New to CPAP

[jjsemperfi]

Hello,

I am a new user to CPAP. I have very mild Central Apnea. My first sleep study only showed I only have an AHI of around 3. I did a second study (this time on CPAP) and my AHI went to 0. So I was given a ResMed S10 AutoSet and I am currently using the nasal pillow. My settings are extremely low (only 6 in with EPR at 1) to start with. I have only been using for 2 nights, and I understand it can take a long time to start seeing results but I have a couple questions. First, could I expect to lower my AHI (like the in lab study did) any time soon? Why did the in lab study (with nasal pillow) lower my AHI and I can't do it at home? Also, my mask leak is 4-5 L/Min, is that normal? I always run mask fit check before bed, and it sounds great (no leaking) while using. Would I have more mask leak if I am opening my mouth a little at night? So my main problem with sleep is constant urination at night (usually 1-3 times), and toss and turns averaging 30-40 times per night. I am a fit 30 year old male, 5'11" 160 lbs, no caffeine, no alcohol, no smoking, drink plenty of water, eat glueten free, go to the gym 4-5 times a week. I have a watch that "estimates" my sleep cycles (I even wore it during both sleep studies and it is very accurate) and I rarely get into deep sleep past midnight. Most of my Central Apnea occurs around 2-6 am. I am so tired and fatigued I havn't been to work in 4 months, and I am really hoping that this CPAP works for me.

[Julie]

Hi, welcome.

You said you have central apnea, but your machine is not equipped for that and a different type would be needed. You may in fact have some central events at certain times, but it would be best if we could see a report of your sleep study. Also, the number of events you mention does not seem to be high enough at all to need a machine. Can you post a copy of your report on Imgur.com and leave a link to it in this thread? Without being able to see that it's hard to comment or advise.

[R1200ST]

The waking up to urinate is directly related to your "toss and turn" movement. Your body is not dropping into deep sleep so your systems are not slowing down, hence the need to pee.

I used to get up 2 or 3 times a night to pee prior to using my equipment, now I never get up.

Keep on the forum, research, get sleepyhead software and post your results and others here will help you get dialed in.

You found the right place to be.

Good luck!

[jjsemperfi]

Is it safe to post sleep results on that site? I know it seems very strange to be given a machine with such a low AHI but (again, after about 2 am) my O2 sats were consistently dropping below 90%. My lowest sat was 84%.

[Julie]

You can white-out your personal details, but in any case, who's going to care? A lot of us routinely post nightly stats there so we can see what's going on - you can't DL graphs onto the forum directly.

[jjsemperfi]

http://imgur.com/gallery/o7hko/new

[Julie]

What you need is for someone called Palerider (has a red devil avatar) to look at the results you posted because I'm not sure I can interpret them well enough to make suggestions - I see almost no problems at all that would necessarily require Cpap, vs making every effort to not sleep on your back, but PR should be around very shortly and you can address him by editing your subject line, or sending a PM.

Have you recently had thorough testing for other potential health issues that might need looking at?

[jjsemperfi]

Ok thanks. Yeah I never sleep on my back if I can help it. I am a side sleeper. Had to for the studies of course. I've been sleeping on my side the past couple of nights with my CPAP as well. I've had just about every test under the sun. It started out 4 months ago with an ear infection that damaged my left balance organ. I've been feeling very fatigued, foggy, and "out of it". Also, as a kid I had mono, and a continued fatigue that was then diagnosed as "chronic fatigue syndrome". I have not slept well for the past 10 or so years, but never had a sleep study until now. So in the course of trying to figure out what is going on I've had blood tests, MRI's, ENG balance testing, I was on antibiotics, now I'm on probiotics. Nothing else that the docs can find should be causing me to sleep poorly. I have completed the Vestibular Therapy (as my tests are now good with my balance organs) and sleep is my only other option at this point. So far I have no problems with light and REM sleep. Its the N3 or deep sleep that I just can't get to at night. I've had countless nights that my watch says I've only spent 8% of my sleep in deep sleep. Normal is 15-30%. Yes, I do understand that the watch isn't 100% accurate, but as tested in both of my sleep studies and by studies from a couple of univeristies in California and a sleep study doc, it is said to be about 85% as accurate as a Polysonogram.

