Any recommendations based off this sleepyhead data?

[Jasba64]

So I called my Sleep Doctor's office today but can't get in until the end of the month. Into my 3rd month of Pap therapy and don't seem to make a lot of progress. I have a Dreamstation Pro which is a regular Cpap machine. I can make it go Auto for 90 days (A-Trial) which I've done several times trying to establish the correct pressure. My issue is snoring. Some nights are worse than others. I also wake up a lot throughout the night and tend to have headaches throughout the day. My prescribed pressure was 6. I am at 12.5 now and it still don't think it's enough. I once rose the pressure up to 14 and snored even more. Also had obstruction events. I do have Central events but not every night. I have a hunch I need another study performed. I dread it as I didn't sleep much from the first one. Any advice will be much appreciated.



http://imgur.com/a/88rND

[Wulfman...]

So I called my Sleep Doctor's office today but can't get in until the end of the month. Into my 3rd month of Pap therapy and don't seem to make a lot of progress. I have a Dreamstation Pro which is a regular Cpap machine. I can make it go Auto for 90 days (A-Trial) which I've done several times trying to establish the correct pressure. My issue is snoring. Some nights are worse than others. I also wake up a lot throughout the night and tend to have headaches throughout the day. My prescribed pressure was 6. I am at 12.5 now and it still don't think it's enough. I once rose the pressure up to 14 and snored even more. Also had obstruction events. I do have Central events but not every night. I have a hunch I need another study performed. I dread it as I didn't sleep much from the first one. Any advice will be much appreciated.



http://imgur.com/a/88rND

That doesn't look too bad.
Regarding the snoring, if you're not doing nasal cleansing before bedtime, you might try that. If you're using a high humidity setting, you might try turning it down or off. (too much humidity can contribute to nasal congestion)

You could try another .5 increase in the pressure setting and see how that works.
You're already getting a "sleep study" every night with your machine, I can't see getting another in-lab one.


Den

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[Pugsy]

What position do you sleep?
Spend much time on your back?
How is the nasal congestion situation...nose clear or congested a lot?

Can you post an image of a report where you tried apap mode? Something recent that you felt helped you come up with the current settings...something that shows a lot of snore flags.
Omit the Snore and AHI graphs though (those are easily seen either in the AHI on the left or the events graph on the top)...include the leak graph though I doubt it will tell us much.
So these graphs on the right
Events
Flow rate
Pressure
Leak

[linuxman]

Looking pretty good by the numbers, but looks like it did detect some snoring. Do you actually know that you are snoring (as in..a partner telling you so)? I have quite a few snoring events recorded but I don't think I actually am snoring or if I am, it's very mild. My wife's been having a little trouble sleeping (unrelated), and she confirmed I didn't snore at all while they were recorded. It might just be misdetecting that.

A tip, you don't have to save your screenshots to a file. Just use CTRL-PRINTSCREEN to copy the screenshot to your paste buffer, then paste it into imgur after you hit new post. Saves you the step of saving and pointing to the file (unless of course you just want to save your screenshots away as files).

[Jasba64]

I didn't know how much data you would like to see so here is the file for the past 10 days. I have been in both Auto-trial and Cpap modes. I do nasal rinses almost every day and take Flonase EVERY night or day (shiftwork) before I sleep. I know the data looks good but I can't stop these headaches nor the constant wake-ups. Like I said, I was up to 14 pressure one night which you will see in the data, but snored madly. I am single so there isn't anyone to tell me that I am snoring. I never sleep on my back. Only sleep on sides and stomach. I do have a humidifier and heated tubing. I had both set on 3 but turned the humidifier down to 2 a few nights ago. I read where it may cause snoring. My mask never leaks enough to record anything other than 100% no leaks. Only once did I have a bad leak in all 3 months.

http://imgur.com/a/lnFqp

[Wulfman...]

I didn't know how much data you would like to see so here is the file for the past 10 days. I have been in both Auto-trial and Cpap modes. I do nasal rinses almost every day and take Flonase EVERY night or day (shiftwork) before I sleep. I know the data looks good but I can't stop these headaches nor the constant wake-ups. Like I said, I was up to 14 pressure one night which you will see in the data, but snored madly. I am single so there isn't anyone to tell me that I am snoring. I never sleep on my back. Only sleep on sides and stomach. I do have a humidifier and heated tubing. I had both set on 3 but turned the humidifier down to 2 a few nights ago. I read where it may cause snoring. My mask never leaks enough to record anything other than 100% no leaks. Only once did I have a bad leak in all 3 months.

http://imgur.com/a/lnFqp

Yeah, I think I'd try 13 cm. for awhile and see what happens.
Any ideas as to why the headaches?


