Need help with OSCAR graphs part 2

[imrdyman]

Hey guys so i finally got my resmed machine and slept with it last night. I switched from my usual nasal mask (n20) to the airfit p10 mask. I would sleep with the machine for an hour or two and would wake up, my sleep was very scattered. I didnt wake up with a headache but still feel tired, but i would attribute that mostly to not sleeping enough. Is there any settings that i can change to stop waking up so much or is it something ill just get used to eventually? I have 2 screenshots here from the same night, theyre just seperate because i would turn off and restart the machine. Thank you!

https://www.flickr.com/photos/197657176@N03

[ChicagoGranny]

Your statistics look good.

Waking a few times per night is normal. If a person has trouble falling back to sleep, that's a problem.

Study "good sleep hygiene" and strictly practice it.

Do you know why you awakened too much? Do you take any drugs that interfere with sleep? Caffeine usage? Stress over learning to sleep with CPAP?

[imrdyman]

Nope i dont take any medication. Ive always been a light sleeper and Im finding its harder to exhale with the nasal pillow mask than it was with the nasal mask, and it can be a bit distracting. The reason i switched is because i feel i can get a better seal with the nasal pillows because my nasal mask would leak from time to time, its also alot more minimal and comfortable. I do drink caffeine about once a day but thats sometime in the early afternoon. Thanks for ur response

[ChicagoGranny]

Ive always been a light sleeper

In my personal dictionary, "light sleeper" is code word for untreated sleep apnea causing frequent awakenings. Once you adjust to CPAP and practice good sleep hygiene, you might become a healthy sleeper.

Watch that caffeine. It can stay in your body for a long time. Maybe have one cup early morning and no more. Don't forget hidden sources of caffeine, like chocolate. One of the soft drink companies even adds a large amount of caffeine to their orange soda, as if oranges contained caffeine.

[robysue1]

Hey guys so i finally got my resmed machine and slept with it last night. I switched from my usual nasal mask (n20) to the airfit p10 mask. I would sleep with the machine for an hour or two and would wake up, my sleep was very scattered. I didnt wake up with a headache but still feel tired, but i would attribute that mostly to not sleeping enough. Is there any settings that i can change to stop waking up so much or is it something ill just get used to eventually? I have 2 screenshots here from the same night, theyre just seperate because i would turn off and restart the machine. Thank you!

The screen shots are not "separate" because you turned the machine off and on; they're separate because you sleep past noon. Resmed machines use noon as the beginning of each day's "usage" with the idea that most people don't sleep past noon on a regular basis.

Put together, you screenshots show one "night" where you appear to have gone to bed around 5:00 AM on 2/16 and you woke up (for good) around 2:10 PM on 2/16. You screen shots also show that you may have made a brief effort to use the machine around 1:30 AM on 2/16, but you gave up pretty quickly.

As ChicagoGranny says, your data indicates that your current settings are doing a good job in treating your sleep apnea problem. But there is evidence some significant restlessness (i.e. so-called "sleep-wake-junk" breathing, or SWJ for short) at several places in your data. SWJ breathing occurs when we're sort of asleep, sort of awake, and drifting back and forth between the two without ever establishing getting into a sound, continuous sleep. It has characteristics that resemble a mix of wake breathing and sleep breathing; SWJ tends to look "spiky" when we're looking at the flow rate for a whole night. The period between 12:15 and 12:55 on the 2/16 screenshot is a good example of something that may be SWJ, as does the period between 8:30 and 9:15 on the 2/15 screenshot.

As for your question about settings that you can change to "stop waking up so much", I'm afraid the answer is, no, there aren't any magic settings on a CPAP that prevent you from waking up when the wakes are not triggered by obstructive sleep apnea problems. With time and effort you will get used to sleeping with the machine and that in turn may eventually reduce the number of wakes.

But the real question that I think you need to address in order to try to further improve your sleep is dealing with your sleep hygiene.

In particular, can you answer the following questions:

Do you have a regular bedtime? If so, what time do you usually try to go to bed?

How long does it typically take you to fall asleep when you do go to bed?

How often do you remember waking up in the night? And when you wake up in the night, what's the first thing you do?

Do you have a regular wake up time? If so, what time do you usually try to get up?

Do you do shift work? In other words, do you intentionally sleep well past noon because you are working late night shifts?

How much sleep do you think you need in order to be well rested?


