Deepnap

I reguarly drink alcohol ... say 3 to 4 times a week. Totalling about the equivalent of 2 bottles of wine per week. I wonder if you have a similar habit. As one of my next experiments I will try to stop alcohol completely for 4 to 6 weeks and see if it makes a difference.

Hi Raquel2.

My symptomes are very similar to yours. I am 64, male, and have been diagnosed with sleep apnea about a year ago. To majority of apnea events are central in nature. Doktors have no explanation. I do not fit in the typical sleep apnea patient pattern. With CPAP I can manage to keep my AHI around 10.

My worst events are those you describe. As I relax and transist into sleep I wake up and notice that I have stopped breathing (Scary!). Sometimes my heart rate goes up to 120 or more. One or two such events occur in the first hour after going to bed. Then for the rest of the night no such events occur anymore.

I have started to notice some triggers. If I avoid them, things are much better. Typically, if I spend several hours watching TV, working on the computer or looking at my mobile phone screen, these events occur frequently. When I avoid those triggers after 6pm these events are less frequent.

Another trigger I noticed are many hours driving my car.

I typically get up around 4 or 5 am for a visit to the bathroom. I noticed from my CPAP recording device that when I go back to bed after those bathroom visits, my AHI score shoots up quite a lot. So in general the average AHI of around 10 over the whole night is mainly due to the last third of the night.

I think in my case it is self-induced mental stress that is a factor. So I am starting to explore medition, breathing stress management exercises.

There may also be a serotonin link. I had a genetic test taken (cost me 200 Euro). Apparently, I am very low on serotonin. So I hope by improving my diet and using above techniques, as well as taking L-Tryptophan supplements I can make improvements.

Also, and I have reported this in this forum, when I have a decent amount of alcohol (in the order of 5 pints of beer or a bottle of red wine), my overall AHI through the night drops to 4-6. Still, the last third of the night is manly responsible for this total average.

I have no blood flow issue in the brain.

Best regards Deepnap

Here is another detailed graph around a CA clutter later that night.

Thanks, Sierra. Below is the graph. On that night, my average heart rate was 56 and the average SPO2 96%.

My low resting hear rate at night without alcohol is typically 50-55 with alcohol (depending on dose) 60-70. Indeed, there could be another explanation for the odd behavior when I have alc.

The low arousal threshold hypothesis would be consistent with my observation that alcohol flattens the AHI mountains in the first 3-4 hours after sleep-onset.

Hi, Sierra, many thanks for your comments and the links.

I could share a password-protected zip file of the entire dataset (165 MB) via tranfernow.net or similar platform that does not require registration. The data set does not seem to include my identity. If you agree, I could send you a link to the file (if this is allowed here) and the password.

I seem to be seeing some interesting patterns in the data.

The big rises in AHI seem to appear right after sleep onset and towards the end of the night. The overview daily screenshot below shows my 3 travels to the toilet and right after that, when I go back to sleep, the AHI rise is clearly seen.

The other screenshot shows the last big rise of AHI around 6pm after my visit to the toilet. What is interesting there is that right after the end of the 5 min ramp period set in the CPAP machine, the expiration rate frequently drops to zero. This pattern seems to be repeating across the entire data set. Maybe I should remove the ramp setting entirely. Also, my expiration rate always is lower then the inhalation rate. Is this normal?

Initially, a polygraph at home put me at an AHI of 37, the first night in the sleep lab came up with AHI=25, after that, 2 nights in the lab were used to determine a pressure of 9 for me. Apparently, at this stage, we talked about 1/3 of apneas being central. When I went back to the lab after wearing CPAP for about 6 weeks, the pressure settimg was reduced to 7 recognizing that central appneas were predominant. Since then I have played a little with the pressure; it is set to 7 now.

I have done a 36h ECG which found nothing except that my heart rate at night is around 50, that is why drugs that further reduce the heart rate are not conisdered at the moment. I will have a head MRI in 2 weeks looking if there are any blood flow issues in the brain. Thyroid is normal so are static ECG and heart ultra sound inspection. Currently I am wearing a 24h blood pressure monitor.

My current hypothesis is that I may have a too low arousal threshold as mentioned in the paper: Breathing Re-Education and Phenotypes of Sleep Apnea: A Review J. of Clinical Medicine P. McKeown et al. 2021

Thanks for your reply, Sierra. I appreciate your comments. Below I have 2 typical daily sreenshots (each divided in 2 parts). One from last night, with 4 pints of beer prior to sleep. AHI flat but rises sharply towards the end of night. The other is a night without alcohol. Typical AHI pattern is stron AHI rise after sleep-onset and also a rise towards the end of night.

Using AirSense 10 for 4 months now (pressure at 7 cmH2O) but my AHI is always between 10 and 15, unless I drink the equivalent of 4-5 pints of beer alcohol, which brings the AHI down to 3-5. The OSCAR software tells me that 80% of my apneas are clear airway (CA) and less than 10% obstructive. Looking at the time course of AHI over night, there is typically a sharp rise shortly after falling asleep. I am also using a device that tells me the sleep pattern. When my AHI is between 10 and 15, I normally have only 2-3% of deep, non-REM sleep, which explains my dizziness, headache next day. Any suggestions?

The image shows the rise of AHI after sleep-onset.