Frequent Awakenings

[tan]

What do you think about 13? I was going to try 13 tonight and see if it stops the snores. Too soon?

Well, if you want to try it, go ahead. It's not like you haven't been at that and higher (changing) pressures before.


Den

.

Well here is last night, and even though Pugsy said to turn off the AHI graph, I left it on this time because I still wonder why my wake-ups are right after an AHI event?

The snoring frequency looks quite-quite horrible. What if each or every other VS event results in an arousal? I reviewed my sleep study's results: most of the brief and pronounced snoring events screwed up my sleep. I wonder if your case is the same.

[Java]

I am not tired so I do watch movies or read on my iPad. ...
As for the environment, I don't think there are any alarms or sounds or lights that bother me. .

more and more research is showing that the bright blueish light shined right into your eyeballs from tablets and phones disrupts sleep. it's surely not the only thing, but it's probably a contributing factor.

https://justgetflux.com/ is an app that dims and reduces the "STAY AWAKE" blue light from tablets in the evenings.

try it.

Thank you. I will try it. However, I have had these sleep problems for 12 years and only had the iPad maybe 2 years. But anything is worth a try.

[Java]

The snoring frequency looks quite-quite horrible. What if each or every other VS event results in an arousal? I reviewed my sleep study's results: most of the brief and pronounced snoring events screwed up my sleep. I wonder if your case is the same.

Well, How do I fix the snoring?

[Jay Aitchsee]

Well, I don't know about the snoring. Honestly, I don't know how to interpret the snore chart. It could be the scale of the chart just makes it looks worse than it is. Is a snore of 45 really terrible? It does seem the snoring is related to deeper sleep judging by the flow chart. You might be able to reduce it with breathe right strips or a neck brace (see here how to make one).
Maybe your awakenings are just normal arousals at the end of REM periods, but you've become aware of them and are now focusing too much on them as a source of non-restorative sleep. Most people wake (but few remember) several times in the night.
Java, I would continue to work on the environmental issues as well as the respiratory. As pointed out above, going to bed with your Ipad, or TV probably doesn't help your sleep. I would be suspicious of the caffeine as well. You say your last cup is at 6pm and that it not late because you don't go to bed until 2, but I bet you probably start drinking coffee when you get up in the morning (because you're tired) and then drink it all day. It could be that your system never really becomes caffeine free. And why aren't you tired when you go to bed at 2 AM. Is it because you've been drinking coffee (or coke, or ?) all day? Have you always gone to bed that late and gotten up that late? Most people are more in sync with the sun. How about your mattress? Is it comfortable? If it's 8 or 10 years old, it's probably time for a replacement. Google "Sleep Hygiene" for things you can do that will improve conditions for sleep, I doubt, as you've found out, a "quick fix" like cherry juice or melatonin will help, but good sleep hygiene, over time, might.

Edit: the more I research this "Vibratory Snore" issue, the less convinced I am it is something one should try to control in the absence of a higher than normal index of hypopneas or obstructive apneas. From what I read, it can be heavily influenced by artifacts - things other than actual snores. Apparently, Respironics treats an indication of Snores (Vs) in its autopap algorithm as a precursor of hypopneas or obstructive apneas and will raise the pressure in the presence of Vs to prevent the events (hypopneas/apneas) from occurring. In the example above, the OP has a relatively low AHI so the Vs index or events may not be of concern. Thoughts, anyone?

[Wulfman...]