Den

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[Jasba64]

I have no idea why I have these headaches. Today has been all day. Usually have a mild one every day from therapy. I always thought that meant either too much or not enough pressure? Last night was a good night as far as RERA's go which is what I usually attributed the headaches to be an indicator. I often wonder if I should be on an Auto versus a Cpap machine.

[Pugsy]

I don't think the answer for your wake ups or headaches are necessarily going to be found in the reports.
I doubt that more pressure is the answer either. You can try more but I doubt that it will help.
Not all our problems can be blamed on OSA and fixed by the cpap machine and/or more pressure.
Some nights with more snores being flagged than others could be related to you rolling on your back and not remembering or even maybe getting into REM stage sleep but from the apap reports shown it doesn't look like the machine is trying to respond to the snores so they may not be something the machine deems worthy of fighting. There's a difference between the VS and VS2 snores that I don't know what it is except the machine doesn't seem to try to fix VS2 snores.
RobySue had some thoughts on it here.
viewtopic.php?f=1&t=75927&p=694174&hili ... re#p694174
and here
viewtopic.php?f=1&t=114028&p=1106678&hi ... s#p1106678

Do you take any medications of any kind?
When you have the wake ups during the night approx how many do you have and how long does it take you to get back to sleep?

[Wulfman...]

I have no idea why I have these headaches. Today's has been all day. Usually have a mild one every day from therapy. I always thought that meant either too much or not enough pressure? Last night was a good night as far as RERA's go which is what I usually attributed the headaches to be an indicator. I often wonder if I should be on an Auto versus a Cpap machine.

To me, your reports on fixed pressure look better than in ranges of pressure. It's also a "constant" when analyzing the reports.
Headaches could be anything from adjusting the headgear too tight to foods or drinks you're consuming.
Did you have headaches before you started therapy?
I used to get headaches before therapy when there would be a low pressure front coming through the area. No problems now.


Den

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[OkyDoky]

I noticed shift work in your other thread. How often do you rotate and how long have you been doing rotating shifts? Do you notice a difference in sleep or headaches between day and night sleeping?

[linuxman]

You might give some more detail on the headaches you're having. Where does it hurt? Is it on the back of your head and neck? If so, might be due to muscle strain on the back of your neck due to improper alignment while sleeping. Let us know more about the headaches. There are a lot of causes of headaches - including things as simple as dehydration.

[Jasba64]

My headaches are on either side of my temple. I can sometimes massage them away. I have worked 29 years 6-6 both ways. That is 6a-6p and 6p-6a. Here is my work schedule: work 4 nights, off 3 days, work 3 days, off 1 day, work 3 nights, off 3 days, work 4 days, off 7 days and then it starts all over. I never had any headaches until Pap therapy. I never was tired during the day nor required naps. I had the sleep study performed based on waking up every 2 hours at night. I then always went back to sleep. My sleep study showed I had 112 events in the 183 minutes of sleep. I had a RDI of 36. I believe RDI and AHI are the same thing. The sleep study concluded I had mild sleep apnea and require a pressure setting of 6. After 10 nights of therapy with headaches and fatigue all day, I began raising my pressure. I was able to get the AHI down to what it is today. I can't be dehydrated because I drink water all day long. I still have all my sleepyhead data from day 1 til now.

[Wulfman...]

Have you had a blood draw and evaluation?

Just trying to throw out some thoughts and possibilities as to finding clues.


Den

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[Jasba64]

Just had my annual physical. Everything is fine. Blood pressure is great. I just switched out tubes. I had a heated one on it and now I put my non heated tube on the machine. Do you think it could be the vibrations from humidifier causing the snores?

[OkyDoky]

ok so sleep schedule not something new and headaches at the temples after starting therapy. Does your mask put pressure in the area? Does your sleeping position or bed covers block the mask vents?
AHI is apneas and hypopneas. RDI includes RERAs so is usually higher. Some consider the RDI a better indicator of sleep disturbance.