a powerful effect on us.
That is one reason I have not and likely never will allow a brain chemical altering drug past my lips. They scare the heck out of me.

Now, I can remember years ago (long before CPAP) having awakened like you did. I have no idea what it was and why it happened.

[Pokey49]

im in agreement that i think its the medication im weaning off of because the symptoms occur both on & off cpap. ive actually only been on that medication for a little over 2 months.  ive told my doc i think its  a bad combination with other medication im on and i need to get off. trouble is i cant just stop the one im weaning off of.

[jdougc]

I hope your breathing around 9:10 was not as bad as the zoom-in chart. So many under 10 second events. No wonder you woke up so.
Do you use  a soft cervical collar?

[ejbpesca]

I read your OSCAR chart as a highly successful example of APAP therapy with curiosity about what level of sleep apnea you have.  I am guessing mild.  I would check my sleep study report for CAs.  Was it CAs that gave the diagnosis of sleep apnea?  What was the AHI of the sleep study report?  Perhaps you have the sleep study report in an earlier post I didn't see. 

BiLevel or BPAP and ASV machines provide better therapy than APAP machines.  They are much more sensitive to inhaling and exhaling than an APAP AS 11.  They have a wider range of functions than APAP and do what APAP does better.  I believe the only reason they are not as common as machines like the AS 11 is due to a lack of insurance coverage unless a sleep study advises their specific use. 

Your description of the way you felt upon waking is a mirror image of the way I felt before I treated my severe sleep apnea.  It has some of the same terms as how I told others how I felt upon waking each day.  "I feel like I'm coming out of a coma."  Your OSCAR report does not reflect that apneas are the cause of why you feel so bad upon waking.  The figures on it are those I envy and will never see.

[super7pilot]

Pokey, i think the word of the day for you is ‘perseverance’ you need to stick with it and focus on the good that getting off that drug will bring.

[ejbpesca]

On medications:

Psychotropic medications can certainly affect sleep.  It can take weeks maybe months for adaptation depending on the drug.   If it is one for depression/anxiety it may be ineffective and the side effects can be worse than what the drug is supposed to treat.  Psychiatrists are quick to prescribe antidepressants when an anti-anxiety med would do better.   But the Benzo family (Xanax/Colonapen/Librium) of meds for anxiety are DEA Schedule IV and difficult to get prescribed.

What doctors may not tell you is how difficult it is to quit an antidepressant.  The process is long and if the pills are capsules then counting pellets is necessary to titrate the dose down gradually, and even then one can experience feeling horrible both mentally and physically.  Cessation of benzodiazepines is not nearly as difficult as withdrawing from antidepressants.   

I use melatonin to help me sleep sometimes (a lot lately).  It is OTC.  My neurologist approved of me using it up to 10mgs.  I have no clinical study proof but I think it may raise my AHI,  but at least I get to sleep and sleep longer when I use it.

I was prescribed Ambien and then Seroquel for sleep.  Those put me quickly into an unconscious state for up to ten hours which I found alarming.  I am not sure how they affect breathing during sleep since it was over 20 years ago I tried them.

[Pokey49]

Fellow PAPers. JDoug the breaths earlier in the night looked pretty good I think. Had nice round tops and were uniform for some time. Question is what made the breaths before waking up so ragged? That stinking medication???

EJ. My sleep study was done at home. My AHI was 16 and central apnea was not diagnosed. 

Super Pilot. Yes I need to keep with the Cpap and get off that med. I’m changing taking the daily dose to morning instead of evening My gut tells me it’s the med causing these sh**ty symptoms.

[Pokey49]

EJ I was on a benzo & AD in the past for 20+ years. I’m very familiar with getting off them by slowwwwwww taper. I’m an ex-lab geek and made my own solutions to taper off in the past making cuts of only 10% every 3 weeks.. I only allowed (mistakenly) to be put back on a low dose (50mg) of doxepin because of ongoing life issues getting the better of me. In the past I had no issues with it. But I am now and am in the early stages of a long slow taper.  It’s my fault and I have to deal with it. Sleep well tonight.

[jdougc]

Poker, maybe it is time to check the exhalation ports.

The P10 can get those little holes clogged.

https://www.youtube.com/shorts/zEqUM010ZEY