Well, I don't know about the snoring. Honestly, I don't know how to interpret the snore chart. It could be the scale of the chart just makes it looks worse than it is. Is a snore of 45 really terrible? It does seem the snoring is related to deeper sleep judging by the flow chart. You might be able to reduce it with breathe right strips or a neck brace (see here how to make one).
Maybe your awakenings are just normal arousals at the end of REM periods, but you've become aware of them and are now focusing too much on them as a source of non-restorative sleep. Most people wake (but few remember) several times in the night.
Java, I would continue to work on the environmental issues as well as the respiratory. As pointed out above, going to bed with your Ipad, or TV probably doesn't help your sleep. I would be suspicious of the caffeine as well. You say your last cup is at 6pm and that it not late because you don't go to bed until 2, but I bet you probably start drinking coffee when you get up in the morning (because you're tired) and then drink it all day. It could be that your system never really becomes caffeine free. And why aren't you tired when you go to bed at 2 AM. Is it because you've been drinking coffee (or coke, or ?) all day? Have you always gone to bed that late and gotten up that late? Most people are more in sync with the sun. How about your mattress? Is it comfortable? If it's 8 or 10 years old, it's probably time for a replacement. Google "Sleep Hygiene" for things you can do that will improve conditions for sleep, I doubt, as you've found out, a "quick fix" like cherry juice or melatonin will help, but good sleep hygiene, over time, might.

Edit: the more I research this "Vibratory Snore" issue, the less convinced I am it is something one should try to control in the absence of a higher than normal index of hypopneas or obstructive apneas. From what I read, it can be heavily influenced by artifacts - things other than actual snores. Apparently, Respironics treats an indication of Snores (Vs) in its autopap algorithm as a precursor of hypopneas or obstructive apneas and will raise the pressure in the presence of Vs to prevent the events (hypopneas/apneas) from occurring. In the example above, the OP has a relatively low AHI so the Vs index or events may not be of concern. Thoughts, anyone?

Regarding the caffeine, I drink coffee up to the time I go to bed and probably consume a half pot or more in the evening and I'm able to stay (sound) asleep for 4 - 6 hours before my nightly bathroom trip. I can probably count on one hand the number of times in my life when my sleep was affected by drinking coffee in the evening. So, I think that's an individual thing.

Regarding the Snoring issue.......that's why I wanted her to switch to single pressure so the pressures don't keep jacking up. It'll also eliminate one of the potential questions about what the wake-ups are all about. In that last report, her snoring wasn't all that terrible (numbers wise), so we MAY be making headway in searching for a potential therapy pressure.

And, somewhere back in this thread, she indicated that there had been a "golf ball sized something" show up in a scan of her nasal area. But, they didn't think it was a critical problem at that time. However, it might be, but we're just working around that issue at the present time.

Edit to add link:

viewtopic/t103529/viewtopic.php?f=1&t=1 ... ll#p973607


Den

.

[tan]

I don't get it. What is the rationale behind straight 13? Based on what? The very first charts showed pressures close to 18, did they not? My original settings were 4-20 APAP and my machine drove into 12-14 territory all the time. I finally settled with 13 IPAP 9 EPAP - haven't sleep so well in years.

As far the dry mouth with a full face mask is concerned, the best solution for me was to put a vertical strip of 1' tape from right under the nose to the chin, which prevents too much of a jaw drop during sleep due to muscle relaxation AND helps, due to the incomplete taping, equalize the pressure inside and outside of my mouth, my cheeks look like a blowfish no more.

And, of course, nasal strips to expand my flimsy nostrils.

[Wulfman...]

I don't get it. What is the rationale behind straight 13? Based on what? The very first charts showed pressures close to 18, did they not? My original settings were 4-20 APAP and my machine drove into 12-14 territory all the time. I finally settled with 13 IPAP 9 EPAP - haven't sleep so well in years.

As far the dry mouth with a full face mask is concerned, the best solution for me was to put a vertical strip of 1' tape from right under the nose to the chin, which prevents too much of a jaw drop during sleep due to muscle relaxation AND helps, due to the incomplete taping, equalize the pressure inside and outside of my mouth, my cheeks look like a blowfish no more.

And, of course, nasal strips to expand my flimsy nostrils.

To keep the snores from driving the pressures to where they DON'T NEED TO BE!
Snores don't always need to be squashed by an auto-algorithm.
I didn't expect that 12 or even 13 cm. is going to provide optimal therapy.......it was a starting point and also to eliminate the pressure changes.......to eliminate some of the potential problems with her sleep problem.


Den

.

