First night of CPAP

[AHI15]

Hi:

So last night I went to bed for the 1st time with my new CPAP machine at about 12:20am. I logged 6.3hrs and AHI=3, and a for mask fitting. The pressure seemed to only go up to 6.6 or so. I think I got 5-5.5hrs of actual sleep. The overall experience was less annoying than I expected. I accomplished the simple goal of falling asleep, and sleeping for at least about 4 hrs pressurized. I didn't expect a good night sleep, enough sleep, or easy falling asleep for various other reasons in addition to the first CPAP attempt.

So overall--better than expected.

I feel like I spent much of the night in light sleep. A few times I think I woke up with the need to emit a small burp. Aerophagia? I managed to fall asleep again after feeling hungry at 4am, and after p-ing at around 5:45. I think I also p-ed around 2:30. Finally rising at 6:45.

I felt fairly alert in the morning. However, that did not hold and I descended into severe exhaustion after lunch. I expected this, given the short sleep. I usually want to sleep for 7-8 hrs, and stay in bed 8.5-9hrs.

Tonight I will try it again, with a more normal bed time. I hope I sleep better.

What I hope to see is a trend toward waking less. I think if the apneas are reduced, then IF they are the primary arousal cause, then arousals should diminish, I should get more deep sleep, and begin crawling out of my fatigue hole.

What worries me is the prospect that I may still sleep like hell, not because of the CPAP bugging me, but for some other reason. The reason this concerns me is the fact that I began having non-restorative sleep 19 yrs ago, and the first study revealed a total 0 of apneas. So there is just a lot of questions. I hope that I get at least substantially better from CPAP.

I will be returning to Stanford for CBT-I in about 5 more weeks, and a CPAP follow up in about 6 weeks.

[Carl LaFong]

Sounds like my first couple nights. There's a lot to get used to. But with an AHI of 3 you've already hit the mark. Stay with it!

Suggestion: List your equipment in your signature. We wanna know!

[AHI15]

Hi:

Let's see if my equipment shows up, now that I have some...

[jweeks]

I felt fairly alert in the morning. However, that did not hold and I descended into severe exhaustion after lunch. I expected this, given the short sleep. I usually want to sleep for 7-8 hrs, and stay in bed 8.5-9hrs.

Hi,

Yes, the short amount of actual sleep probably didn't help much. But there might be a second effect going on here. You say that you hadn't slept well in 19 years. It might be that your brain and body has developed so many coping mechanisms that it is kind of confused about you suddenly sleeping better. In fact, it might take a while for you to unlearn how you were making it through the night, then re-learning how to sleep again. Add in that you have a pretty big sleep debt to pay back.

The best thing right now might be to sleep as much as you can. Doing some serious exercise or other activity to get yourself good and tired each day would also help. If you have the ability to take a week off of work to focus on sleep, so much the better.

The good news is that you can and do get adapted to CPAP and will sleep better. For example, pre-CPAP, I would get up for the bathroom every 90 minutes. Since starting CPAP, that no longer happens. In fact, your bathroom trips last night tell me that you didn't sleep well. Those trips will probably go away after a few weeks. My struggle was waking up after about 3 hours and not being able to get back to sleep. There might be other issues that pop up, so please keep us updated, and post questions as they happen.

-john-

[Xney]

Even if you do have something else, the sleep apnea has to be treated first and solved before the other ones can be worked on.

[Tino2You]

as many people on the forum like to say, one day does not make a trend. Hang in there. Start looing at the data your machine is keeping on the SD Card. Take a look at any of Pugsy's comments. In the signature field is a link to the SleepyHead software. It reads and graphs the data from your machine. You only need a PC that has a SD Card reader (many come with it now).

Pay attention to your leaks first. Get them under control. The little happy face your S9 displays only frowns for major leaks. Look at your AHIs. Are there clusters of them or spread out. As Carl pointed out, an AHI of 3 is very acceptable.

Keep the faith It's as easy as sleeping!

-tino

[AHI15]

I felt fairly alert in the morning. However, that did not hold and I descended into severe exhaustion after lunch. I expected this, given the short sleep. I usually want to sleep for 7-8 hrs, and stay in bed 8.5-9hrs.

