Frequent AHI events early & late

Now that I'm about to get leaks under control, I'm starting to drill into the events detail data (using ResScan 3.5 software). I'm keeping my AI under 0.4 for the most part and often it's zero. AHI is usually between 3.0 and 6.0 but is sometimes higher. Here's the question: I've noticed most events occur at the beginning of my session (before I've made it to sleep I think) or at the end of the session after I wake but before I kill the pump and roll out of the sack. Hypopneas tend to be clustered in those same time slots: early & late in the session. Looks like if I went to bed about 1/2 hour later and got up about 1/2 hour earlier, my index numbers would be a lot better But I guess the good news here is I typically have a good 6 to 7 consecutive hours of apnea-free "rest" (I wouldn't call it sleep as I still tend to wake up several times during the night, but that's getting better too). Anyone else notice this pattern with their data?

Others have said it and so will I - I'm very glad I stumbled across this discussion forum. I would still be lost in the deep woods otherwise.

Thanks,
Steve

StevenJ wrote:Now that I'm about to get leaks under control, I'm starting to drill into the events detail data (using ResScan 3.5 software). I'm keeping my AI under 0.4 for the most part and often it's zero. AHI is usually between 3.0 and 6.0 but is sometimes higher. Here's the question: I've noticed most events occur at the beginning of my session (before I've made it to sleep I think)

Are you using "Ramping"?

If not then engage it and set for the time you think it takes you to settle down, start to get relaxed and perhaps even sleeping. When the machine is in "Ramping" mode no events are recorded. Basically events that are recorded when you are awake are meaningless.

or at the end of the session after I wake but before I kill the pump and roll out of the sack.

Same thing there... those events are basically meaningless since you are awake. If you are not going to be going back to sleep in the morning turn the machine off.

StevenJ wrote:Now that I'm about to get leaks under control, I'm starting to drill into the events detail data (using ResScan 3.5 software). I'm keeping my AI under 0.4 for the most part and often it's zero. AHI is usually between 3.0 and 6.0 but is sometimes higher. Here's the question: I've noticed most events occur at the beginning of my session (before I've made it to sleep I think) or at the end of the session after I wake but before I kill the pump and roll out of the sack. Hypopneas tend to be clustered in those same time slots: early & late in the session. Looks like if I went to bed about 1/2 hour later and got up about 1/2 hour earlier, my index numbers would be a lot better But I guess the good news here is I typically have a good 6 to 7 consecutive hours of apnea-free "rest" (I wouldn't call it sleep as I still tend to wake up several times during the night, but that's getting better too). Anyone else notice this pattern with their data?

Others have said it and so will I - I'm very glad I stumbled across this discussion forum. I would still be lost in the deep woods otherwise.

Thanks,
Steve

I have the exact same problem. My h.i. goes up quite a bit especially as I'm lying awake in the morning before I get up. I feel this is normal and just part of the resmed algorithm. I have come to a point of disregarding these particular events as I know I am quite awake when they occur.

Most algorithms don't do well at all in scoring someone when they are awake. I discount any events that happen during waking periods. After all, when you're awake, you know when you stop breathing.

The algorithms do well when you are asleep and breathing regularly, and that regular sleeping breathing is disturbed. When it comes to sorting out all the sighs and scratching and wiggling that is associated with getting to sleep or waking up, there is no algorithm that will be able to figure that out.

I also discount any apnea events that happen at the same second as a distinct change in leak rate. From watching the video tapes I can see that I get a "pop" up in the leak rate when I change position and there is often an apnea event scored at that same second. When I turn over I take a breath and hold it, I think it is picking this up.

Remember that these machines only know things about how much air pressure is in the hose. They don't have any other kind of sensors.

Overall it sounds like you are doing great.

Events seen at the onset of sleep are just that onset events or artifacts, usually just a bunch a junk for the first 20 to 30 minutes. Actually they are only onset events if they appear in the first 90 seconds or so.

But on your machine there is a feature called "Settling" go into setup and enable it for 30 minutes. What it will do is maintain the Minimum set pressure for that period getting past those artifacts. The result might be a lower AHI.

The events seen in the early morning hours before you awaken are most likely from REM sleep as that is where we do most of our dreaming. You
may have 3-5 periods of REM per night but the morning cycles will be longer.