Frequent Awakenings

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Java
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Frequent Awakenings

Post by Java » Tue Jan 27, 2015 5:20 pm

Hello,

I have been on CPAP for over 2 years now, my average AHI is just under 2.0. My problem is frequent awakenings EVERY NIGHT. I wake up every 1-2 hours every night. I have not slept threw the night in 12 years. It is so frustrating and I am so exhausted. I just wonder what it must feel like to actually sleep 6-8 hours straight. So in reviewing the data on my SD card, I notice I wake up after each Apnea. Wide awake. I get up, use the restroom, get a sip of water (Even with the humidifier on 5 my mouth and nose get so so so dry. Any advice?
Java :)

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Julie
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Re: Frequent Awakenings

Post by Julie » Tue Jan 27, 2015 5:31 pm

Wish you'd have given more info - like your pressure settings, as they can make a difference, plus some people on Apap do best on Cpap because they wake up (if not aware of why) when pressure changes with Apap. Do you use SleepyHead software and can you post a picture of a printout graph so we can see what's going on?

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Sir NoddinOff
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Re: Frequent Awakenings

Post by Sir NoddinOff » Tue Jan 27, 2015 5:41 pm

If you think your general health and CPAP therapy are essentially on track you could discuss REM behavior disorder with your doctor... from http://sleepfoundation.org/sleep-disord ... r-disorder:

"For most people, dreaming is purely a "mental" activity: they occur in the mind while the body is at rest. But people who suffer from REM behavior disorder (RBD) act out their dreams. They physically move limbs or even get up and engage in activities associated with waking. Some engage in sleep talking, shouting, screaming, hittting or punching. Some even fly out of bed while sleeping! RBD is usually noticed when it causes danger to the sleeping person, their bed partner, or others they encounter. Sometimes ill effects such as injury to self or bed partner sustained while asleep trigger a diagnosis of RBD. The good news is that RBD can usually be treated successfully.

What we call "sleep" involves transitions between three different states: wakefulness, rapid eye movement (REM) sleep, which is associated with dreaming, and non rapid eye movement (N-REM) sleep. There are a variety of characteristics that define each state, but to understand REM Behavior Disorder it is important to know that it occurs during REM sleep. During this state, the electrical activity of the brain, as recorded by an electroencephalogram, looks similar to the electrical activity that occurs during waking. Although neurons in the brain during REM sleep are functioning much as they do during waking, REM sleep is also characterized by temporary muscle paralysis.

In some sleep disorders such as narcolepsy and parasomnias, like REM behavior disorder, the distinctions between these different states breaks down; characteristics of one state carry over or "invade" the others. Sleep researchers believe that neurological "barriers" that separate the states don't function properly, though the cause of such occurrences is not entirely understood.

Thus, for most people, even when they are having vivid dreams in which they imagine they are active, their bodies are still. But, persons with RBD lack this muscle paralysis, which permits them to act out dramatic and/or violent dreams during the REM stage of sleep. Sometimes they begin by talking, twitching and jerking during dreaming for years before they fully act out their REM dreams.

In the course of "acting out their dreams," people with RBD move their arms and legs in bed or talk in their sleep, or they might start sleepwalking without waking or realizing they're dreaming. The only sensations the sleeper experiences are what is occurring in their dream. And many of these dreams can be violent or frightening, causing injury to the sleeper and his bed partner.

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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Tue Jan 27, 2015 5:47 pm

Java wrote:Hello,

I have been on CPAP for over 2 years now, my average AHI is just under 2.0. My problem is frequent awakenings EVERY NIGHT. I wake up every 1-2 hours every night. I have not slept threw the night in 12 years. It is so frustrating and I am so exhausted. I just wonder what it must feel like to actually sleep 6-8 hours straight. So in reviewing the data on my SD card, I notice I wake up after each Apnea. Wide awake. I get up, use the restroom, get a sip of water (Even with the humidifier on 5 my mouth and nose get so so so dry. Any advice?
Can you post a report?
That snippet of information doesn't tell us what your machine did before, during or after the event.......or, how it happened to wake you up.
The time frame of your awakenings could also coincide with the amount of time we typically cycle through our sleep stages.
It appears that you have a straight pressure Bi-PAP, so one would have to ask whether your pressure settings are adequate. It may be that they are not.

I would also throw out the thought that your humidifier setting is too high. The high humidity is probably causing you more congestion and promotes mouth-breathing.

Over all, I'd say you need to do some tweaking with various settings.


