Bad insomnia, bad dream, bad breathing... just bad

[laprof]

I just had a pretty bad night: About 4 hours of insomnia brought on by very clogged nostrils (after 1.5 hours of wonderful sleep). At the 4 hour mark of sleeplessness during which time I kept trying different sleeping positions to help my rough breathing (which would help only for a few minutes - I really had to work to get air through my nostrils) and read a lot, I got up, used saline nasal spray, and climbed back into bed. Awake for about another .5 hour b/c the saline helped, but it took a bit of time. Then, about an hour later, had a bad dream - complete with thumping heart - and awoke again... awake for about .5 hour... slept for about 2.5 hours before getting up for good. I know that I should not have waited 4 hours of insomnia before using saline spray, but, honestly, I dreaded having to unhook myself from the machine, take off the mask, take off the mouth tape... and then put back on everything.
1) When I awoke after 1.5 hours of sleep, I checked the Clinical Data and saw 2L/Min for leaks and "0" for all apneas.
2) At the 4 hour mark of insomnia, I checked the machine and saw 6L/Min for leaks and 2.0 for AHI and 1.0 for CA
3) I did not check the data after the bad dream b/c I just wanted to fall back to sleep
4) When I got up, here's the data: 24L/Min for leaks, 3.5 AHI (highest ever for me since using the machine), 2.9 total AI, 1.9 CA (highest ever - usually <1.0)

That's the background info; here are my questions, although I think I have found the answer to the first one via the search engine here. 1) I did not turn off the machine while awake and reading. From what I just saw in other threads here, that was a no-no. Considering how jagged my breathing was during that time, I'm sure the machine "wondered" what the heck was going on! 2) Would the bad dream and thumping heart have raised the AHI/CA numbers? 3) Any ideas why the leaks shot up rather dramatically, although I didn't change my sleep position after the dream? I guess that I'm just bummed by the rough night and, for me, not great apnea numbers (although they have been slightly higher since switching from nasal pillows to a nasal mask). Thanks to this site, I'm learning how to deal with this machine. And, now I know to shut off the ding dang thing when insomnia strikes!

Last tidbit: Chatted with the IT department re: SH. Nothing can be looked at/considered (regarding changing my security settings) until I return to the States around Labor Day weekend, so I only have the ResMed Clinical Data info until then. Thank you for bearing with me. Best. (BTW: OTC nasal sprays wreak havoc with me, so can't use them - only saline solution.)

[Julie]

For one thing, the machine doesn't record 'awake' breathing (when you were reading) the same as it does when you're asleep, and that can throw off your results. It's too bad you had the nasal issue, but unless you find another solution, or unless that was just a one-off night, you may continue to have issues. The machine can only deal with what you present it with... difficulty breathing, insomnia, breathing while awake, etc... so you may have to figure some of those out before turning on the machine. And numbers will rise (maybe fall, on occasion) to address changes in circumstances - that's what it's supposed to do, but don't get too concerned about one night among many others that have been ok... unless things change consistently from here on, I wouldn't worry too much.

[Pugsy]

I would rather you use the machine while awake if you are laying in bed and there is any chance you might fall asleep.
The machine getting confused with awake vs asleep breathing is less of a problem than risking falling asleep without the machine.
You had a bad night...we all have them from time to time. The awake breathing flagging...goes with the territory when we have insomnia issues. Not much you can do about it and it isn't the end of the world if the AHI is elevated a bit or even a lot by non real events. I would rather see that than you sleep without the machine and have a bunch of real events without cpap.

[laprof]

Julie and Pugsy, Thank you both for your thoughtful replies. I'm just feeling a bit blue today b/c of last night's results (and, a bit tired!). The machine on/off dilemma is something I'm aware of. I leave it on while reading, but I've never fallen asleep while reading through an insomnia attack, so still am unsure about the on/off issue - although I would hate for "never" to become "once" and, then, suffer with apneas! I'm beginning to wonder if I need to get fitted for a different mask. I used the ResMed air pillows, but hated how they gave me a "pig nose" and made my nostrils very, very red and sore each morning, so I am now using a ResMed nasal mask. Interestingly, my apnea results have increased a bit and the leaks have increased quite a bit since the switch. It's more comfortable, but I have to use a liner to keep it from hurting my nose. I've looked online at all of the nasal pillow masks and find it overwhelming. When I return to the States, I'll see what else is available - or, maybe, what I have is the best I can get. Thank you, again, for your help! Best.

[Pugsy]

If you have piggy nose that mask is too tight or the pillows the wrong size... or both.
No wonder it hurts.

[Folgore_202]

Can confirm, I had this issue as well. I managed to find pillows the right size, but locally so I can't really recommend anything ; plus, it has to fit your morphology, what works for me won't necessarily work for anything else. Do you feel some discomfort just by putting your head on the pillow?