Hell in a handbasket

[Dogjudge]

Well, first of all, thank you to everyone who has been helping get through getting to this point with how to use the forum. Additionally, thank you to everyone for your suggestions.

As a quick recap. Got my machine on 9/22. Wasn't great. Went to the doctor on 10/22. He reduced the pressure from 12 to 10.

Since then, I've kept a spread sheet with the date, AHI, pressure setting, my comments, and a * to **** rating of my sleep. * being horrible and **** being great. From 10/22 until 11/7, the AHI trended lower from 6.5 to 2.5. My sleep ratings went from * to **. Pressure always at 10. Then the AHI started to go back up ending back up at 5.

Then the AHI bounce around from 2.5 to 5 over the next week.While the pressure was still at 10. My sleep ratings during that week were essentially *** the entire time.

During the next week, things went bad again.Tried reducing the pressure to 9.5. Things were mixed enough that I decided to go back to 10. That was on 11/19. From 11/19 until 11/28 AHI went from 3.5 to 1. Not linear, but trending.

Then things went to hell in a handbasket. 4.5 to 5 AHI. Although last night was absolutely the worst since I've started (3 hours sleep approximately), the AHI was 3.3. All the time, my rating of my sleep was *.

I do have an appointment for Tuesday.

[Dogjudge]

Got up at about 3:00 because I couldn't stand waking up any more. Probably slept around 4 hours during the night.

[SGearhart]

Numbers alone just show how you basically slept (or didn't). There are many other factors to consider. Some to consider are:

1.Are you going to sleep and getting up at the same time each day?
2. Are you taking any meds and if so, are they taken everyday and at a set time?
3. Do any cause drowsiness or designed to invoke sleep?
4. How long after eating before you retire?
5. Do you have GERD?
6. Do you eat any spicey food prior to the bad numbers?

I apologize for all the questions but variables like I've listed can play a significant role in you sleep numbers. I'm hoping you might have OMG! moment and see something that might have triggered it,

[Dogjudge]

Numbers alone just show how you basically slept (or didn't). There are many other factors to consider. Some to consider are:

1.Are you going to sleep and getting up at the same time each day?
2. Are you taking any meds and if so, are they taken everyday and at a set time?
3. Do any cause drowsiness or designed to invoke sleep?
4. How long after eating before you retire?
5. Do you have GERD?
6. Do you eat any spicey food prior to the bad numbers?

I apologize for all the questions but variables like I've listed can play a significant role in you sleep numbers. I'm hoping you might have OMG! moment and see something that might have triggered it,

1 - Trying to. The primary problem sine the inception of this was been waking for period of an hour, or more. Right now, because of the lack of sleep, I'm going to bed at 10:00 and waking at 7:00.
2 - Meds haven't changed. Advair, for asthma is only thing taken in the evening, typically a couple of hours before I go to bed.
3 - As far as I know, the Advair doesn't depress, or stimulate.
4 - Eat around 6:30. Give or take an hour (usually later on the weekends)
5 - Nope
6 - Have had anything from a chicken/broccoli/sun dried tomato pasta to tacos. Doesn't appear to make any difference.

Thanks for the comments, however.

[LSAT]

Your pressure is not set at 10...It is set at Min 5 and Max 10. It's set to Auto Pap not CPAP. I think the minimum should be slightly increased and the Max should go back to 12.

[Pugsy]

You are adjusting the maximum pressure.
You are in APAP auto adjusting pressure mode and starting out at 5 cm with the maximum being 10.
Wonder what would happen if you adjusted the minimum of 5 upward and left maximum at 10. Perhaps it's the changing of the pressures in auto mode that is a factor in sleep quality. Some people simply don't sleep so great with variable pressures. Perhaps you are one of those people.

You aren't spending the whole night at 10...only maybe a third of it (at least on this report shown).

How do you judge your *s for rating sleep? Is it how many times you might wake up during the night or how you feel during the day? Or what? What do you feel is lacking in your sleep?
Are you waking up often during the night for any reason? If so, any idea why?
Any other meds besides Advair?

[Dogjudge]

You are adjusting the maximum pressure.
Wonder what would happen if you adjusted the minimum of 5 upward and left maximum at 10. Perhaps it's the changing of the pressures in auto mode that is a factor in sleep quality. Some people simply don't sleep so great with variable pressures. Perhaps you are one of those people.

Thanks. It's a thought. Realize that, just didn't phrase it correctly.

[/quote]You aren't spending the whole night at 10...only maybe a third of it (at least on this report shown).[/quote]

Understood

[/quote]How do you judge your *s for rating sleep? Is it how many times you might wake up during the night or how you feel during the day? Or what? What do you feel is lacking in your sleep?
Are you waking up often during the night for any reason? If so, any idea why?
Any other meds besides Advair?[/quote]

I tried to make the rating simple. If I was (ever) able to go to bed at 10:00, sleep through the night, and wake up anywhere from 5:00 on, it would be a ****. Wake up 1-3 times for 15 minutes, or so, but sleep the rest of the night, that's a ***. Wake up 3+ and for periods of up to an hour, and I feel as if the total hours I've slept is 5-6 hours, that's a **. Less than 5 hours of estimated sleep (i.e. deducting the time that I think I've been awake over the night.) coupled with the number of times I've awaken. *. So if I actually slept 5-6 hours without waking, I'd probably give it a 2-3. Obviously, it's subjective.

