sleepyjean wrote:isn't the 2nd graph the titration one? In the morning after breakfast I take 75mg. Effexor, .05mg Xanax..what is GERDY?
I was looking to see if there was a specific graph or table of all the CPAP pressures tried, but if you were on 6 cmH2O all night, that answers that.
A normal arousal index (events per hour) is probably less than 5, assuming that even that does not cause any symptoms.
The delayed REM onset is undoubtedly due to the Effexor. Antidepressants and long-term use of benzodiazepines (like Xanax, and I assume that a 0.5 mg dose) can create sleep problems like insomnia and arousals. Don't throw 'em out yet, you could also make it worse, check with the MD before you go that route.
You've got PLMs, that might be the cause of all the arousals. Treating them might help. That wouldn't be my first choice, however.
With that single pressure, all those arousals could be from RERAs (respiratory events a little more subtle than apneas or hypopneas). They really should've turned up the pressure a bit to see how they respond. Trying an AutoCPAP might help identify if that's the issue. Get one that identifies flow limitations however, just in case. Or be ready to kick up the low limit a little if you don't feel better.
GERD is gastro-esophageal reflux disease. Heartburn, give or take. Something caused by GERD is GERDY. OK, I made that up. If you have symptoms of GERD, treatment may also include a medication, so again, check with the MD. Long term use of PPIs and H2 blockers are not without concerns either. That pile of arousals showing up at 4:30 AM looks a little curious, tho.
The way you tell for sure if it's GERD is do a pH probe. If your sleep is that bad, and it's GERD-related, a pH probe would be well worth it before you went on 10 years of PPIs.
I don't think your basic architecture looks too bad otherwise, my guess it's one (or more) of those four things.