why first half of night no apnea, second half full of apneas

[williamco]

it is not 1 night deal, it is a trend that I can't find a reason for, for 7 hours of slepp, first half of night (3-4 hours) my chart is clear of apneas (may be one ) but second half of night AHI reaches to a level that causes entire night AHI to be 4-5

if I sleep 5 hours, my AHI is around 2 because first 3-3 1/2 hours no apnea whatsoever then I start to build up
the longer I sleep after 3-4 hours, the higher AHI starts to get

is there any explanation for that?

[elg5cats]

it is not 1 night deal, it is a trend that I can't find a reason for, for 7 hours of slepp, first half of night (3-4 hours) my chart is clear of apneas (may be one ) but second half of night AHI reaches to a level that causes entire night AHI to be 4-5 if I sleep 5 hours, my AHI is around 2 because first 3-3 1/2 hours no apnea whatsoever then I start to build up the longer I sleep after 3-4 hours, the higher AHI starts to getis there any explanation for that?

If you had a sleep study, did it note how long you slept before REM sleep. If your REM sleep is later in your sleep, that may be one reason why increased events......sleep position may be a factor as well.

elg5cats

[DJ_Boxer]

williamco: can you post a screenshot of the reports including dailies? Also how are you feeling after each night or successive night?

DJ

[williamco]

elg5cats: not really I didn't have a sleep study that I could sleep during. but my understanding about REM that is cyclical not stright up like that
DJ: This is report of last night . I don't really feel well if AHI goes above 2

[DoriC]

Do you think you're turning onto your back at that time? My husband's looked like that until he trained himself to stay on his sides. Also, I think RestedGal mentioned in one of her posts that REM sleep cycle towards morning could cause that. I'd never want to quote her but you might be able to find her explanation somewhere.

[cinco777]

DoriC wrote

Do you think you're turning onto your back at that time? My husband's looked like that until he trained himself to stay on his sides.

Ditto to Dori's explanation as a good possibility for why you are experiencing, at times, the higher # of sleep events.

Using myself as an example, I can, by changing sleeping positions, experience a very different time-line of sleep events. My best (lowest AHI) occurs when I sleep on my left side, the next best occurs when I sleep on my right side (2x - 3x higher AHI), and, for the few times that I have slept on my back (once in August for an experiment), my AHI goes through the roof (24 Apneas in a one hour period even though I had raised the pressure from 8 to 10). I'm a quick learner so I never (except for experiments) sleep on my back (took me one month to train myself not to).

However, I'm not as disciplined as I would like to be. For a 3-week period in August/September, I managed to sleep on my left side all night (required more tylenols as I develop a sore neck from not changing positions). My avg AHI was 0.2 for the three weeks. However, I found sleeping all night in one position too stressful (mentally and physically) so I have returned to sleeping some on my left and some on my right side. My resulting avg AHI is 0.4 and I am OK with that, as I feel very rested and energetic in the morning and, if I have slept 7hrs plus, do not get sleepy in the afternoon.

Just to be clear, the mental stress was one of boredom - I just felt really bored sleeping on my left side all night. I didn't feel bored going to bed but I did feel bored going back to bed and sleeping on the same side after a bathroom break. I couldn't figure out how to conquer my boredom so now I do both left and right side sleeping. I also no longer have a goal of reaching a weekly avg AHI of 0. I've had a 0 AHI many nights but they occur randomly and independently of anything that I knowingly do. So I am content with my 0.4 AHI average and am now focused on reaching an average of 1 uptime a night (where I get up to go to the bathroom). I averaged 1.14X/night for last week (six nights with 1 up time and one night with 2 uptimes) and hope to hit my magic # of once/night by my one-year anniversary.

[Hawthorne]

Looks, to me, as if you may have moved more (or moved once and disrupted your mask) and so your mask leaked more in the second part of the night.

Note the leak line. It is almost straight for the first part of the night and then lots of hills and spikes for the rest of the night!

[cinco777]

Hawthorne wrote

Looks, to me, as if you may have moved more (or moved once and disrupted your mask) and so your mask leaked more in the second part of the night.

Note the leak line. It is almost straight for the first part of the night and then lots of hills and spikes for the rest of the night!

Hawthorne's explanation is also a possibility, especially if the move was to "back" sleeping. Of course, the higher leak values/spikes could be a result of the higher # of sleep events. Which is cause? and which is effect? requires more information than what is provided on the graph (since the recording/reporting granularity of sleep events, leak, and pressure is on a 30-second interval). Figuring out which is the likely cause and which then is the likely effect would be easier/possible if the recording/reporting granularity were on 1-second, 2-second, or even 5-second intervals. A recording interval that has less duration than the sleep event duration (Apnea & Hypopnea) is required to confidently and accurately analyze potential cause and effect relationships.

