Noctuary wrote:Its so discouraging. I don't have major leaks; so why am I still tired? Is it because of broken sleep? Before the sudden onset of this "disease" I would often wake up after a few hours and go back to sleep; I didn't feel bad then. I'm compliant, I use my machine regularly; but in what is now almost a year of therapy I've only really felt good a handful of times.
Even though the whole SH window didn't get captured in your image there are some things that immediately catch my eye in the data that you did post:
1) The CAI is the largest part of your AHI on this night. While your total AHI is well less than 5.0 and your
obstructive part of the AHI is very low (OAI + HI = 1.27), your CAI is 2.63. Which, in principle, is nothing to worry about since the total AHI < 5.0. But sometimes a higher than expected CAI can indicate that you are indeed dealing with a lot of fragmented sleep since wake breathing patterns can be misscored as CAs by our machines. Is your CAI usually higher than the OAI and the HI? Or is this night unusual?
2) In the snippet of data that was posted, there's a large cluster of events scored between 2:50ish and 4:40ish. Did you have a whole lot of trouble getting back to sleep after the obvious wake at 2:45 when you turned the machine OFF and back ON? If you were lightly dozing or tossing and turning trying to get back to sleep during this time, that cluster of events may be a lot of SWJ, which means it doesn't really "count" in terms of how well or how badly the apnea is controlled. But long chunks of SWJ indicate that your sleep is pretty fragmented (at best) or that you are not really sleeping (at worst). And this is SWJ, it represents a 2 hour chunk of the night where you were NOT sleeping very soundly (if you were sleeping at all). And 2 hours of SWJ in the middle of the night is more than enough of a disruption to your sleep to make you feel pretty rotten the next morning and into the next day.
3) Do you often see this kind of 1-2 hour clustering of a lot of CAs mixed with a few Hs or OAs right
after you have a wake where you turn the machine OFF and back ON? In the morning do you have any memory or sense of how much time you are lying in bed and not really sleeping?
If I had to guess as to what making you tired based on this one small piece of data, I would place my bets on
broken or
fragmented sleep. The question, of course, is what can you do to encourage the sleep cycles to consolidate and become less fragmented. And if I had a definitive answer for that, I wouldn't still be dealing with fragmented sleep issues of my own.
I do know that in my particular case, certain aspects of sleep hygiene are pretty important in keeping the fragmentation to a minimum. One thing that I have to be careful about is keeping my "time in bed" window sufficiently short that my body knows that it can't pull the trick of wake up and not get back to real, continuous sleep for 40-60 minutes. Another important thing for my body is a regular sleep schedule for all seven days of the week. (I really HAVE to get back into the saddle on that one; this spring I've been way, way too lax about not getting up on time.) And, though I hate to admit it, in my case the judicious use of prescription sleeping pills under the guidance of my sleep doc has helped. With the sleeping pills, I usually manage to get one or two sleep cycles completed between the times I wake up. And the wakes are short enough where I usually don't remember them. (I know they're there because I turn my machine OFF and back ON out of habit.) And if I can get through a night with only 3 or 4 post REM wakes, I usually feel pretty good the next day.
Good luck in trying to track down the source of your fragmented sleep. If you can get your sleep cycles to properly consolidate, you might feel much, much better.