I have had asthma for years, with normally no meds required unless it was an rare bout of bronchitis. Last summer I developed asthmatic bronchitis that was severe enough to have me in and out of the ER numerous times. The "normal" meds barely did anything to clear my lungs. The prednisone caused substantial weight gain. I went a total of 6 weeks with NO sleep at all, and once I got to the point of being able to sleep I noticed the waking up gasping for air that others have talked about. In Sept 2004 my doctor ordered a sleep study.
Apnea Hypopnea Index 23.9
Snore Arousal Index 4.2
Oxygen Saturation 81.4% at lowest
Total Arousals Index 27.6
PLMS Arousal Index 0
Spontaneous Arousal Index 14.3
Sleep Efficiency 27.1%
Sleep Onset Latency 119.5 minutes
Total RecordingTime 371 minutes
Total Sleep Period 251.5 minutes
Total Sleep Time 100.5 minutes
Total Stage Shifts: 36
Stage 1 Shifts: 14
Awakenings (during sleep): 11
Number of REM Periods: 0
Wake: 270.5 minutes
Stage 1: 18.0 minutes
Stage 2: 82.5 minutes
Stage 3: 0 minutes
Stage 4: 0 minutes
Central Apnea Events
Number: 36
Index: 21.5
Mean Duration (sec): 12.3
Longest Duration (sec): 18.5
Occur in Non-REM: 36
Non-REM Index: 21.5
Obstructive Hypopnea Events
Number: 4
Index: 2.4
Mean Duration (sec): 22.6
Longest Duration (sec): 35.0
Occur in Non-REM: 4
Non-REM Index: 2.4
Non-REM Summary
Apneas and Hypopneas: Number 40, Index 23.9
Respiratory Arousals: Number 15, Index 9.0
Non-Supine Events (Right Side): Number 40, Index 23.9
Snore Events
Snores: NREM 364, NREM Index 217.3
Snores w/Arousal: NREM 7, NREM Index 4.2
Snores w/Respiratory: NREM 1, NREM Index .6
PLM Events without Arousals
Total Non-REM Events: Total 1, Index .6
Spontaneous Arousals
Total Non-REM Events: Total 24, Index 14.3
Total Arousals: 46
Arousals Index: 27.5 arousals per hour
Oxygen Saturation
Mean: Wake 98.1, Non-REM 94.3
Min: Wake 83.9, Non-REM 81.4
Max: Wake 100.0, Non-REM 97.5
Total number of desaturation w/respiratory events: 38
Total number of desaturations: 38
The study states "Respiratory events are scored only during sleep. Apneas must be at least 10 seconds in length and accompanied by an EEG Arousal and/or a desaturation of at least 4%. Hypopneas must be at least 10 seconds in length and must be accompanied by a desaturation of at least 4%."
Some of the review notes: "Arousals types included spontaneous, coughing, hypopneas and central apneas. EKG rhythm was sinus. Patient had several mild to moderate O2 desat's in association with obstructive hypopneas and central apneas."
My doctor (pulmonologist) started me on a ResMed AutoSet Spirit, low setting 4.0 and high setting 11.0. Average pressure really varies from day to day, but median is around 8.2. I have been compliant with usage, never sleep without the machine. Apnea Index from machine has always been under 3.0. He wanted to switch me over to CPAP, but with my continuing breathing difficulties I asked to remain on the machine I have. He refused to change meds or run any new tests.
Out of frustration of still breathing poorly, and believing that it might be the reason for not responding to xPAP use, I asked my family doctor to prescribe different meds for the asthma. The new meds have made a HUGE difference in my breathing, but no difference in my chronic exhaustion. I still have trouble sleeping, and it's still severely impacting my cognition and memory function. Thyroid tests came back "normal" as did blood sugar tests. Family doc is trying to get me in to see a specialist at a teaching hospital that has an excellent reputation.
I have tried everything I can think of to try to get some real sleep. No caffeine, eating really healthy for the last year, and staying right around 1,000 calories a day. Slowly starting to lose the weight I gained last year now that I am not taking any steroids. Stopped taking decongestants at night. Sticking to a sleep schedule and no napping during the day. I still don't have energy to exercise, even doing small things (like making dinner and cleaning up) exhausts me completely.
After reading other posts, the only thing I can think of is maybe my O2 levels are still low, even with the xPAP treatment. Or maybe the machine only recognizes obstructive apnea and thus isn't showing continuing central apneas?
Can anyone offer any clues for me to pursue? Please?
I just want my brain to start working again instead of being in a constant fog. I won't even mention how long it took me to compose this post!