[williamco]

so do you mean that there is OSA that CPAP alone can't treat?
that you need to sleep on this side or that side otherwise your AHI would be that high

as far the leak in the second half of the night, that is an exception because other nights leak was stable but yet I still had the same pattern of split personality disorder on the chart (if I may use this term)

as far as in middle of the night I change my position to be on my back, why does it happen every night at same period, which is after 3-4 hours. it seems like a programmed sleeping which I don't think I would be that consistant. this is too much to be coincidence

here is another night of sleep (I choose nights that I exceed 5 hours of sleep in them)
the leak is still stable on the second half (after 3 hours) yet the same pattern, so here leak issue should be excluded
back position: it would be co incedince that every night after 3 hours I turn on my back and stay on the back till end of the night. this is just too much of a choreography that I can't believe. what do you think???

the funny part is : raising the pressure didn't change AHI, as you notice from the first report: at pressure 11 --> AHI was 4 - pressure 12-->AHI was 6 pressure 13 -->AHI was 5

[roster]

Yeah, try to figure out what positions you are sleeping in. I trained myself to sleep on tummy (or sides) and 7.5 cm keeps my AHI at or below 1.0.

On my back, I need an unbearable pressure of 19 cm. It's the tongue being pulled back into the airway by gravity.

[cinco777]

You can find out if your sleep event #s are influenced by your sleeping positions throughout the night in a number of ways:
1) Easiest (for you) is to have someone observe you all night and take detailed time-stamped notes. That can be a spouse, significant other, child who wants to earn extra money (you would likely have to pay them) or someone else of your choosing. A night-lite would be needed to ensure that your sleeping profile is visible, plus they would need a flashlight to write their notes. You could think of this approach as "sleep sitting".
2) Rig a digital camera with movie capability (what I have used) or a camcorder so that it can record your sleeping. Place a clock in the view (make sure it is visible on the digital image) of the recorder so that you have another way of knowing the time-of-day besides the elapsed time of the recorder. Again, a night light or something similar will be needed to show your profile. You will want to test this approach first before doing it for a full night. I have read the postings of one member who has a night-vision camera that he/she uses to record his/her sleeping.
3) Train yourself with pillows, tennis balls or something bigger positioned in such a way that you will be awakened if you find yourself in a back sleeping position. I used a tennis ball and then 3 pillows over the course of one month to train myself. I have read that some folks have worn backpacks full of books or whatever. Luckily, I didn't have to go that far.

Yes, treating OSA is not simply using an XPAP at a pressure (or range of pressures, or one pressure for inhale and another for exhale, etc.). Treating OSA and even more complex Sleep Disordered Breathing (SDB) conditions is more complicated, thus the reason for this forum and its many active members. I believe that all the information that you need to be successful with your CPAP-enabled therapy can be found on this forum - you just need to remain motivated to find, read, ask questions, and, as many will proclaim, take charge of your own therapy. You, as an informed XPAP user, will also have more beneficial (to you) interactions with any DMEs, Drs, Sleep Drs, ... that cross your path on your journey to a restful night's sleep.

[williamco]

rooster: if the tongue is the cause of all that have you tried something for the tongue that of any help? tongue device that keeps it from sliding backword? have you haerd about any that works and not scam

[SuperGeeky]

williamco, I always guess at when I fell asleep on the Encore Report and count out ninety or so minutes to develop a REM type pattern. I also try to correlate large blocks of leaks with apnea flags bunched together. Maybe this is intuitive for everyone anyway?

I'm not seeing a pattern to draw conclusion whether it's REM sleep or leaks. Personally, controlling your sleep position would be maddening. Who could relax with that??

If your set to Auto, and you have that many flags, I would look at your options on adjusting your auto Range and discuss with your Sleep Doc. I wouldn't put up with your Encore Report Results. It's unacceptable and I know personally I wouldn't be feeling too hot...

Tale care.

SG

[Yoda]

I have exactly the same thing experience. Your download could be mine. I asked my sleep doc about it at our last appointment and she said that having more events in the second half was a normal occurrence. Her explanation was that there is more REM sleep in the second part of the night and events are more likely to happen in REM.

Yoda

[SuperGeeky]

I would assume williamco, with Apnea skewed at second half of night, your not consuming Alcohol, Caffeine, eating food or taking something like a cold or allergy medicine before bed??

You know, maybe effecting your sleep latency. Falling asleep with TV on, listening to headphones??


Take care,


SG