Do I have sleep apnea?

FYI, my at home sleep study is scheduled for next week, I'm 5'10"" 164 lbs and in decent shape, exercise occasionally (2-3 times per month)

Essentially I try to stay in bed for 10 hrs but get much less sleep than that. As a result, I'm tired but not exhausted. Wife says I snore, it gets louder then I wake myself up. I usually remember seeing the clock at least 3 times a night. It's very common for me to go to bet at 10:30 and see the clock around midnight, then 3, etc.

Any opinions of if I have apnea or obstruction? I read that cpap is only effective in 30% of people with mild apnea. I'm assuming I have mild apnea but it could be moderate or non existent. Any thoughts?

Ps, I only get headaches occasionally, usually yawn throughout the day, and avoid naps..

Sleep cycles are around 90 mins.... so 10:30,12midnight (1 cycle), 3am, 6pm (each are two cycles each). Common possibly wake up at the end of each cycle. Sometimes you string two of them together.

The test will show what is going on related to obstruction but it is possible you also have something external which is distrubing you that wakes you up as you near the end of each cycle.

Hi, can't say whether you have apnea, but staying in bed that long is a red flag, and so is snoring. If you're a back sleeper, that'll provoke more apneas if you have them, so do whatever it takes to not sleep like that at least until your study. The fact you apparently wake up at times overnight could be a lot of things like a form of insomnia, apneas that do wake you (whereas most only arouse - you wouldn't be conscious of them), meds you're taking, sleeping conditions locally, too many to speculate about and not lead you in the wrong direction. Weight shouldn't be blamed on apnea, it's now thought that apnea can cause weight gain... and it's not necessarily about exhaustion but sleepiness... and you should also be tested for other conditions like thyroid problems, low Vit D, general bloodwork, etc. Yawning is a tip that you might be short on oxygen, whether at night or otherwise, again something the test will look at. And not having headaches does not mean you don't have apnea, but it's better than having them every morning.

Let us know how things go, get your results asap and come back to this thread to we can all follow your story, and if you need advice or help then, there are lots of knowledgable people here that can give it.

It's good that you have a sleep study scheduled. If you do have sleep apnea -- right now there's no basis for assuming that it's mild based on your subjective experience. The number of times you remember waking up may only be a tiny fraction of a percent of the number of times you actually stop breathing.

Some people diagnosed with mild sleep apnea report a significant improvement in how they feel when they start using their CPAP machine. So although the article you read is interesting, the research really can't predict how any one individual will do on CPAP therapy.

My guess and it truly is only that, is that most of the 70% that don't respond to CPAP are the ones that don't/can't use it. IF you need it, it is best to use it, or you body will make it more important that you do-you don't want that.
Sleep Apnea is just that, it happens when you are asleep so it is quite difficult to figure it out without a study or recording device

I had my sleep study done and I have an AHI OF 13 & RDI OF 27 done via a home study.




Here is my scrip calling for pressures of 5-12

I am using a Resmed auto set 10 APAP machine.
The initial settings were 4, ramp up to prescribed min of 5 with max of 12. First night using it I had an AHI of 4.59



The next night, I increased the min. pressure from 5 to 5.6 and had an AHI of 2.87



I then adjusted the pressure once more to a min of 5.8 and max of 12.4 MY AHI that night was 5.47



Night 4, I did not use it because I had a sore nasal septum. I will be using it again tonight as the soreness of my nose is minimal from the nasal pillows.

I'm sure it will take some time to get consistent AHI readings, but is it generally considered ok in this situation that I raised my min and max pressures slightly? Keep in mind that my insurance did not pay for anything and I have already spent over 3,000 on this process and cant afford a titration study.
Thanks, C.

Watch not only the AHI but what the AHI is made up of.
That night with AHI of 2 something...the bulk of the AHI was CA (clear airway/centrals) and we don't treat those with more pressure with your machine...in fact more pressure could potentially create more centrals.
Don't go changing things on a nightly basis. Give a setting choice time for the body to adjust to things unless the results are horrible.

Take 15 minutes and review this youtube video it will help you understand what is going on with snoring..
https://www.youtube.com/watch?v=-gie2dhqP2c

This video put the whole thing in perspective for me.

The you tube video was pretty informative, thanks.
I was able to wear the mask all night and my results are below. I have a question though. For years, I was waking up every few hours. I can specifically remember fully waking up an average of 3 times per night. I was hoping that would stop with APAP therapy. However, (and its only been 4 times using the device) I am still becoming fully awake at least 3 times per night even when using my APAP. Now I wake up with air coming our of my mouth and my mouth is very dry. When I look at the machine, the pressure is usually at 10. I have set the humidity to max and adjusted the line temp down to 80 but no difference. I have since set the climate back to auto. Please look at my results below and suggest how to proceed or adjust pressures so I don't wake up 3+ times per night. (unless its too soon to make adjustments) FYI, I find my nasal pillow very comfortable and the pressure easy to tolerate. Even when I wake up to a 10 pressure, I am able to fall back asleep easily.

Thanks for your input/suggestions.

