Still New and Sleepy - Interpreting Flow Graphs

[motorgeek]

Hi All,

I was diagnosed with mild sleep apnea. Male, early 30's, normal weight/BMI so I think I may have UARS. My numbers seem to look good with RDI of less than 1, as many others mentioned I'm still feeling sleepy during the day. I've only been on CPAP for about 2 weeks so I still may just need to adapt, but I was looking at my flow graphs from last night with 7.6 hours of sleep and noticed the below happening about 1 -4 times an hour. It looks like I'm having trouble on the inspiration phase which leads to large recovery breathing.

I'm on CPAP at 5cm with Cflex+ 2. The machine isn't flagging any of this for AHI/RDI, but I wonder if this is contributing to my continued daytime sleepiness or if this is normal. I'm curious if I should discuss with my doctor to maybe increase the pressure if this continues.



Here's another example:

[penuel]

Can you show SleepyHead graphs for longer sleep period to include Events and Stats?

[motorgeek]

Can you show SleepyHead graphs for longer sleep period to include Events and Stats?

Is this what you're looking for?

[penuel]

Can you show SleepyHead graphs for longer sleep period to include Events and Stats?

Is this what you're looking for?

Yes, the graphs show that your respiration waves are MOSTLY rounded (not flat) indicating no UARS, except a few waves that are distorted. Some of the Snores and RERAs could have caused it, but I am not a physician.

[Pugsy]

It's doubtful that those minor little flow quirks are significantly impacting how you feel.
I wish all the answers were available in the software reports but often they aren't.

Your reports shown are really pretty boring...that's good and bad.
Bad because we don't see anything that stands out and screams "fix me and you will feel better"

Sometimes it is simply a matter of "give it time" and 2 weeks is really a very short period of time to expect much.

Do you normally get 7 1/2 to 8 hours of sleep each night?
Do you take any meds of any kind (even OTC)?
Are the hours of sleep you are getting fragmented with very many wake ups?

[motorgeek]

Do you normally get 7 1/2 to 8 hours of sleep each night?
Do you take any meds of any kind (even OTC)?
Are the hours of sleep you are getting fragmented with very many wake ups?

I get 6.5 to 7.5 hours every night. I'm taking lipitor and using flonase every night. I haven't been noticing as much wake ups as pre Cpap and I'm noticing much less nocturia which is an improvement. I still get the slight fog and headaches in the morning. Still dozing off at work at times. I guess I'll keep at it and hopefully see improvements.

Thanks all!

[Pugsy]

You may just simply need to give things more time.
I know we all hear about someone feeling like a new person pretty much overnight and wonder why we don't and think something is wrong if/when we don't.

The reduction in nocturia was the first symptom that I saw that showed me the cpap was working.
I didn't feel like a new person ....I still needed to nap....I still woke up with headaches but they weren't nearly as severe.
In fact I woke up with headache this AM...just a little one and it's from my neck...I was on the bed pillow in a weird position.

Not all our problems are related 100% totally to sleep apnea though and can't be fixed by good numbers from the machine.
Even though we really, really want them to.

I found personally that the number of wake ups during the night (for whatever reason) and the number of hours of sleep (I need nearly 8 hours or I will need to nap during the day) were the biggest 2 factors in how I felt during the day.

[avi123]

My respiration waves are a bit like your but my S9 Autoset says that it is OK by lowering its pressure:



This is how my respiration waves look during Hypopnea:



p.s. I am also the poster "penuel"

[sleepyruss]

It took months of use for me to start feeling better...

My personal opinion is, if you spend months depleting your body of adequate sleep, you can't expect to be back up and running in a short time frame.

Think of your sleep "bank" as a running average or running balance. It may take extended use to really pull that average up (and how you feel)...I know I struggled for a while...

[Sludge]

I've only been on CPAP for about 2 weeks so I still may just need to adapt, but I was looking at my flow graphs from last night with 7.6 hours of sleep and noticed the below happening about 1 -4 times an hour...

...but I wonder if this is contributing to my continued daytime sleepiness or if this is normal.

No, they are not "normal", but since that happens in everybody, it must, by definition, be "normal" (or, at least, "WNL"), so 2 weeks is plenty of time to recover from "sleep debt".

[Sludge]

No, they are not "normal", but since that happens in everybody, it must, by definition, be "normal" (or, at least, "WNL"), so 2 weeks is plenty of time to recover from "sleep debt".

OTOH, that statement requires so many factors to be true, WNL, correct, etc., that we have ceased to be "making assumptions" and moved right into "taking a giant leap of faith".

Starting with these:

• Your initial diagnosis. What exactly is it and is it even correct. If you have "mild sleep apnea" or "UARS" (and do you, in fact, have UARS, or "think" you have UARS?) then you could have an AHI of <5, and if the number of events that you have noted above are happening at a an index of 4, then you aren't really doing anything.
• Nocturia in a 30 year old with mild OSA is unusual. It may be worth taking a look into whether you're making more urine (which is what happens in OSA) or just getting up because of periods of Wake and "Why not 'cause I'm awake anyway".
• If the sleep disturbances are "arousals", then they last from 3 to 15 seconds (generally more on the side of 3). More than 15 seconds and they are classified as "Awakenings", and that moves into a whole new area.
• If we are to take "weird breathing", and use it as a surrogate for "sleep disturbance", then the above event looks to be ~23 seconds long:
  
  
  
  so if you have 25 arousals all night it's NBD, but if you have 25 awakenings then it's a BFD.
• In re: "feeling better" because you have "paid off" the Sleep Debt, you have to be actually "making payments". That means not only getting the required hours (in your case ~7.5), they have to be quality hours (and if there are 25 awakenings, then that ain't it), but additional hours beyond that. How do you wake up in the morning? Naturally or with an alarm?