[tan]

I don't get it. What is the rationale behind straight 13? Based on what? The very first charts showed pressures close to 18, did they not? My original settings were 4-20 APAP and my machine drove into 12-14 territory all the time. I finally settled with 13 IPAP 9 EPAP - haven't sleep so well in years.

As far the dry mouth with a full face mask is concerned, the best solution for me was to put a vertical strip of 1' tape from right under the nose to the chin, which prevents too much of a jaw drop during sleep due to muscle relaxation AND helps, due to the incomplete taping, equalize the pressure inside and outside of my mouth, my cheeks look like a blowfish no more.

And, of course, nasal strips to expand my flimsy nostrils.

To keep the snores from driving the pressures to where they DON'T NEED TO BE!
Snores don't always need to be squashed by an auto-algorithm.
.

Well, while I agree that the auto-algorithm is not necessary smart, that seems to have worked in my case. Why do you think 18 or something around that is not what it needs to be?

[Jay Aitchsee]

Re: Caffeine

So, I think that's an individual thing.

Agreed, but it is a variable over which the OP has control.

[Wulfman...]

I don't get it. What is the rationale behind straight 13? Based on what? The very first charts showed pressures close to 18, did they not? My original settings were 4-20 APAP and my machine drove into 12-14 territory all the time. I finally settled with 13 IPAP 9 EPAP - haven't sleep so well in years.

As far the dry mouth with a full face mask is concerned, the best solution for me was to put a vertical strip of 1' tape from right under the nose to the chin, which prevents too much of a jaw drop during sleep due to muscle relaxation AND helps, due to the incomplete taping, equalize the pressure inside and outside of my mouth, my cheeks look like a blowfish no more.

And, of course, nasal strips to expand my flimsy nostrils.

To keep the snores from driving the pressures to where they DON'T NEED TO BE!
Snores don't always need to be squashed by an auto-algorithm.
.

Well, while I agree that the auto-algorithm is not necessary smart, that seems to have worked in my case. Why do you think 18 or something around that is not what it needs to be?

I haven't said WHERE or WHAT it needs to be.
Supposedly, in the past, there were experiments with her settings at high fixed pressures and that didn't help either.

When you have an in-lab sleep study done, they start with a LOW pressure and work up. They don't start with a high pressure and work down. I'm having her start with a relatively low pressure and let it take us to "wherever". Her "problem" isn't her AHI or even with the snoring levels (at certain pressures), it's her fractured sleep that is what I'm trying to find a cause/solution and a "balance" in the pressure settings.

Some people experience satisfactory results with auto-pressures and others don't.


Den

.

[Wulfman...]

Re: Caffeine

So, I think that's an individual thing.

Agreed, but it is a variable over which the OP has control.

.......since I don't even go to bed 'till 1:00am that's 7 hours with no caffeine.

Sounds like she is/does.


Den

.

[tan]

Supposedly, in the past, there were experiments with her settings at high fixed pressures and that didn't help either.

I must have missed that.

When you have an in-lab sleep study done, they start with a LOW pressure and work up.

Her machine also starts from a Low pressure and works up.

They don't start with a high pressure and work down. I'm having her start with a relatively low pressure and let it take us to "wherever". Her "problem" isn't her AHI or even with the snoring levels (at certain pressures), it's her fractured sleep that is what I'm trying to find a cause/solution and a "balance" in the pressure settings.
.

I also didn't have a high AHI, but my sleep was fractured by FLs and snoring alright. Why do you rule them out?

[Java]