I strongly suggest you try a full face mask because it would alleviate the dryness and mouth breathing that causes it. Raising your pressure to try and overcome the problem only makes it worse - more pressure, more likelihood of your mouth being opened by it. And don't back sleep if you can possibly avoid it by having something behind you to keep it from occurring overnight.

The dry mouth is likely from mouth breathing and it's unlikely that you will find a humidity choice that will fix that issue. The mouth needs to be kept shut. Easier said than done when we are asleep.
The actual amount of time spent in large leak territory isn't horribly horrible though (see the LL flags on the events graph..those are time spent over 24 L/min in large leak territory)...but could stand some work. The time spent over 35 L/min the leaks are bad enough that therapy and machine response and flagging can be affected.

While the bulk of the leaks probably aren't impacting therapy itself...they are big enough to perhaps contribute to causing a person to wake up.
Waking up 3 times a night...some wake ups are normal part of the sleep cycle...especially at the end of a REM stage sleep cycle.

Up to you if you wish to try a full face mask to help with the dry mouth...but people using full face masks complain of dry mouth all the time...it's the mouth breathing that is the culprit and even with a full face mask the humidifier can't crank out enough humidity to fix dry mouth totally for some people. So using a full face mask doesn't guarantee fixing the dry mouth.
In terms of mouth breathing leaks affecting therapy and thus making it necessary to use a full face mask...the time you spend in large leak isn't horrible if this is the worst it gets. It's only been 4 nights...unless you are mouth breathing due to nasal congestion causing a physical need...it isn't urgent to change to a full face mask simply because of large leaks because you aren't spending a prolong period of time in large leak.

Now if those leaks (even small ones) are a factor in the wake ups then of course we would want to limit them.

Finally...only 4 nights...not very long in the adjustment time frame. Part of your wake ups could simply be the brain waking you up to say "hey dude, do you know that there's an alien planted on your nose" with time the brain comes to accept the mask as part of your face and not wake you up to alert you.
I had this happen to me...took about a month for me to stop waking up just to feel my nose.

Also...you are using apap mode and your pressures are roaming around quite a bit. This roaming could also possibly be a factor in your wake ups...it can disturb some people's sleep.
Tightening the range might help if that is maybe a factor in your wake ups. Some people even the slightest change will disturb their sleep and other can sleep through massive pressure changes and not even notice any change or know it happened until they see their report the next day.
It's hard to see your pressure numbers but it looks like 7 or 8 ish might be a good start on limiting the pressure range.. Maybe use a starting minimum of around 8 cm...see what the machine wants to go to with that starting point. Often if the minimum pressure is more optimal we find the pressure won't climb as much as often so a slight increase in the minimum often will bring down the maximum reached as a by product without doing anything to the maximum.

Good luck...it's only been 4 days and you are already so far ahead of where I was at when I was at 4 days. You are really doing quite well.

If you wish to try the usual chin strap stuff in an effort to curb the mouth breathing you can do that but it isn't something that is urgent (at least from this report you show).
Adding a chin strap....the brain will wake you up and say "hey dude...do you know your head is in a vise" even if it isn't very tight. It's the brain's job to alert you to a change in norm...it takes it a while to learn a new norm.

You guys are giving some great advice, thanks.
I'm going to give it about a week more, then experiment with raising my minimum pressure. Unless I am wrong, its been around 6, then quickly ramps up to 10 to deal with the obstruction, resulting in me waking. Maybe if im at 8, then the raise to 10 wont wake me.
Until then, I will leave the pressures alone to see if it improves on its own, but it seems like it raises to 10 a lot so starting at 5 my be too little.

If you start at 8 cm the machine might not (I can't guarantee it) not need to go to 10 as often or for as long.

It's hard to know for sure what is actually causing the wake ups this early in the adjustment period since part of it can simply be the newness of all this. It could be the pressure changes...it could be the brain on alert...it could be normal sleep stage awakening...could be outside factors that we don't know about or remember.
Unfortunately we don't have a crystal ball that tells us exactly why we might wake up so we can try to fix it.
The best we can do is take a logical approach and try different things to see if it helps or hurts.
I never (or extremely rarely) ever sleep through the night but I have other factors at play so I don't really expect to. Those factors are unrelated to OSA or pressures (I sleep through massive pressure changes routinely) and I have learned to manage them as best I can. Sometimes I win and sometimes those other factors win. Not everything is related to OSA or the therapy and the machine can't fix problems that aren't related to what it is designed to fix no matter how much we might want it to.

But it never hurts to at least try some of the common fixes to help reduce potential wake up causing culprits so we at least do the best we can.

In your situation...if it were me the first thing I would try is that increase in the minimum...your machine wants to be a little higher anyway.
Whatever you do...always allow a few nights with a change (and try to only change one thing at a time) to see how things want to trend unless the change happens to cause horrible results. I did that once when I turned off AFlex after using it for 2 plus years...bad change with horrible results so I quickly abandoned that idea and went back to using AFlex after only 1 night.

Big C wrote:

well, that's new.

and, almost completely useless.

try this: https://sleep.tnet.com/resources/sleepyhead/shorganize three pages, read 'em all.