Meds - Advair 2X per day. Levothyroxine 112 mcg (once per day when I awake). Lamotrigene 200 mg. (once per day in the am). Metopolol ER 100 mg in the AM. 81 mg aspirin. Centrum Silver.

[Pugsy]

Is your sleep quality any better or worse or about the same as before you started cpap therapy?
Meaning is there any improvement at all or has it actually gotten worse?
When you have those nights where you wake often...do you know why? Is it leaks or mask comfort or just because there is an alien on your face? Fragmented sleep will simply kill sleep quality when we wake often. It's a battle I face every night but not because of cpap related issues. Instead it is related more to arthritis pain. Even 8 hours of sleep with nice low AHI would end up with a 1 star night in terms of quality if I wake up a lot (even if I go right back to sleep). When I only get 6 hours and it's fragmented then I am going to be totally a crabby woman and it wouldn't even rate a 1 star.

There's so much more to feeling those "good numbers" than just getting them. If it were that easy we wouldn't need this forum.
Meds is something I always suggest that we look at first to see if there is remotely any chance that meds are a factor in poor sleep quality. It doesn't look like any of your meds are known to be much of a factor in sleep quality or how we feel the next day.

Isolating the culprits for poor sleep quality and short hours of sleep is easier said than done though. Takes a lot of detective work.

4 hours of sleep simply isn't enough sleep no matter if it was A one sleep quality or not.

So....first order of business is to try to figure out why the short hours and why the wake ups.
I do think a little more pressure might help.
It's very possible that the changing pressures themselves are a factor in your sleep quality...some people don't do so great with even the least little changes. Increasing the minimum will reduce the changes and also help with the apnea events, snores and RERAs which could also be a factor.
Your report shown isn't horribly horrible but it does show some little stuff that could possibly be improved upon and maybe sleep quality would improve along with it.

Often it isn't just one single thing that causes poor sleep or short hours of sleep. Usually it's a combination of several things and we just have to keep trying to figure out what they might be and see what we can do to improve things.

[Dogjudge]

For the first month, things seemed to be slowly improving. i.e. sleeping more and waking less. The waking issue seems to be the entire issue.

Forgot about 0.5 mg. of Melatonin at night.

Many of the waking episodes seem to be that I startle awake. External issues just aren't there. Comfort, temperature, noise, etc. I'm asleep and then bang, I'm awake. The first mask did bother me, but since I received the ESON mask, I essentially don't know it's there. Once in a while I'll awake because I can feel the mask making leaking noise. Adjust it slightly and then I'm back to sleep. That might happen once every couple of days.

I just added my own scale because I wanted to see what things I could watch for and see if their was any correlation. As an aside, I do teach and train dogs. A long time ago I learned that you never judge anything by a few instances. I always look for trends. Over a week are things getting better, or worse (sleep or dogs).

Since I only got Sleepyhead up and running, I only had some information. I posted what I thought was pertinent. Things on the readout, such as Large Leaks, has always read zero, so I thought that it was extraneous to put that down.

As far as I know/knew, things were going okay up until a week ago. There's nothing that I know of that's changed. I wish that something external had changed.

At this point I'm going to change the low pressure and see what happens. Another thing I've learned about solving problems is to change as few variables as possible. KISS

[ChicagoGranny]

At this point I'm going to change the low pressure

I would not hesitate to take the min to 7.

Forgot about 0.5 mg. of Melatonin at night.

How old are you? In your case melatonin supplementation is only appropriate if you are old enough that your body is not producing sufficient melatonin. For most people this does not happen before the age of 55.

[Julie]

I take tiny amts of melatonin at times, and I find that when I do it every night, by the 3rd night or so I wake up a couple of hrs into things, whereas if I only use it 1/3 nights, everything's fine. In case this helps. And you are mixing up your pressure settings - the higher one can be left relatively high, if not all the way (to 20), but it's the low one that counts and you've got yours too low to be effective. You also say you eat tacos, etc. (and pasta, which has a high carb count, and can translate to symptoms of GERD if you're susceptible). I imagine there's some spice in those, and if you have 'silent' GERD it can definitely waken you without you're realizing why... so I'd be careful about what you eat when... it does make a real difference.

[Dogjudge]

Thanks about the settings.

I'll try skipping the Melatonin for a couple of days and see what happens. (I'm 66)

My wife was treated for GERD. Have none of the symptoms. In addition to working in the food ingredient industry, I'm definitely a foodie. Other than not wanting to eat some things, such as uni, I don't know if I've ever had a problem except for once.

Raw milk cheese in France. Forgot about that. Then, despite my rudimentary French, learned that diarrhea is pronounced the same way in French as it is in English.

[Julie]

Did you see the 'Silent" in my note (re GERD)? It's a real thing, not something I made up, and the older you get, the more apneas you have, the more likely it is that you have it to some extent, and even if you don't have the obvious symptoms, it can wake you up, and do other damage you don't need.

[Dogjudge]

Julie,

Thanks.

I'll talk to my GP about it, the next time I see him.