Low AHI but still feel like I'm not sleeping well half the time

[fruitbowl]

First night on the nasal mask, great night on paper but feeling decidedly below average. At least the dry mouth and aerophagia went away. I saw something concerning in my sleep report, the flow limit graph looks really crazy to my eyes:

may17th.PNG (53.61 KiB) Viewed 2765 times

Is this flow limit pattern normal? Looking back on all my previous nights the flow limit graph looks similar. Is this consistent with UARS or is it nothing to worry about really? Here is an example of a RERA detected by the machine, looks like it coincides with flow limit:

flowlimit.PNG (39.44 KiB) Viewed 2765 times

[Jas_williams]

Please provide full information do not crop graphs we are missing important information

[fruitbowl]

My first instinct was to immediately quit on the nasal mask (Resmed Mirage Softgel Nasal Mask) but I gave it another shot last night, figured out there was a little knob that could be rotated to ease the pressure on the upper nose. Last night I had the best night's sleep in recent memory, 0.3 AHI, no dry mouth, no gas, hardly any leak and I'm feeling great today. The only issue I really had was some bad congestion throughout the night which woke me up a couple of times, working on resolving that now. Also got some angry red marks on my face from the mask but I ordered a mask liner to hopefully alleviate that issue. Things are looking up

[zonker]

My first instinct was to immediately quit on the nasal mask (Resmed Mirage Softgel Nasal Mask) but I gave it another shot last night, figured out there was a little knob that could be rotated to ease the pressure on the upper nose. Last night I had the best night's sleep in recent memory, 0.3 AHI, no dry mouth, no gas, hardly any leak and I'm feeling great today. The only issue I really had was some bad congestion throughout the night which woke me up a couple of times, working on resolving that now. Also got some angry red marks on my face from the mask but I ordered a mask liner to hopefully alleviate that issue. Things are looking up

winnerisyou.jpg

well done! good feeling, ain't it? let's hope it's the start of a trend.

btw, on that congestion? try flonase, it works a treat. once you've decided it works for you, it can be baought generically and in bulk at costco, if you are a member.

[fruitbowl]

Thank you for the recommendation, I will definitely give Flonase a try

[zonker]

Thank you for the recommendation, I will definitely give Flonase a try

hat-tip.gif

[JennySawyer]

I can relate as when I had the polysomnography I had AHI 14 which I assume was normal/average for how I used to sleep every night pre-CPAP, since I've been using the machine (2 months) my AHI has been about 3 - but I don't feel any better at all.

[fruitbowl]

I can relate as when I had the polysomnography I had AHI 14 which I assume was normal/average for how I used to sleep every night pre-CPAP, since I've been using the machine (2 months) my AHI has been about 3 - but I don't feel any better at all.

From my understanding, I think 3 is still considered sub-optimal, you're essentially taking 20 minute naps over the course of the night. You should probably revisit your doctor if you can, I don't have health insurance anymore which is why I'm pretty much having to troubleshoot my sleep problems myself.

[fruitbowl]

I have a problem I need to bring up because it's really bothering me. For the past couple weeks, about maybe 50% of the time I wake up with twitching muscles in the morning, most often in the legs. I attributed it to lack of sleep because it usually occurs after a bad night. However, last night as I was falling asleep I was jolted awake after what felt like an apnea and my muscles starting tingling and twitching furiously. I felt extremely confused and had trouble grasping reality, and it took me a while to get back to sleep.

My concern is that I had a focal seizure while falling asleep, and perhaps have been having seizures while sleeping for some time now. I'm wondering whether seizures are a symptom of sleep apnea and exhaustion or whether the sleep apnea can be caused by seizures. I have no history of seizures or epilepsy.

[zonker]

I have a problem I need to bring up because it's really bothering me.

you may be experiencing Restless Leg Syndrome. google it and see if the symptoms match. i don't have this myself, but forum member kteague knows about it. perhaps she'll drop by with more about it.

[Pugsy]

Might want to see if any of this fits. PLMD
https://en.wikipedia.org/wiki/Periodic_ ... t_disorder

[kteague]

Have any lab sleep studies made mention of PLMs or periodic limb movements? Now, I am going to throw some information out there that is strictly personal experience. It may not apply to you at all, and I am certainly not trying to diagnose you. PLMD is not something you want to have, nor do you want to treat for it if it isn't really your issue. Based on your descriptions, I will say I can see some things that remind me of my experience with PLMD, yet could be attributed to apneas, so nothing is conclusive. I will insert those remarks after each section of your text.

I have a problem I need to bring up because it's really bothering me. For the past couple weeks, about maybe 50% of the time I wake up with twitching muscles in the morning, most often in the legs.

Jumpy legs are/were frequently the cause of my wakeups, and in the time before fully waking I became aware of movement of my legs. For a long time I thought I was just changing positions a lot until I saw video and realized what I was aware of was actually the tail end of a periodic limb movement event.

I attributed it to lack of sleep because it usually occurs after a bad night.

Just maybe the bad night was due to limb movements but you slept (poorly) through much of it till they finally woke you enough to be aware.

However, last night as I was falling asleep I was jolted awake after what felt like an apnea and my muscles starting tingling and twitching furiously.

Here's how a limb movement event can feel like it could be an apnea event. The intial contraction of a periodic limb movement can feel like being startled with a sudden inhale and brief holding of breath till the contraction releases a few seconds later. Another way is if one has just inhaled when a movement hits, a sudden contraction can cause one to forcefully exhale, giving an illusion of a resolving apnea event. Since limb movements can kick in (pun intended) upon falling asleep, it would be no surprise if it was experienced when falling asleep.

I felt extremely confused and had trouble grasping reality, and it took me a while to get back to sleep...

I often found myself stuck in this place between awake and asleep. I had a foggy awareness of what was going on but could neither fall into a deeper sleep nor fully wake myself up. It's an unsettling state to be in.

Now, all that said, sometimes people have limb movements with apnea events as part of the struggle to resolve apneas. These movements are not periodic limb movements. They are termed respiratory related limb movements. I am not familiar with your machine or settings, but I would think your data would show if you are having apnea events. If you think periodic limb movements could be at issue, we can talk more about next steps. RLS could be at play, but some of the things you mentioned lean more toward PLMD, but anything is possible. I don't know enough about nocturnal seizures to be helpful.

[fruitbowl]

Hi kteague,

Thank you very much for the detailed response. I should have been more specific when I posted. I experience muscle twitches throughout the day while I am awake after getting a bad night's sleep. The past couple days I've been sleeping decently and haven't had any muscle spasms but when I was falling asleep last night I had the weird event I mentioned, my muscles started to twitch and continued to twitch until I fell asleep again and continued the next day.

I haven't had any sleep lab study done, I was diagnosed with an at-home oximetry test (which I am now regretting, I wish I had insisted on a sleep lab test).

[kteague]

Have you had things that pertain to muscle and nerve function tested? Things like Magnesium, Vitamin D, B Vitamins, Iron? When someone says "twitchy" my first thought is magnesium.