What happened?

[mwarn]

I've posted on this board before about having sleep onset insomnia and gotten good advice. I was recently diagnosed with borderline severe OSA on 4/4/17 and got my machine on 4/12/17. The first 2 1/2 weeks I thought my insomnia was cured. I was going to bed and falling asleep quickly - within 20 minutes if not quicker. It would usually take me a minimum of 3 hours to fall asleep before.

My APAP pressure was set at 13-20 before my visit on 5/2/17 with my sleep doctor. My doctor looked at my download and noticed that my pressure was hovering in the 13's and said that because of my range, the machine was not allowing me to go below 13, so he ordered a pressure change to 10-15. He said this would still allow me go to 13 if I needed that pressure. I thought ok.

The last 3 nights since my visit with him, my insomnia has returned. It's taking me hours to fall asleep again. The first night the pressure the machine was hitting was 11.6 with an AHI of 1.5 and last night the pressure was 11 with and AHI of 1.2. So, my needed pressure has gone down, but my AHI has gone up. When my pressure was 13-20, the highest AHI I had was 0.9. I know the previous AHI are not high, but they're higher than what I've been getting.

Do you think a pressure change could affect insomnia? Should I up the pressure back to where it was? Is this fluctuation normal when just starting out? Any advice is welcome. Thanks.

[LSAT]

AHI will vary from night to night. No one sleeps the same night after night. My personal AHI can vary from 1.0-2.5 night after night.
Your minimal changes of .9 to 1.2 mean nothing.

[TASmart]

I would certainly try going back to the settings that work best for you. Having spent years not able to fall asleep for hours, and now after starting CPAP I fall asleep in 20 minutes or so, I would be most unpleasant to anyone who messes with my ability to fall asleep.

As a slight aside, why did the good doctor think that a lower pressure was better?

[kteague]

Ideally one can hone in on the lowest effective pressure, so I don't fault the doctor for experimenting a bit. With higher pressures there is more chance of leaks issues and air in the belly. While those AHI numbers aren't alarming, over the course of a night that's potential for several sleep disruptions. Also, duration matters. Short events can disrupt sleep, long events can do even more. I'm all for prevention when the air pressure is not at issue. And I agree with what was already said about your quality of sleep says more than the numbers.

[mwarn]

As a slight aside, why did the good doctor think that a lower pressure was better?

He said that because my pressure was 13-20 and it was nightly running in the mid-13's he wondered if I could use a lower pressure, but with my range I wasn't allowed to go lower. Now, as I stated, it's running in the 11's.

I think I'll put the machine back to 13-20 and see what happens. I'm not sure if a pressure change would cause the insomnia, but it's worth a try.

Thanks for the advice everyone.

[robysue]

mwarn,

My take on your story is that the doctor broke the cardinal rule that states, "If it ain't broke, don't fix it."

You were doing fine 13-20 in terms of both the AHI and the insomnia since you state:

I was recently diagnosed with borderline severe OSA on 4/4/17 and got my machine on 4/12/17. The first 2 1/2 weeks I thought my insomnia was cured. I was going to bed and falling asleep quickly - within 20 minutes if not quicker. It would usually take me a minimum of 3 hours to fall asleep before.

There was no compelling reason to change your pressure since you weren't complaining of aerophagia and you were not experiencing a boatload of CAs. And you were NOT complaining that the pressure was so high that you were having trouble getting or staying asleep ....

My advice? Quietly change the pressure back to 13-20 and see if your sleep gets back to what it was before the dang doctor "fixed" things that were not broken.

[LSAT]

AHI will vary from night to night. No one sleeps the same night after night. My personal AHI can vary from 1.0-2.5 night after night.
Your minimal changes of .9 to 1.2 mean nothing.

the problem was insomnia not apnea
could the pressure change affect that ?

He/She is concerned about the increase in AHI
"So, my needed pressure has gone down, but my AHI has gone up. When my pressure was 13-20, the highest AHI I had was 0.9. I know the previous AHI are not high, but they're higher than what I've been getting."

[Christine L]

totally taken out of context

his problem was insomnia
his AHI rate is noise and irrelevant at such a low level
he needs to get to sleep and get rid of the insomnia

My husband would like to know what your education level is.

[LSAT]

30 days ago he started with CPAp and was having all sorts of problems...today he has all the answers.

[palerider]

30 days ago he started with CPAp and was having all sorts of problems...today he has none of the answers.

ftfy.

[ChicagoGranny]

30 days ago he started with CPAp and was having all sorts of problems...today he has all the answers.

[chunkyfrog]

Not capitalized means mail order or internet.
Congratulations!