AHI at ~6-7 after 2 months treatment. Any feedback?

[byowenader]

Hey everyone! Firstly, as a long-time lurker I want to say a massive thank you to everyone that contributes to this forum. Many of the threads here have been enormously helpful in my journey of identifying/diagnosing and now treating my sleep apnea.

I had a Philips Respironics at home sleep study which identified mild sleep apnea and so purchased a CPAP machine, which I am using with the simplus full face mask.

I am not sure that I am feeling any noticeable benefits since starting therapy (except just feeling more comfortable when breathing when falling asleep at night – as if my nose isn't blocked). I wondered if anyone could take a look at my data here and spot anything that looks off (I have done my best to follow the instructions in displaying these graphs but let me know if you need other information):

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[zonker]

Hey everyone!

welcome to the zoo!

here's how the experts would like to see the charts-

How to order the charts
When you start Oscar and select Daily view, you will see a page with information on the left, and charts on the right.

Each chart has a name displayed on it vertically on the left side of the chart.

Drag the Oscar window to use as much of your screen as you can, so that you can get as much info as possible.

You can move a chart up or down in the order by pointing your mouse pointer in the label part of the chart, left clicking and holding while moving the mouse up or down.

Suggested Support Order for your charts
Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limit (Only for Resmed machines, not on Respironics)
Below these charts, you can organize the remainder any way you want. We normally don't need, or want, to see those, because they end up scrunching up the charts we do want to see.

as you have it now, it's too cluttered and thus too tiny to see.

give it another try, won't you?

good luck!

[Papinaway]

I would suggest you list your equipment on your profile, please. Also, your Oscar charts are a bit fuzzy.

[Pugsy]

I would suggest you list your equipment on your profile, please.

The equipment profile link to equipment used is broken.
At this point we don't know if someone has listed their equipment and it's just not showing or they haven't filled out the profile yet.
Until the equipment link problem is fixed ....waste of time telling people to list their equipment in their profile.

I have my equipment listed...been listed for years but it doesn't show up. No one's equipment profile is showing up.

Multiple forum software issues going on right now. This is just one of them.

[Papinaway]

Sad, ok will do.

[byowenader]

Thanks for the replies. Hopefully these images are clearer?

Equipment:
Philips Respironics DreamStation Auto CPAP Machine with Humidifier
Simplus Full Face CPAP Mask

I am often waking up in the night feeling extremely claustrophobic and am attempting to pull the mask off my face. I tried a nasal pillow mask instead but I found this made my nose extremely sore and felt like I was suffocating at times (I think I must have some nasal obstruction - I am trying to get an appointment to look into that).

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[byowenader]

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[Pugsy]

What position are you primarily using when you are trying to sleep?
On your back or side or what?
Why do you use ramp sometimes and not other times?

[byowenader]

I fall asleep on my side and sometimes move onto my front if I wake up in the night. I have woken up feeling very uncomfortable when on my back (I never fall asleep in that position so must move into it in my sleep).

The ramp I had been experimenting with to see if I could fall asleep without it (which it seems I can).

[Pugsy]

How long does it typically take you to fall asleep?
I see that when you do use the ramp that you are using the "smart ramp" thing but it's still taking a long time for the ramp to end...either the smart ramp isn't thinking you are asleep when you are or it's taking a long time to fall asleep. Some reports show the full 45 minutes before ramp ends and a bunch of flagged events during ramp and the machine didn't suspend ramp and increase the pressure....which makes me wonder how much of the flagged stuff is asleep flagged stuff or awake flagged stuff which doesn't count.

Awake flagged stuff doesn't count in the AHI evaluation.
It does count in terms of it telling us you aren't sleeping so great...if that is what we are seeing.

So how is your overall sleep quality? Wake often during the night? Take a long time to fall asleep?

[byowenader]

Thanks Pugsy.

I normally fall asleep in about 20-30 minutes. I am pretty certain I am falling asleep before the 45 minute ramp period is over. Sometimes it can be within just 5 minutes if I am particularly tired.

My sleep quality is very bad (at least it feels bad!) and I wake up knackered in the morning even if I've used the machine. I normally have to have a nap in the afternoon for 20-30 minutes.

I then tend to catch up on sleep a lot at the weekend by sleeping in and napping. I wake up in the night every night, usually 4-5 times but sometimes more.

My wearables (Apple Watch and Oura ring) are both saying I am waking up a lot and having very poor quality sleep.

[byowenader]

Another thing to add that might be relevant:

The last two nights I have been dreaming about being unable to speak and then have woken up with an extremely dry mouth and a feeling as though my tongue is about ten times bigger than usual! Both times I have woken up lying on my back. I assume that indicates that (a) I am not breathing through my nose! and (b) I should possibly increase the humidity.

I do have SomniFix strips that I could try for taping my mouth shut.

[Pugsy]

Do you take any medications? Even OTC? If so, what?

Where are you located?

[byowenader]

I'm in London, UK.

I take 3.75mg zopiclone nightly at the moment (prescribed by psychiatrist).

[Pugsy]

I thought you might be in the UK....the "knickered" comment was sort of a giveaway.

How long have you been taking the zopiclone?
How old are you?

https://www.medicinenet.com/zopiclone-o ... rticle.htm
https://www.primroselodge.com/prescript ... zopiclone/
https://en.wikipedia.org/wiki/Zopiclone read the EEG and Sleep section at this website

It can suppress REM....and it can cause daytime drowsiness and lethargy.
I don't know how much this medication is maybe impacting your unwanted daytime symptoms....but it is a potential factor if for no other reason you don't get enough REM stage sleep for optimal restorative sleep.

I don't know if more pressure will help or not. If those flagged events are real asleep flags.....might help but if those flagged events are more related to arousal or awake breathing false positives then more pressure is unlikely to help.
I assume you have a history of poor sleep quality since you are prescribed the sleeping pill at night.
If the poor sleep quality isn't caused by apnea or airway issues then cpap isn't going to help the poor sleep quality.
Sometimes your machine wants to go higher...sometimes it doesn't.

In the UK patients screwing around with pressures is frowned upon.....how do you feel about changing things yourself?
I think a higher minimum might be a good experiment to try but with the realization it is just an experiment. If your poor sleep quality isn't from the airway then most likely it won't help but it is all that I know to offer at this time.
There are many potential culprits for poor sleep quality than just apnea/airway issues. Your reports above scream poor sleep quality but they don't tell us what might be causing it.....airway issues or just bad luck to have something else causing the poor sleep????