Hi,

Yes, the short amount of actual sleep probably didn't help much. But there might be a second effect going on here. You say that you hadn't slept well in 19 years. It might be that your brain and body has developed so many coping mechanisms that it is kind of confused about you suddenly sleeping better. In fact, it might take a while for you to unlearn how you were making it through the night, then re-learning how to sleep again. Add in that you have a pretty big sleep debt to pay back.

Yes, I am wondering about the possibility that prolonged sleep deprivation may even harm sleep architecture at the causative level, ie., the physiology of the hormonal regulatory mechanisms as well as other potentially unknown neurological subtle forms of damage. And if such degradation mechanisms exist, how reversible are they?

I'm sure these questions fall into the category of the deeply unknown about the effects of sleep disorders.

The best thing right now might be to sleep as much as you can. Doing some serious exercise or other activity to get yourself good and tired each day would also help. If you have the ability to take a week off of work to focus on sleep, so much the better.
The good news is that you can and do get adapted to CPAP and will sleep better. For example, pre-CPAP, I would get up for the bathroom every 90 minutes. Since starting CPAP, that no longer happens. In fact, your bathroom trips last night tell me that you didn't sleep well. Those trips will probably go away after a few weeks. My struggle was waking up after about 3 hours and not being able to get back to sleep. There might be other issues that pop up, so please keep us updated, and post questions as they happen.
-john-

I have to be careful about over sleeping, since that may trigger insomnia. I hope to keep a 9hrs in bed schedule for a few weeks, since I know that doesn't lead to problems, and see if sleep quality within that window improves.

I've been on zero to once per week of light-moderate exercise in recent weeks. My exercise frequency collapsed in just the past few months. I'm hoping I can get it started again soon. In just a year past I exercised very regularly.

I could theoretically take a week off of work. It's hard since the people at work need me. I'm currently taking every other Fri off, which added to my usual alternating Fridays off, means I'm only scheduling myself 4 days a week. But those are 9hr days. I haven't made it through a full day in a few weeks.

The bathroom trips are a good sleep architecture/quality indicator. I have two categories of perceptible awakes: 1. Brief awakes to change position, which may return to sleep in a few minutes, or which may lead to insomnia of 15-45 minutes, or worse for several hours; 2. wakes to P.--with the same spectrum of consequences.

In general I think that if my sleep quality improves, it will mean more deep sleep, in which the brain doesn't pay attention to bladder fullness. So I'll be keeping a close eye on this. I'm really sick of waking up in general during the night, so I really hope this quickly improves. Even if it didn't immediately translate into feeling more refreshed, it would be a strong sign that improved restoration is soon to follow.

[AHI15]

Sounds like my first couple nights. There's a lot to get used to. But with an AHI of 3 you've already hit the mark. Stay with it!

Suggestion: List your equipment in your signature. We wanna know!

Listed.

On the second night, I got 8.9hrs logged, and AHI=2.5 .

Unfortunately, today I feel worse than yesterday.

[AHI15]

as many people on the forum like to say, one day does not make a trend. Hang in there. Start looing at the data your machine is keeping on the SD Card. Take a look at any of Pugsy's comments. In the signature field is a link to the SleepyHead software. It reads and graphs the data from your machine. You only need a PC that has a SD Card reader (many come with it now).
Pay attention to your leaks first. Get them under control. The little happy face your S9 displays only frowns for major leaks. Look at your AHIs. Are there clusters of them or spread out. As Carl pointed out, an AHI of 3 is very acceptable.
Keep the faith It's as easy as sleeping!
-tino

I will certainly be wanting to get started reading the data soon. Maybe I will have the energy for this on Saturday. I think I have a reader...

The leaks from my mask seem to be very audible, so I think the leaking is really low.

One question is:

Does the machine calculate AHI based on breathing patterns including awake periods?

Ie., are its algorithms sophisticated enough to make a pretty reliable determination of when sleep is occurring, and calculate AHI based only on sleeping times, or is the AHI figure corrupted by the breathing patterns while awake?

[jweeks]

One question is: Does the machine calculate AHI based on breathing patterns including awake periods?

