Waking up every few hours

Hello all,

I was diagnosed with OSA about five years ago, for the most part the CPAP was the ideal cure. However, over the last six months I have been waking up every two hours or so with a dry mouth. I am also starting to feel fatigued during the day.

I used to use a Resmed S9 which I purchased myself. I was recently referred to a NHS consultant who gave me a Phillips Respronics Remstar Auto with A-Flex because they were unable to read the data from the S9. My pressure has always been set to low:4/High:20, because it is an APAP machine I am told it adjusts to what I need. From my research I see people suggesting changing pressures - up until six months or so ago, I had never had a problem with the way the machie was set.

I use a Resmed Mirage Nasal mask.

In the main the doctors will tell me that my AHI is good and I am getting good sleep. Obviously I know I am not!

I have tried taping my mouth shut, but doesnt seem to help. There is a ramp feature on the machine - I normally press this when I wake up, you can probably tell by the graphs when I have pressed this.

I have attached my sleepyhead stats from the last two days. Any advice or suggestions would be much appreciated.

Your minimum pressure is not quite able to get to where it needs to be to prevent the airway collapsing or trying to collapse (and the snores you see are likely from the airway trying to collapse or partially collapsing)....and while the AHI is low it means that the snores aren't growing up to be full grown apnea events but they still could be disturbing you sleep.

The machine can't get to where it needs to be quickly enough with the current minimum pressure setting.
Probably 1 cm more (maybe 2 cm more) would get the job done...will it fix your issues? Don't know but it might and is worth trying.

I'm also wondering if you've gradually put on some weight over the years... it can sneak up and definitely affect your progress until the day it all of a sudden is obvious (things no longer working, not the weight .

Thank you for the response. I shall try setting the minimum pressure to 6 tonight - see if that helps.

Thanks again.

Yes Julie - I went on holiday last April and didn't get back to being healthy for a while. Probably put on between 7lbs and 14lbs in the past year.

Hello again,

I have upped my minimum setting to 6 as suggested previously, but have still been waking up during the night.

Last night (23rd) I took screen shots on my phone when I woke up and it was 03.39 and 05.05.

I am dreaming a lot when asleep, which I am told is a good thing as it means I am getting deep sleep. But the daytime fatigue and frequent waking up is really getting me down.

I'd appreciate if people would have a look at the sleepyhead data for the last two nights and offer any further suggestions/advice.

Guest82 wrote:Hello again,

I have upped my minimum setting to 6 as suggested previously, but have still been waking up during the night.

Last night (23rd) I took screen shots on my phone when I woke up and it was 03.39 and 05.05.

I am dreaming a lot when asleep, which I am told is a good thing as it means I am getting deep sleep. But the daytime fatigue and frequent waking up is really getting me down.

just fwiw, dreaming and deep sleep are different phases, and, if you're sleeping through your dreams, you're not going to remember them, because they fade rapidly after they're over.... so the fact you remember you're dreaming a lot probably means you're being roused often during your dreams.

So it means I am actually being awoken during the dreams?

I have also read that Nasal drops can cause insomnia. I don't seem to have too many problems falling asleep (probably because I am so tired) but wake up every two hours or so, it is so frustrating!

Have you tried a fixed pressure, or at least a very narrow range just in case you are one of those people who are sensitive to the pressure changes? Aside from the sensitivity thing, when I used an auto I found I did much better to start my range pretty close to where it might need to go. An ounce of prevention...

Any chance you've started a new med since the waking became a problem?

When you wake up do you fall back asleep quickly? Are you using a ramp feature? If so, how long is your ramp period? People with long ramp periods (often set 30 mins or more) need to be aware that if they fall back asleep quickly, they are exposing themselves to events during that ramp time. Then if that happens several times a night - not good. If this doesn't apply to you, please disregard.

While we can dream in other stages of sleep too, REM is considered the dream stage. It's also the stage where sleep apnea events are often the worst. It would make sense a person being awakened by events during REM would be waking during dreaming, and per popular thinking about dreaming, thus more likely to remember them. If it were me, I'd want my lower pressure high enough to ward off trouble instead of having to react after a problem starts.

I haven't tried a fixed pressure or a narrow range. Do you think it's worth trying? I've used an open range (4/20) for years and it's always worked ok. Until the last six months! I am willing to give it a go though.

I do have a ramp feature on my new machine, which I do press sometimes when I wake up. My awakenings seem to be every two hours so don't think that's causing them.

I had started taking otrovine nasal drops to clear my nose for the CPAP...I read on here yesterday that it has been linked to insomnia so I'll stop using it as of last night...(still woke up though!)

I put my lower pressure up to 6 earlier this week - looking at my graphs where would you suggest I go next?

Sorry - realised I didn't answer one of your questions. Yes I do tend to fall back asleep quickly when I wake up.

The numerous snores points to that minimum pressure still not being optimal.
It's hard to see any real pattern for the snores as in thinking if REM stage sleep is a primary culprit but it could be.
It could also be supine sleeping causing higher pressure needs...or maybe a little bit of both.

No matter what the reason you are having enough snores (and at times the machine wants to try to fix them with the increased pressures) that it's possible that the snores (remember generally they are signs of an impending airway collapse) and/or the associated airway collapse is causing the awakenings.

I would increase that minimum pressure a little more to see if the snores will reduce and see if that helps.
If not then maybe consider a fixed pressure but I can't tell just what I would suggest from these reports but maybe start with 9 or 10 cm.....or use a tiny range so we don't lose FL flagging (it's turned off if you change to cpap mode) which you can use a tiny range and mimic apap mode or even set minimum to equal maximum.

Also...take a look at your meds...have they changed? Sometimes meds cause us to wake often during the night.
So if you take any meds be sure to dig deep in the potential side effects. Sometimes meds will surprise you..I take a pain pill during the day that comes with a "may cause drowsiness" sticker but there's a small % of people who take it that get insomnia and I am in that small percentage. If I take it after 6 PM then while I might get to sleep fairly easily I find I wake up about 3 hours after I go to sleep and the rest of the night I wake often or sometimes I am up cleaning house at 2 AM because I simply can't sleep.

It just means your c-flex needs to be set higher (or turned on). They tried me on a different machine that didn't have the c-flex and i was miserable, painful dry mouth throughout the night! Apparently I'd gotten so used to the c-flex that I couldn't function without it.

[quote="Guest82"]Hello all,

I was diagnosed with OSA about five years ago, for the most part the CPAP was the ideal cure. However, over the last six months I have been waking up every two hours or so with a dry mouth. I am also starting to feel fatigued during the day.

I used to use a Resmed S9 which I purchased myself. I was recently referred to a NHS consultant who gave me a Phillips Respronics Remstar Auto with A-Flex because they were unable to read the data from the S9. My pressure has always been set to low:4/High:20, because it is an APAP machine I am told it adjusts to what I need. From my research I see people suggesting changing pressures - up until six months or so ago, I had never had a problem with the way the machie was set.