Den

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OkyDoky
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Re: Frequent Awakenings

Post by OkyDoky » Tue Jan 27, 2015 5:58 pm

I believe your machine can be found if you scroll down to PR System One REMStar 60 Series BiPAP Pro with Bi-Flex. The Respironics names can be confusing. Check it out and see if it is yours. There's also a 60 series humidifer.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

JDS74
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Re: Frequent Awakenings

Post by JDS74 » Tue Jan 27, 2015 7:23 pm

Java,

In addition to waking up frequently at night, are you having other symptoms - night sweats, headaches, chills, etc.?
Do you have a copy of your sleep studies, diagnostic and titration? What do they say about arousal frequency during the study?

Do you have a copy of SleepyHead or Encore so you can run your own reports? As previously asked, what does the data say was going on in the minute or two before you wake up?

Are your pressures in line with numbers from your sleep study? Have you fiddled the settings?

Waking up that frequently is a real bummer. I wake up 4 or 5 times each night and my arousal index is about 9 per hour even with my machine on optimal settings. There is a separate medical issue that causes my problems and am only recently getting close to finding the cause. So you may have something that is not apnea related but you first need to be sure your apnea is being treated optimally before going off on a snipe hunt for something else.

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Java
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Re: Frequent Awakenings

Post by Java » Tue Jan 27, 2015 10:23 pm

Image


Sorry for not including a screen shot earlier. I hope this works. All I have been able to gather is that I wake up after each apnea.
I've updated my equipment on my profile page.
I don't have any other symptoms like night sweats or headaches.
My doctor says my AHI is "within normal" so she doesn't seem to care that I have fragmented sleep.
Java :)

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OkyDoky
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Re: Frequent Awakenings

Post by OkyDoky » Tue Jan 27, 2015 10:27 pm

You stated that you had a 660 but Sleepyhead shows that you have a 760. So your equipment should look the same as mine. It's hard to find the right one sometimes.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

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OkyDoky
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Re: Frequent Awakenings

Post by OkyDoky » Tue Jan 27, 2015 10:41 pm

Just scroll down till you find the Pr System One Remstar 60 series Bipap Auto with Biflex and use the text option. It is easier to tell because the pictures are so small that you have to click on them to find out what it is. Have you been on the same pressures for 2 years?
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

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Java
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Re: Frequent Awakenings

Post by Java » Tue Jan 27, 2015 11:10 pm

I have been on these same pressures since September 2014 when I got the Bi-PAP. Before that I had APAP
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OkyDoky
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Re: Frequent Awakenings

Post by OkyDoky » Tue Jan 27, 2015 11:13 pm

What were your pressures on the apap and how long have you had the frequent awakenings?
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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Tue Jan 27, 2015 11:30 pm

So, you DO have an Auto Bi-PAP.........
Part of what we're missing is the "Events" section.
We don't know for sure what events are causing the pressure increases. Typically, only Flow Limitations and Snores will drive the pressure increases.
However, from looking at that much, I wonder if what's waking you is the leaking after the pressure rises to pursue the events and you're losing your mask seal. And/or a combination of that and the pressure increases themselves.


Den

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(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
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Java
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Re: Frequent Awakenings

Post by Java » Wed Jan 28, 2015 12:46 am

Wulfman... wrote:So, you DO have an Auto Bi-PAP.........
Part of what we're missing is the "Events" section.
We don't know for sure what events are causing the pressure increases. Typically, only Flow Limitations and Snores will drive the pressure increases.
However, from looking at that much, I wonder if what's waking you is the leaking after the pressure rises to pursue the events and you're losing your mask seal. And/or a combination of that and the pressure increases themselves.


Den

.

Image

Does this give you more information? Sorry I am not very good at figuring out sleepyhead graphs and such.
Java :)

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Java
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Re: Frequent Awakenings

Post by Java » Wed Jan 28, 2015 12:59 am

OkyDoky wrote:What were your pressures on the apap and how long have you had the frequent awakenings?

Image

This is when I was on APAP. My settings were 4-20. I played around with them and tried like 10-20 and 13-17 but nothing was making it any better. I still wake up every 1-2 hours.
I have been having frequent awakenings for 12 years.
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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Wed Jan 28, 2015 1:15 am

Yes it does!
It shows me that Snores and Flow Limitations are what are driving your pressures up.
You're having very few apnea and even hypopnea events. There were a couple of times when you did have a few hypopneas but overall not bad.
My suggestion would be to increase your EPAP pressure a bit and drop the IPAP (max) pressure some, too. If I'm reading the settings correctly, it's showing the Pressure Support at 15. That may be what you may want to throttle back, too. You could try it gradually over a period of time to monitor the results. Other than the Snores and Flow Limitations, your "base" pressures are pretty well taking care of the hypopneas and apneas. I'm not even sure why you're on Bi-PAP, but I think a pressure of around 12 cm. (in CPAP mode) would probably keep your events to a minimum and let you sleep better. But, we'll try to work around that in Bi-PAP mode. (Unless you want to try straight pressure.)


Den

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(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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