Geat AHI but Not Best Sleep?

Last night I had a record 0.24 total AHI in over 8 hours of sleep. Those 8 hours were broken twice for me to get up. I should have been feeling top of the world but I didn't. While I wasn't brain fogged I was weary most of the day. There was a period at the end of the night where I had a large mask leak and maybe this is why, I don't know.

The other night I had an AHI of around 5.0 and felt great all day, go figure. This has happened before

I've posted last night's results to see if anyone has any ideas for me. Do I now need to do some more tweaking of my settings? Is my flow rate OK? Is my leak rate dodgy? I'd love some feedback.

Having said all that, I am at the end of a very long and hard term here at school and this might also be where the tiredness comes from.

I see nothing helpful in your screenshot:



in case the message isn't clear... photobucket sucks. don't use it

Holden, CPAP can only treat sleep apnea, it can not fix poor sleep caused by other things. A low AHI is not necessarily indicative of Restorative or Refreshing Sleep. Sleep Architecture, i.e., the composition of the stages of sleep, can play an important part, and sleep architecture can be affected by many things: Sleep Hygiene, meds, stress, health, etc. Simply waking in the wrong stage of sleep or setting the snooze for another 5 minutes can cause a feeling of grogginess that persists long after waking.

My recommendation would be that once apnea is controlled as evidenced by a low AHI < 2, stop worrying so much about that number and look to other reasons your sleep may not be restorative. You mentioned leaks, that's a possibility, you mentioned, indirectly, stress from school, and that's a definite possibility. Concentrate on all the precepts of Good Sleep Hygiene and see if you don't feel better.

ChicagoGranny wrote: - Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- Use CPAP software, such as the free SleepyHead, to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular medical checkups to confirm there are no other medical problems
CG

Is it possible that you have something else going on like restless legs?

I'll try imgur - after seeing that post photobucket is history.

Many years ago Photobucket used to be really good. No junk crap or stuff forcing you to close ads, etc.
Last few years though they have gotten really bad with pushing the ads and stuff.
Your link above...I couldn't even get the ad. It kept redirecting me to somewhere that wouldn't load for some reason.

Holden4th wrote:Last night I had a record 0.24 total AHI in over 8 hours of sleep. Those 8 hours were broken twice for me to get up

Twice is what you remember. There may be more. And arousals, which you can't remember. What's your RDI from the initial sleep study? If you AHI is great, but you don't feel great, chances are you may have UARS (besides myriad of other disorders). And if you have UARS and occasionally have a good sleep, but not consistently, it may mean that your therapy is not optimized. Don't know how it is for pure OSAers, UARSers shouldn't wait to get their good sleep to come gradually. The benefits of CPAP should be available almost immediately.

All my insomnia patients have, at a minimum, something resembling upper airway resistance syndrome (UARS). They’re fatigued, they have inspiratory airflow limitation during sleep,” Gold says. “The vast majority of insomnia patients have unrecognized sleep-disordered breathing, and it’s not being treated, and they could benefit from that treatment.

I can't get imgur to upload the SH file. Is there an alternative I can use?

I'll try Imageshack

http://imageshack.com/a/img922/4943/sIwQm8.png

Looks like it works.

Holden4th wrote:I can't get imgur to upload the SH file. Is there an alternative I can use?

I'll try Imageshack

http://imageshack.com/a/img922/4943/sIwQm8.png

Looks like it works.

If you are a light sleeper, your issues could be:
- leaks (as in sleep murderer);
- flow limitations;

tan wrote:

Holden4th wrote:Last night I had a record 0.24 total AHI in over 8 hours of sleep. Those 8 hours were broken twice for me to get up

Twice is what you remember. There may be more. And arousals, which you can't remember. What's your RDI from the initial sleep study? If you AHI is great, but you don't feel great, chances are you may have UARS (besides myriad of other disorders). And if you have UARS and occasionally have a good sleep, but not consistently, it may mean that your therapy is not optimized. Don't know how it is for pure OSAers, UARSers shouldn't wait to get their good sleep to come gradually. The benefits of CPAP should be available almost immediately.

All my insomnia patients have, at a minimum, something resembling upper airway resistance syndrome (UARS). They’re fatigued, they have inspiratory airflow limitation during sleep,” Gold says. “The vast majority of insomnia patients have unrecognized sleep-disordered breathing, and it’s not being treated, and they could benefit from that treatment.

Tan; Good article, thanks for sharing. My main symptom is chronic insomnia and I've had it for years. Finally got referred to a sleep clinic earlier this year.
I don't fit the profile for sleep apnea so it was never suspected by many doctors. My restless legs/numbness has gotten better, much less jerking awake at sleep onset but still working on trying to get longer sleep. I've been on cpap for 5 mos. and have done better since switching from fixed to variable pressure in July. My sleepyhead data shows some airflow limitation every day. My sleep study showed a large number of spontaneous arousals.

tan wrote:

Holden4th wrote:I can't get imgur to upload the SH file. Is there an alternative I can use?

I'll try Imageshack

http://imageshack.com/a/img922/4943/sIwQm8.png

Looks like it works.

If you are a light sleeper, your issues could be:
- leaks (as in sleep murderer);
- flow limitations;

I've never been a light sleeper. My leak rate looks as if it has increased so I wonder if I need a new nasal piece for my Dreamwear mask. I'm not sure how long they are meant to last.

Sylvia, Tan, and Holden,

I want to stress again (I am a crusader, I guess), the importance of Good Sleep Hygiene in treating sleep issues. As I have said before, until all the precepts of Good Sleep Hygiene are being followed once OSA has been largely treated, efforts to improve sleep are likely to be futile, especially by tweaking CPAP settings. The CPAP just can't fix poor sleep from causes not related to SDB and there are many.

The article Tan refers above about Dr Gold reminds me of how these issues are interrelated. If one looks at the precepts of Good Sleep Hygiene, it can be seen that they are really the same as self treatment for Good Mental Health. I think we know there is a link between good sleep and good mental health, kind of "chicken or egg" link, so it does make sense to treat both at the same time.

Holden has indicated he is under considerable stress. Reducing stress is one of the precepts of Good Sleep Hygiene and following the "rules" of sleep hygiene will help with that, although it is often difficult to accomplish.

I am a crusader because it worked for me. After my OSA was successfully treated, I still suffered from fatigue, fragmented sleep, many CA's, Severe PLMD, and the rest of it. I tried nearly all the medications commonly prescribed for these conditions and nothing worked; in fact, many made my sleep worse. It wasn't until I really got serious about Sleep Hygiene (all of it) that my condition started to improve along with an improvement in my feeling of general well being. In particular, I think most beneficial to me is a daily I hour moderate exercise program, outside, in the morning, first thing. I used to walk, now I ride my bike. I doubt there is a pill that works better to reduce stress and relieve minor depression than a brisk walk or ride in morning with the sun on your face.

OK, off the soapbox, just a FWIW.