still puzzled over why I'm waking up (sleepyhead data)

Okay so I'm still waking up 2-3 times per night after being on CPAP for about 6 weeks. The few times I haven't woken up I've felt great so I know it is working, but something is waking me up a lot and I can't figure it out! I have the Airsense 10 machine and the airfit p10 nasal pillow mask. Mask feels super comfortable and I barely notice it. I just got a hose buddy which gives me a lot more slack and I think helps (though it's not perfect for getting the cord out of the way with my mask).

I am really stumped as to why I'm waking up so often because I think I'm doing everything I should. My AHI is usually under 1 and last night it was .89, but I woke up at least twice and I'm tired again. I'm meeting with my doctor this week for a followup, but I'd like to go in there with an idea of what is wrong. Can anyone help? Here are some graphs from my sleepyhead, I think they look okay, but I'm a total noob so I am probably missing something.

http://imgur.com/a/oAwar

Thank you!

It would help if we knew your machine and pressures. It looks like you are starting at 5 and it goes up pretty quickly at times. It's possible that is waking you. I would change my lower pressure to 7 and see if that helps.

Yes, a wild guess would be the pressure changes are waking you. Raise the minimum as Oky suggests, or better yet in my opinion, change to straight CPAP around 8cm and see if that helps.

Nothing "puzzling" about that report.
I'd put my money on pressure changes waking you up......and leaving you feeling unrested (as I believe you mentioned in previous posts).

Try straight pressure.......maybe 7 or 8 and see how things go.


Den

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Thank you all for the replies!

yes I am starting out at a pressure of 5 and then it changes throughout the night. They told me only the doctor can change my pressure to continuous so I will ask them about that when I meet with my doctor that week. Hopefully that fixes it

Of course you can change your pressure - we all do, seeing as it's our therapy and lives at stake. We can help any time you want. The doctors and DME's who tell you not to do it (or that the machine's been locked) have no respect for you and want control, but it's wrong and a very outdated way to deal with patients unless they're 5. Speaking of which, diabetic children know how to test their sugar and make adjustments, so don't believe the nonsense you're told by your doctor - get a new one if necessary.

You need to have this clinical manual anyway.

https://sleep.tnet.com/home/files/resme ... -guide.pdf

As Julie hinted at, you need to take control of your own therapy. Nobody will care about it as much as you will.


Den

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Julie wrote:Of course you can change your pressure - we all do, seeing as it's our therapy and lives at stake. We can help any time you want. The doctors and DME's who tell you not to do it (or that the machine's been locked) have no respect for you and want control, but it's wrong and a very outdated way to deal with patients unless they're 5. Speaking of which, diabetic children know how to test their sugar and make adjustments, so don't believe the nonsense you're told by your doctor - get a new one if necessary.

Wow, I had no idea I could do it myself lol. The person at the sleep center made it sound like I couldnt. Thank you Julie and Wulfman... for the manual! I will try to put it at a constant pressure of 7 and see if that helps.

If you are going to limit your Cpap to straight pressure, I think I would go with the 8 pressure. If you look at your graph you can see it bounces to around 8 when you have your obstructives. Otherwise, with 7, you might not control the obstructives. When I stated starting at 7, I was thinking of leaving it in Auto mode but you can do it ether way. Just monitor with sleepyhead and give the changes several days to evaluate results.

Now that you are about to take control of your own therapy, resist the urge to make changes willy-nilly. Take a methodical approach. Give your body a chance to adjust to each change. I would say at least 3 days or more, 5 would be good, but few have the patience for that. Try to change only one variable at a time. Remember that variances in sleep can be caused by a number of things not necessarily related to CPAP therapy. The last thing you want to do is start "dial wingin", making random changes at close intervals chasing an elusive AHI or feeling. Obsessing over sleep is not good for sleep.
Good luck, post your charts and ask for help.
I see OKyDoky slipped basically the same advice in while I was composing, but I'll let mine stand. I agree with 8 as a good place to start with constant pressure.

Good points and thank you both for the advice. I will try 8 and report back here after a few days.

While it's frustrating to not have this perfected (or good enough) yet, the scientist in me is kind of looking forward to playing around and figuring it out

My pressure settings were set at 5 to 12, but looking over my sleepyhead data, it seems like I only need a maximum of 8 or so. My overall average was right around 6 and my 90% pressure was around 7.3. So I'm going to keep it on APAP for now since I'm used to it, but change it from 7-10 so I don't get the big jumps in pressure they may have woken me up.

If that doesn't work after a couple days, I'll try straight CPAP at 8.

OSAdude76 wrote:My pressure settings were set at 5 to 12, but looking over my sleepyhead data, it seems like I only need a maximum of 8 or so. My overall average was right around 6 and my 90% pressure was around 7.3. So I'm going to keep it on APAP for now since I'm used to it, but change it from 7-10 so I don't get the big jumps in pressure they may have woken me up.

If that doesn't work after a couple days, I'll try straight CPAP at 8.

You can do whatever you want......it's your therapy. BUT......you posted this thread asking why you were still waking up.
It sounded to me like you WEREN'T used to it. If you were, you wouldn't be waking up.


Den

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Wulfman... wrote:

OSAdude76 wrote:My pressure settings were set at 5 to 12, but looking over my sleepyhead data, it seems like I only need a maximum of 8 or so. My overall average was right around 6 and my 90% pressure was around 7.3. So I'm going to keep it on APAP for now since I'm used to it, but change it from 7-10 so I don't get the big jumps in pressure they may have woken me up.

If that doesn't work after a couple days, I'll try straight CPAP at 8.

You can do whatever you want......it's your therapy. BUT......you posted this thread asking why you were still waking up.
It sounded to me like you WEREN'T used to it. If you were, you wouldn't be waking up.


Den

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That's a good point Maybe I should try constant pressure first since I'm trying to determine if APAP was giving me issues. I guess I was worried that the jump from the ramp to 8 would automatically wake me up. We'll see!

No - the whole point of the ramp is that it increases in slow increments - you set the timing... don't confuse it with the prescribed pressure setting it ramps up to, the one where if you did not use the ramp the pressure would jump all at once (but in fact, 8 is so relatively low it really shouldn't be a hard thing to manage... there are people here with settings starting at 15 who don't use the ramp and just take the initial blast).