You also write:

Nope i dont take any medication. Ive always been a light sleeper

As ChicagoGranny points out, very light sleep is often a symptom of untreated OSA. And it can take some of us a while to start sleeping more soundly and more deeply after starting therapy simply because our bodies and brains have become so accustomed to being hypervigilant during sleep in order to restart our breathing dozens of times throughout the night.

But light sleepers also can have real problems that are not directly related to untreated OSA. One big contributor to light sleeping is bad sleep hygiene. By that, I mean there are numerous behavior patterns that we can fall into that encourage light sleeping instead of deep sleeping.

It would help us help you if you gave us a bit of your medical history: Have you had a sleep study done? Was it an in-lab study or an at-home study? What were the results of the study?

and Im finding its harder to exhale with the nasal pillow mask than it was with the nasal mask, and it can be a bit distracting.

Are you using EPR? If so, what is EPR set to? EPR changes the pressure when you start to exhale. That makes it easier to exhale, but at the same time, some people find the change in pressure on every inhalation and every exhalation a bit distracting at the start.

The reason i switched is because i feel i can get a better seal with the nasal pillows because my nasal mask would leak from time to time, its also alot more minimal and comfortable.

Mask comfort is critical. But you do have a constant, low level leak in your data. The leak is not large enough to be affecting the efficacy of your CPAP therapy. But since you report lots of wakes, this low level, constant leak may be affecting the quality of your sleep more than you realize.

Please note: I'm not saying you need to switch mask types. I am saying that you may not yet have your nasal pillows mask and its headgear properly fitted yet. More questions to answer: How much of the nasal pillows are inside your nostrils? When you wake up in the night, do you feel any leaking around the edges of the pillows? Any chance your lips are slightly opening up creating a small leak there?

I do drink caffeine about once a day but thats sometime in the early afternoon. Thanks for ur response

What kind of caffeine? And how much? And when is "early afternoon" in relationship to "bedtime"?

Also, what does your alcohol consumption look like?

And when is your last meal for the day relative to bedtime?

And do you get much exercise on a daily basis? If so, when do you exercise?

And finally: Do you get outside during the daytime? If so, when do you go outside and how long do you stay outside? And do you live in a relatively sunny or cloudy area?

[imrdyman]

Ah ok, i thought the "seperate" screenshots were for the reason i stated, although i dont sleep past noon hehe, i just try to use the machine over a long period of time. On 3 days of the week i fall asleep around 2-3 am and have to wake back up at 6:40am to take my nephew to school and then i come back home and try to fall asleep again from about 7:30am to 11:30am the latest. Other 4 days i sleep around 1-2am and wake up at 8:30am for work. Usually take me anywhere from 10 mins to an hour to fall asleep depending on how tired i am. I remember waking up each night maybe about 3-4 times, usually to go pee and im able to fall back asleep. i work 4 days out of the week and get 3 days off. So on my 4 days that i work i always get up at 8:30AM. On my 3 days that i have off i usually stay up a bit later until 2-3am with the brief pause in sleep to take my nephew to school at 7:00 then sleep from 7:30am to about 11AM. No shift work i just work somewhat late, thats why my bedtime is a bit later than usual. The hours i need to feel rested is still something im trying to figure out, i know the average most people should be getting is 7-8hrs but sometimes i feel worse or the same with that amount.

Yes ive had a sleep study done, ive done in-lab and at-home. They were both the same giving a reading of 14AHI. Mostly OSA but a small amount of central apneas as well. No titration or help with settings, they just gave me the usual 4cm default and ive been switching the pressure myself to get a more comfortable inhale, settled on 6.4.

Leaks with the pillows i rarely notice, it happens once in a while slightly, but i feel like i have a pretty good fit with them. I also sleep with my mouth taped closed so mouth leaking isnt an issue. Leaking was much much worse with n20 mask that i was using.


For Caffeine i drink caffeinated tea that has 150mg once a day, at around 1pm, bedtime being around 1-2am. No alcohol. Last meal for bedtime is around 8pm(i get out of work really late). Yes i go to the gym daily and im also a package delivery driver so i do alot of walking. Always sunny here .

Thanks for the response, i tried my best to answer all the questions. Sorry for the weird format i wasnt sure how to responsd to each quote individually without quoting the whole thing.


To sum it up though, i definitely need to work on my sleep hygiene on my days off. Work days are a bit more even and ironed out.

[zonker]

imrdyman?

could you not quote the entire post when replying?

thank you!

[imrdyman]

Yea sorry about that

[zonker]

Yea sorry about that

no problem.

and thanks!

[Pugsy]

You can edit your post and remove the huge block of quoted material.

[imrdyman]

Done!