Well, I don't know about the snoring. Honestly, I don't know how to interpret the snore chart. It could be the scale of the chart just makes it looks worse than it is. Is a snore of 45 really terrible? It does seem the snoring is related to deeper sleep judging by the flow chart. You might be able to reduce it with breathe right strips or a neck brace (see here how to make one).
Maybe your awakenings are just normal arousals at the end of REM periods, but you've become aware of them and are now focusing too much on them as a source of non-restorative sleep. Most people wake (but few remember) several times in the night.
Java, I would continue to work on the environmental issues as well as the respiratory. As pointed out above, going to bed with your Ipad, or TV probably doesn't help your sleep. I would be suspicious of the caffeine as well. You say your last cup is at 6pm and that it not late because you don't go to bed until 2, but I bet you probably start drinking coffee when you get up in the morning (because you're tired) and then drink it all day. It could be that your system never really becomes caffeine free. And why aren't you tired when you go to bed at 2 AM. Is it because you've been drinking coffee (or coke, or ?) all day? Have you always gone to bed that late and gotten up that late? Most people are more in sync with the sun. How about your mattress? Is it comfortable? If it's 8 or 10 years old, it's probably time for a replacement. Google "Sleep Hygiene" for things you can do that will improve conditions for sleep, I doubt, as you've found out, a "quick fix" like cherry juice or melatonin will help, but good sleep hygiene, over time, might.

Edit: the more I research this "Vibratory Snore" issue, the less convinced I am it is something one should try to control in the absence of a higher than normal index of hypopneas or obstructive apneas. From what I read, it can be heavily influenced by artifacts - things other than actual snores. Apparently, Respironics treats an indication of Snores (Vs) in its autopap algorithm as a precursor of hypopneas or obstructive apneas and will raise the pressure in the presence of Vs to prevent the events (hypopneas/apneas) from occurring. In the example above, the OP has a relatively low AHI so the Vs index or events may not be of concern. Thoughts, anyone?

I have tried Breathe Right strips, in fact I used them twice last week. They don't help me I think because the FFM I use goes right over the strip and pinches my nose where the strip is trying to open my nose. That's just my theory.
My doctor agrees the awakenings are just normal arousales at the end of REM periods, but I don't want them. I don't want to remember them.
I am trying to cut back on the iPad, but seriously it takes my mind off worrying about real life stuff that drives me crazy and keeps me up all night.
I don't think the coffee is the problem. I have one cup for breakfast and one cup after dinner. I will have decaf tonight or tea but I don't think that is the problem. Other than that, I don't drink any caffeine, just water. Actually between the ages of 19 and 35 coffee helped me sleep. I could not relax without my evening cup of coffee. I'm 49 now but I still don't think I have a high enough caffeine intake to effect my sleep patterns every night the way I'm experiencing.
My mattress is 3 years old, seems pretty good still. We added a new topper this winter. I use super soft sheets and overall I would say my bed is very comfortable.

I used to sleep so soundly, I would get in bed and nothing could wake me up. I would have to set 3 alarm clocks and have my mother call me and let the phone ring non-stop to get me up!! Crazy how we change

[tan]

I have tried Breathe Right strips, in fact I used them twice last week. They don't help me I think because the FFM I use goes right over the strip and pinches my nose where the strip is trying to open my nose. That's just my theory.

That is a good theory indeed, but using them just twice won't help, but you can also try nasal dilator cones (look up on Amazon)

My doctor agrees the awakenings are just normal arousales at the end of REM periods, but I don't want them. I don't want to remember them.
I am trying to cut back on the iPad, but seriously it takes my mind off worrying about real life stuff that drives me crazy and keeps me up all night.

Ah, here comes a new suspect which clearly warrants a visit to a psychiatrist. With your iPad, you just sweep dirt under the carpet.

[Wulfman...]

Supposedly, in the past, there were experiments with her settings at high fixed pressures and that didn't help either.

I must have missed that.

When you have an in-lab sleep study done, they start with a LOW pressure and work up.

Her machine also starts from a Low pressure and works up.

They don't start with a high pressure and work down. I'm having her start with a relatively low pressure and let it take us to "wherever". Her "problem" isn't her AHI or even with the snoring levels (at certain pressures), it's her fractured sleep that is what I'm trying to find a cause/solution and a "balance" in the pressure settings.
.

I also didn't have a high AHI, but my sleep was fractured by FLs and snoring alright. Why do you rule them out?

She gave me some background history.

That's the problem. I don't want it to do that.

I'm trying to use "constants" to rule out the "variables". It's that simple. And, I like the "K.I.S.S." principle.


Den

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