New user checking in...how am I doing?

First post here, looking for a little feedback/validation/support/advice.

I’m a 58 yr old male, generally good health (few extra pounds), get regular exercise. Symptoms that led to diagnosis were major snoring that disturbed partner’s sleep, reports of gasping/choking at night (never woke me up), chronic morning headaches and general fatigue. I generally fall asleep very quickly but frequently experience restless sleep.

GP ordered at-home sleep test, which reported overall AHI 17, overall RDI 31, 34% snoring over 30db, Mean Sp02 95.3. Apparently I'm 3.7 times more likely to have apnea/hyp when supine (I’m a stomach sleeper). This led to a prescription for autoPAP, 4-20.

Received the machine and started treatment, got accustomed to the mask in a couple days, and my AHI is hovering around 5. Still playing with humidity settings as they seem to affect the likelihood of headache/congestion. Upped the min pressure from 4 to 5, and dialed back the ramp time. Still experiencing occasional wakeup from what seems like excessive pressure (the wind-tunnel, dog-head outside car window effect), which I manage with a hit of the ramp button to reset. Doing more back/side sleeping than I’d like to, as I’m still getting used to stomach sleeping with Avara View mask (mouth breather, don’t feel the nose-only mask will work for me). Also on the plus side, no more late night bathroom breaks.

So this generally seems successful, but…I’m anxious that I’m not feeling significantly different. Not feeling any difference in fatigue levels or restfulness on waking. Biggest difference is the lessening/disappearance of morning headache, but I’m still waking up frequently or sleeping restlessly. Another datapoint - much more dreaming/dream recall. And partner is getting a better night’s sleep, so that’s a big help. One possible side affect - I feel I have better skin tone - more color in the face (more oxygen? Or maybe it’s just that we’re well into spring and I’m getting more sun).

I’ve posted a few nights of Sleepyhead graphs in the interest of sharing with the smart folks here. I’m jealous of the people here with .6 AHI, and want to be one of those success stories.

Oh, another data point. I’ve been tracking my sleep with an Apple Watch app, Sleep++. It’s admittedly a very general tracking device - only tracks “sleep” by the amount of motion it senses. It breaks down sleep into restful/restless periods, and charts the length of the most restful sleep period. It reports that my most restful sleep periods always occur about an hour or so after I turn in, and last about one hour. Since CPAP treatment began, that duration of restful sleep has crept up a bit - a couple times a full two hours, but generally less so. The breakdown of restful/restless sleep has increased very slightly as well, from about 92/8% to 94/6%. App developer has indicated that an update will provide more useful data, I’ll be interested to see how that works.

Anyhow, thanks. I’ve very much appreciated the information this forum provides, it was a surprise and relief to find this kind of support. Cheers!

http://imgur.com/NcoFQxT
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AliClick wrote:So this generally seems successful, but…I’m anxious that I’m not feeling significantly different. Not feeling any difference in fatigue levels or restfulness on waking. Biggest difference seems to be the lessening/disappearance of morning headache, but I’m still waking up frequently or sleeping restlessly.

It is important to be patient. Most people do NOT feel better right away. Most people start to feel better in a few weeks or even a few months. And the improvement can be gradual enough that you don't notice it right away. If your morning headaches areBut already getting better, that's a sign that you are starting to improve.

But real improvement will be hampered by frequent wakes and restless sleeping. Keep in mind that you are in the process of teaching your body to sleep with a six foot hose attached to your nose, and that's not exactly an easy thing for some of us. Again, most people sort out the "how do I sleep with this thing" in a few weeks and naturally start sleeping more soundly in a few weeks. If you have specific problems that you can identify that lead to wakes or restlessness during the night, post them and we'll be able to give you some pointers on how to fix them.

Received the machine and started treatment, got accustomed to the mask in a couple days, and my AHI is hovering around 5.

That treated AHI is a bit high. It may come down on its own as you start sleeping better. Or it may be that you will need to increase your minimum pressure setting a bit so the machine can prevent more events rather than needing to react to events that do occur.

Still playing with humidity settings as they seem to affect the likelihood of headache/congestion. Upped the min pressure from 4 to 5, and dialed back the ramp time. Still experiencing occasional wakeup from what seems like excessive pressure (the wind-tunnel, dog-head outside car window effect), which I manage with a hit of the ramp button to reset.

All of this is normal. When you do change a setting, it is useful to try to use the new setting for at least 3 or 4 days before tweaking again. Unless it's clear the new setting is clearly going the wrong way.

What I mean by that: If you turn the humidifier up (or down) and don't notice much difference, leave it at the new setting for a few days. But if you turn the humidifier down and you're parched the next day or wake up with a sore throat during the night, then turn it back up right away.

Play with EPR in the same way if you want to.

Doing more back/side sleeping than I’d like to, as I’m still getting used to stomach sleeping with Avara View mask (mouth breather, don’t feel the nose-only mask will work for me).

It IS possible to sleep on your stomach with a full-face mask. My husband does it every night. And it is very important to figure out a way to sleep with the mask on, but in your favorite pre-CPAP position.

There's a stomach sleeping position called the Falcon that is particularly CPAP-friendly. It looks like this:

The frequent awakenings will mess with that daytime energy levels because they mess with sleep cycle architecture.
Those should lessen with time and experience and just the brain getting used to the mask as it being its new best friend.

The best AHI numbers in the world don't guarantee anything except a good math score without good solid blocks of sleep and enough hours of sleep.
Gotta have both to stand a chance of feeling those good numbers.
For a long time the only real measurable difference in how I felt once I started cpap therapy was that the headaches went away and I no longer had to get up and pee 4 or 5 times a night. It took a lot longer for the daytime stuff to really improve much and it was a very gradual improvement at that...took months.
It also took me several months just to not wake up several times in the night "just because" and I say just because there wasn't anything going on that I could tell to cause the wake up. Mostly it was my waking up just to feel the mask on my face or something like that.

Overall from your reports it looks like you are doing fairly well but I think that the minimum pressure could maybe stand a little more of an increase and let's see if the AHI and some of the clutter not included in the AHI will reduce.
From the looks of where the pressure wants to go...I am thinking starting pressure of 8 or 9 might be in order.
You don't necessarily have to make the jump from 6 to 8 immediately unless you are okay with it...go up in stages or use the ramp if need be.

So work on doing whatever it takes to fall asleep faster and easier and have less wake ups...remember it's actual sleep time that counts..not laying there with mask on awake time.
AHI numbers are just one of several things that impact how we feel during the day. The best most perfect AHI in the world doesn't mean squat if you don't get enough hours or sleep or your sleep is trashed by multiple numerous wake ups from any reason.