Uptick in central apnea during the hour before waking

While reviewing my sleep reports in Sleepyhead, I notice that I nearly always have a big increase in central apneas in the hour before I wake. I believe that these may be responsible for me feeling in a fog until noon.

Has anyone else noticed this? Has anyone found the reason and what can be done to reduce these central apneas?

My all night AHI hovers around 5-7, but just before waking it can shoot up to 19, with nearly all central apneas.

There are two things that I can think of to consider. One is that for whatever reason you have or are bordering on cheyne stokes breathing. Have you expanded your flow rate (use up arrow when cursor is over the area of interest, or keep left clicking) to see what it looks like around the events? You can recognize the cheyne stokes pattern by the rhythmically increasing and then decreasing flow rate with each breath. See this link for an example of what it looks like.

Cheyne Stokes Breathing

Recognizing it is easy. Figuring out the cause is much harder. The most frequent reported cause of central apnea is the use of opioids or similar sedatives. Heart disease unfortunately is another potential cause. Lower blood flow seems to negatively affect the breathing control system. That said I have it from time to time and I know I don't use opioids, and hope I don't have heart disease. I do use bisoprolol (beta blocker) for blood pressure control and I have blamed that, and even had my doctor cut my dose in half. I think the frequency of it went down, but not away.

There are some things that can be done with a BiPAP machine like the AirCurve 10 Auto. It involves the timing of pressure support on inhale. The more direct way is with a ventilator like the AirCurve ASV, but that would be for pretty serious cases of central apnea probably along with other heart or breathing conditions.

The other possibility is what some call sleep wake junk. That is when you keep waking up and going back to sleep. In that situation your body can simply forget to breath and that is flagged as an apnea. It can be recognized by a more garbage looking breathing pattern than the rhythmic breathing of Cheyne Stokes. Some would say that this sleep wake junk is not real apnea, but if you stop breathing, you stop breathing. One possible cause is trying to sleep too long. Most people only need from 7-8 hours per night. If you are sleeping much longer than that, you are likely going to be having wake up and go back to sleep issues toward the end of the night. Here is a video that is quite annoying to watch, but if you can endure it, the guy does give a few bits useful information as to what the various types of events look like.

How to use SleepyHead

Hope that helps some...