Many CAs and OAs first two hours of therapy last night

[hillbilly1979]

I swapped from a Fitlife Total face mask to a Swift FX and chinstrap last night. I have a devil trying to fall asleep. I kept having episodes where I would drift off and my o2 sat would drop to 90% or less and I would be awakened again. When I checked Sleepyhead this AM, I discovered a massive amount of CAs and OAs during the first two hours. After 7 hours of sleep, my AHI was 15, but if I remove the first two hours, it was only as high as 6 and averaged 3.

Has anyone ever seen this type of repeating episode for the first couple of hours on therapy? Is there possibly a name for this?


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[Pugsy]

How do you know your oxygen levels dropped to 90% and what is it normally?

If you experienced great difficulty in falling asleep that was prolonged then it is possible that those flagged events were the machine flagging awake/semi awake breathing irregularities (sometimes called SWJ or sleep/wake/junk) because the machine doesn't know if you are awake or not. It just measures air flow and awake/semi awake breathing is irregular when compared to asleep breathing.
It's hard to tell for sure though.

Did you have any history of centrals during your diagnostic sleep study?
Or if you had an in lab titration where they hooked you up to a mask and machine to figure out the pressure...did you have any history of centrals during that test?
If you don't have copies of your sleep studies...get a copy of the results.

[OkyDoky]

Very likely what we call sleep/wake/junk since you were dealing with a new mask and new chin strap. What would awaken you? 90% is not a big drop in O2 sat. Do you have a recording oximeter?
Best way to see what's going on is to post some Sleepyhead screenshots. These 3 pages will help with that. When you get to the bottom of each be sure and click on the next page. https://sleep.tnet.com/resources/sleepyhead/shorganize

[hillbilly1979]

How do you know your oxygen levels dropped to 90% and what is it normally?

If you experienced great difficulty in falling asleep that was prolonged then it is possible that those flagged events were the machine flagging awake/semi awake breathing irregularities (sometimes called SWJ or sleep/wake/junk) because the machine doesn't know if you are awake or not. It just measures air flow and awake/semi awake breathing is irregular when compared to asleep breathing.
It's hard to tell for sure though.

Did you have any history of centrals during your diagnostic sleep study?
Or if you had an in lab titration where they hooked you up to a mask and machine to figure out the pressure...did you have any history of centrals during that test?
If you don't have copies of your sleep studies...get a copy of the results.

In my sleep study, the doctor only recorded OSA. Nothing is there about central apnea. On my prescription, the box for central apnea is unchecked.

I can see this reading from the first two hours last night being SWJ. That makes sense. The reason I was rolling in my bed for two hours was the apnea feeling or whatever it was that kept making me feel like I was not right. It would come in waves as I was drifting off to sleep. Really, it was right at the point of transition every time. So, every time I drifted off, I was pulled back and my oxygen was low.

I know my oxygen was low because I was wearing a pulse oximeter throughout the night. I put it on as soon as the first couple of episodes occurred and I let it run all night. My current unit does not record, but every time I woke, I felt horrible and I would check it. I am normally 97-99 throughout the day. I was as low as 89% last night and it might have been lower because as I woke, it would take me 30 seconds or so to get myself together and remember to check the pulse ox.


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[Pugsy]

If your oxygen levels actually did drop to 90 during the first 2 hours then you need to be talking to your doctor because it is not normal to have such a significant drop while awake or semi awake.
Now if it dropped later on during the night due to real apnea events happening while you are asleep...that's more to be expected but that's still a pretty significant drop.
I would see if I could determined exactly when the low oxygen got flagged. Do you have the software to see when the desats get flagged?
While awake or semi awake oxygen levels shouldn't drop from a normal baseline of around 98 to 90 without something going on to cause it and it can't be apnea if you aren't asleep..

Now there is a thing called sleep onset centrals and it's normal to have a few as we transition from awake to asleep. Normally these aren't a problem unless they keep bouncing someone out of sleep or there's a huge number of them. If you had this problem you would most likely be seeing this happen every night with every time you fell asleep. Normally people won't have a sleep onset central that lasts long enough to cause much of a desat....they wake up too soon and breathe on their own.