Hi,

No, the machine doesn't know if you are awake or sleeping. Funny thing is that while your breathing tends to be very stable and predictable when you are sleeping, all bets are off when you are awake. It isn't unusual for the machine to get totally confused if you are awake. The machine might get out of sync with you, and it might score all kinds of events. Also, people sometimes tend to hold their breath when they are awake, and the machine sees that as an apnea event.

The best way to manage this is to get your mask on as you get ready for bed, but don't start the machine and connect the hose until you are ready to get into bed. When you wake up, shut off the machine and get up, then get disconnected. You want to be off of the machine when awake, but you also don't want to set yourself up to sleep without the machine running.

This is, of course, a moot point if you are (a) less concerned about the quality of the data, or (b) you are able to ignore the portions of the data where you were awake.

-john-

[Sharbysyd]

I still remember my 1st night and how hard it was for me. I had a nasal prong mask and I think I was awake more than asleep. I later changed to a nasal mask and found that those were much easier for me. The prong makes me feel like I have a hard time breathing.

Anyhow, good luck on your 2nd night.

[Carl LaFong]

Unfortunately, today I feel worse than yesterday.

But do you feel better than before CPAP?

Maybe use Sleepyhead software to help analyze your data and patterns. Recovery does take time for most people.

[AHI15]

Unfortunately, today I feel worse than yesterday.

But do you feel better than before CPAP?

Maybe use Sleepyhead software to help analyze your data and patterns. Recovery does take time for most people.

No I don't feel better.

I will start looking at the data as soon as I can--maybe this weekend.

Would you expect me to feel better after two nights?

I would have been overjoyed with a 1 or 2 night wonder--noticing some significant improvement right away. But it hasn't happened yet.

More reasonably, I expect something to be noticeable after perhaps a month. I think if there isn't some improvement by then I will become quite worried. Though I am cognizant of the possibility that some have gone though lengthy battles lasting nearly a year before an upward trend was established.

If this happens to me, well, hopefully I have enough fight left to endure it. It is a very frightening possibility since I feel like I have come perilously close to giving up hope due to waiting to get another sleep study until reaching nearly completely disabling fatigue--for reasons discussed in an earlier post.

In other words, if I had gotten on treatment even 1-2 years ago I would have been in a much stronger position to mentally grok the idea of further battle ahead. But in my present condition, it is very scary to think about that. I might not make it through such a lengthy battle with my job intact. It could be nearly impossible to replace the level of income I get from this job.

On the brighter side, much like financial bubbles, people usually have a lot more fight left in them than they feel at the moment. My job also is very accommodating--so far.

I guess you could say I have a lot of worries. It's hard to know if it is better to air them, or just try to keep telling myself that I'm going to turn the corner any night now. I prefer to be realistic. But I also don't want to create any self-fulfilling prophesies. I don't think the latter outcome is probable, because I wouldn't have gotten this far except for that I made a decision a few months ago to do whatever and spend as much $ as needed to get the health care I needed to crack this sleep and fatigue problem.

[Xney]

I'd say you should know better in 2-4 weeks. Initially, it's just very weird to adjust to. If you're actually sleeping with it for most of the hours of the night, you're ahead of the curve. If you can look at your data and see the AHI #s and mask leaks look good, then you're all set.

It might take months to really feel better, but you can probably start to tell after a few weeks.

[Tino2You]

AHI,

Your asked when the AH HA moment will come. Well for some (a very few...very very few) it comes during the first week. A few will feel different the first or second week. More will feel the positive effects the first month or three. Some (a very small few) don't respond at all.

Sometimes the positive effects are small like not having to take a mid day nap or having that mush brain fog clear for a few hours in the morning. For me it was my afternoon nap. I found that after a week, I didn't want to take it. Keep track of stuff for a while and not just your s9 data. On SleepyHead is a Notes tab on the daily window. You can use that area to keep track of how you feel, what you changed and even a general diary (showing my age...I meant blog). Some of the stuff that changes is amazing. I golf. Pre-CPAP I was a 20 handicap. I made stupid decisions on the course. After 90 days on CPAP I am now a 14. I actually think on the course. Never could stay focused long enough.

Take you time, give the treatment a while, relax. Life is good

Cheers,
-tino