Intense Sleep Inertia/Sleeping 9+ hrs on CPAP?

[pretysmitty]

Hey all,

After switching to a FFM, I found it quite easy to keep the mask on for 7-8 hours. I'm now seeing a pattern where I'll sleep for 7-8 hours, feel totally unable to start my day at ~8hrs, and then sleep for another 1.5-3hrs. Upon waking up a second time, I'll feel great and easily start my day.

I'd really like to cut down to 8 hours of sleep - I have a busy schedule and sleeping for 11 hrs is not feasible. Has anyone else had this issue? I've been wearing the mask for 7-8 hrs for around a month now.

Thanks!

[rcobourn]

There is more to sleep than duration. What kind of results are you getting on your device? Maybe post some sleepyhead output.

[pretysmitty]

Sleepyhead results look great. Note that the RDI is inflated - most the centrals seem to be just snorts/changing position etc - not true centrals. This is what a typical night of cpap looks like for me.

[palerider]

Sleepyhead results look great. Note that the RDI is inflated - most the centrals seem to be just snorts/changing position etc - not true centrals. This is what a typical night of cpap looks like for me.

They're not "great", no. The numbers aren't "bad", but there's certainly room for improvement.

Your pressure probably needs to be more like a min of 11.

[pretysmitty]

I see. What's usually a "great" night for you? Apnea index around 1?

[SewTired]

I see. What's usually a "great" night for you? Apnea index around 1?

Needing a nap after sleeping for 8 hours means that either your therapy is not optimized or you have something else going on in addition to sleep apnea. Given the very sharp increases, having a higher minimum would likely reduce those events.

Having an AHI under 1 doesn't guarantee anything, but it's usually a goal to strive for FIRST if no other problems are apparent. Some medications can cause morning hangover which also causes the need for a nap after waking.

[jnk...]

If you are waking up to an alarm, it may be interrupting your sleep in the middle of a sleep cycle and in a sleep stage that your brain/body doesn't like to wake up in. Sometimes moving the alarm ahead 15 minutes or back 15 minutes makes a difference for some people, not all.

The important thing with what you describe is to have a few weeks when you wake up every morning at the exact same time, weekend included. If you do that for a few weeks to let all your inner clocks all line up to the same time for waking up, that can give your brain a starting point to work from. For some of us, when the brain knows exactly when you will be waking up every morning, it can sometimes time that last session of REM so that it ends precisely at your waking up time. After that happens for a while, you may be able to be less regimented from that point forward.

The principles of sleep hygiene are especially important for those of us with OSA starting out with PAP therapy because our brain needs to learn how to sleep a whole new way--with uninterrupted sleep cycles. It is worth it to get it right as soon as possible in the PAP-therapy process.

[rcobourn]

What were your results like before the FFM? If I was getting a 4, I'd need a few extra hours to feel human, so definitely see if you can improve that before you look for a mystery cause for your fatigue. Perhaps your AHI was lower before the FFM? I'm not an expert at interpreting SH data, but it does look to me like your pressure is not able to ramp up fast enough, so I agree you may need to increase your minimum.

If you were having better results with a different mask, perhaps consider going back to that at least temporarily and see if that works better for.

[jnk...]

Your pressure probably needs to be more like a min of 11.

+1

And then there is that.

That is what I would try first if it were me, as long as reported "centrals" didn't increase from doing it.

[pretysmitty]

@rcobourn
Before FFM, I couldn't keep the mask on for more than 4 hours. It was terrible haha. Though on the nights that I was compliant, I do remember the occasional AHI<2.


@jnk...
I'll admit that my sleep schedule isn't super strict/precise. I definitely am not going to rule out sleep hygiene. We'll see if my sleep normalizes within the next several days. Now that I think about it, I'm quite suspicious that sleep hygeine/consistency is the root cause.

I'll also increase my pressure.

Thanks all for the input

[NanTastic]

Oh how I wish I could sleep like that!!! If switching to FFM did that for you I may have to try one because I’m not sleeping with nasal mask. I’m just so claustrophobic!



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[palerider]

I see. What's usually a "great" night for you? Apnea index around 1?

Well, yeah, OA+H under 1, 2 is "good", above that is not good.

My last four nights, for example were 0.33, 0.00, 0.13, 0.25

[kteague]

A relatively low AHI (for example 4) sounds innocuous enough at first glance. Multiple that times hours slept... 4 x 8 = 32. Some percentage of those events are likely to cause sleep stage shifts, arousals, desats and/or stress hormone surges that are not conducive to feeling rested. Are you ok with potentially 32 interruptions per night? The lower we get that AHI, just by the numbers there's better opportunity for restful sleep. Factor in other potential contributors and one could still feel pretty bad. If you optimize your therapy and sleep schedule and still feel bad, I'd start looking outside OSA for other possible contributors.

[pretysmitty]

My last four nights, for example were 0.33, 0.00, 0.13, 0.25

Holy crap. Are you on BiPAP or something? That’s insane


Edit: nvmm just looked at your flair

[palerider]

My last four nights, for example were 0.33, 0.00, 0.13, 0.25

Holy crap. Are you on BiPAP or something? That’s insane


Edit: nvmm just looked at your flair

I am, but only because I got a ripping good deal when I was looking for an autoset. Bilevel doesn't magically give 'better results'.