[Julie]

Oh, you've certainly had other issues! I also had mono (at 25!) and still wonder about a connection because it did seem to take months if not even longer for 'flashback' times of being so tired to go away, but I never had the chronic sleepiness most do, but then wonder if my adHD would account for that. Did have low and long O2 sat drops tho'. Glad you had the vestibular testing come back better. But PR is terrific with the tech stuff and should be along soon.

[Guest]

My biggest question is that my resmed myair sleep score is 99/100. Seal was great, wore it 9.5 hrs, yes AHI of 3 would be stellar for most everyone on here but why was the lab CPAP study able to get AHI to zero and I cannot at home? That is my main question. It's like going to the ER, they give you a pill and it works. Then I'm at home and the exact same pill doesn't work. I would even be happy with a slightly decreased AHI. But it is unchanged, with the exact same settings and pressures that I got a 0 AHI on in the In lab CPAP study. Weird!

[jjsemperfi]

My biggest question is that my resmed myair sleep score is 99/100. Seal was great, wore it 9.5 hrs, yes AHI of 3 would be stellar for most everyone on here but why was the lab CPAP study able to get AHI to zero and I cannot at home? That is my main question. It's like going to the ER, they give you a pill and it works. Then I'm at home and the exact same pill doesn't work. I would even be happy with a slightly decreased AHI. But it is unchanged, with the exact same settings and pressures that I got a 0 AHI on in the In lab CPAP study. Weird!

Sorry, wrote that on my phone, this was me..

[jjsemperfi]

Here is last night's Sleepyhead data. First time doing this so let me know if you need anything else.

http://imgur.com/gallery/rGbfK/new

[OkyDoky]

With centrals it is difficult to tell why you would have more or less different nights. Centrals are clear airway events. You are in CPap mode with a straight pressure to keep your airway open. If you have an event, that lasts for 10 secs, your machine will check to see if your airway is obstructing. But if there is no obstruction and the airway is already open the machine does not respond. I'm not sure what your doctors goal is with this machine since it won't eliminate the centrals. Sometimes insurance requires trying this one first before going to a different machine. I would ask the doctor what his goal is.
The number of centrals you had on the sleep study is low so I'm kind of surprized he decided to put you on cpap. Since it's only been 2 nights with the machine at this point I wouldn't worry since there is a lot your brain has to get used to with this new sleeping routine. Continuing monitoring and see if there are increasing centrals over time.

[jjsemperfi]

With centrals it is difficult to tell why you would have more or less different nights. Centrals are clear airway events. You are in CPap mode with a straight pressure to keep your airway open. If you have an event, that lasts for 10 secs, your machine will check to see if your airway is obstructing. But if there is no obstruction and the airway is already open the machine does not respond. I'm not sure what your doctors goal is with this machine since it won't eliminate the centrals. Sometimes insurance requires trying this one first before going to a different machine. I would ask the doctor what his goal is.
The number of centrals you had on the sleep study is low so I'm kind of surprized he decided to put you on cpap. Since it's only been 2 nights with the machine at this point I wouldn't worry since there is a lot your brain has to get used to with this new sleeping routine. Continuing monitoring and see if there are increasing centrals over time.

Thanks, I agree. I begged him not to be on CPAP. I agree it's probably an insurance thing. It's interesting that all of my results indicate that at around 2-3 am, my brain goes nutty and causes my apnea to go haywire. First sleep study confirmed that 3 am was the start of my major desating events. Then the past two nights, right at around 2 to 3 am, again, there I go. Weird that it's time based and not the entire night.

[BlackSpinner]

It's interesting that all of my results indicate that at around 2-3 am, my brain goes nutty and causes my apnea to go haywire. First sleep study confirmed that 3 am was the start of my major desating events. Then the past two nights, right at around 2 to 3 am, again, there I go. Weird that it's time based and not the entire night.

Actually not weird. Sleep cycles are about 90 minutes long and they repeat all night with sleep getting deeper and deeper as the night goes on. That is when most people have apneas. You have heard the term "grave yard shift"? It is at that time that most people die.