CPAP Struggles: Seeking Answers for Restful Sleep!

[CPAPExplorer]

Hello CPAP Community,

I'm here, seeking your invaluable insights. Despite months of navigating this CPAP journey, achieving restful sleep feels like an unattainable goal. I initially thought the pressure variability on my auto CPAP (AutoSet for Her) within the prescribed range of 6-12 and then changed too 6-9 (due to aerophagia) was the culprit behind my disrupted sleep. However, even with a fixed pressure of 9 and EPR 2, I'm unable to secure more than 2 hours of sleep. The frustration and exhaustion are overwhelming.

Some elusive factor persistently disrupts my sleep, leaving me in a perpetual state of weariness. I've shared my most recent sleep data, hoping that your collective knowledge might offer a solution to my elusive peaceful slumber. Your assistance is invaluable, and your experiences mean the world to me.

[Pugsy]

Do you have any other physical or mental issues going on?
Do you take any medications of any kind...even OTC?
Have you discussed this problem with your doctor? If so...what came of the discussion.

Did you have a history of problems with either falling asleep or staying asleep prior to starting on the cpap machine?

Nothing of great excitement showing on your detailed report except the obvious, much less than optimal, hours of use.

Are you only sleeping 2 hours a night or do you wake up after 2 hours and remove the mask and go back to sleep?
If that is what you are doing...how many hours of sleep without the machine are you getting?

[chunkyfrog]

Starting can be so hard.
We have all been there.
Identify WHY you stop each night, and work on that.
Aim for a little more time each night, never less.

[CPAPExplorer]

Do you have any other physical or mental issues going on?
Do you take any medications of any kind...even OTC?
Have you discussed this problem with your doctor? If so...what came of the discussion.

Did you have a history of problems with either falling asleep or staying asleep prior to starting on the cpap machine?

Nothing of great excitement showing on your detailed report except the obvious, much less than optimal, hours of use.

Are you only sleeping 2 hours a night or do you wake up after 2 hours and remove the mask and go back to sleep?
If that is what you are doing...how many hours of sleep without the machine are you getting?

I'm in good physical and mental health and don't take any medications. Doctors tend to focus solely on AHI numbers. Despite having an excellent AHI, I still feel terrible; it's evident I'm not getting enough sleep (something is causing me to wake up). Before using CPAP, I used to have occasional awakenings, but they weren't as frequent as they are now. However, for the past 5 months now (start of CPAP), every night, I wake up 90-120ish minutes after putting on my CPAP, remove my mask, and then sleep for 5-6 hours without waking up. I'm observing irregularities in my flow rate, which should ideally be smooth but appears spiky and it seems like I experienced an unflagged event before removing my mask (AirTouch N20) ?

[Jimmy Lotus]

Starting can be so hard.
We have all been there.
Identify WHY you stop each night, and work on that.
Aim for a little more time each night, never less.

So much this. A month ago today I started my therapy. I was getting about 2.5 hours of sleep with the CPAP. Then it went to 3.5-4 hours. Then 5 hours. My last few nights I've broken the 6-hour mark and can't remember the last time I've had such restful sleep.

Keep on keepin' on, CPAPExplorer. Stick with the therapy if you can. This is a good community and we're all here to try to help as best we can.

[Pugsy]

I wake up 90-120ish minutes after putting on my CPAP, remove my mask, and then sleep for 5-6 hours without waking up. I

Bad, bad habit to start. You know bad habits are very easy to make but notoriously hard to break.

Sounds like you are waking after the first REM stage sleep. This is entirely normal.
Google "sleep stages" and take a look at the hypnograms for normal sleep stages.
Normally we aren't awake long enough to form a memory of the awakening and we just roll over and go back to sleep.

When we wake prematurely during the night and/or can't go back to sleep that is called sleep maintenance insomnia.
I struggle with this myself and while I know what the problem is....I will be the first to admit not so easy to fix.

Take a look at RobySue's blog
http://adventures-in-hosehead-land.blog ... er_19.html

I'm observing irregularities in my flow rate, which should ideally be smooth but appears spiky and it seems like I experienced an unflagged event before removing my mask (AirTouch N20) ?

We all have slight irregularities in our breathing during the night....and we don't sleep the same every night or even from hour to hour each night.

There are certain criteria that must be met to earn an event (of any kind) flag and one item on that criteria list is that the "event" must have a duration of at LEAST 10 seconds. Other criteria besides duration like amount of flow reduction is also needed. If you aren't getting a flag during what you think is some sort of air flow irregularity....it's not meeting criteria for some reason or other.

Have you discussed this problem with your doctor? If so...what came of the discussion.

answer please.....

[CPAPExplorer]

Absolutely, I've consulted my doctor, which is why I'm here. Most doctors focus solely on AHI, so I've decided to take matters into my own hands. You're right; I've observed the pattern of waking up and removing my mask during REM, and it's beyond frustrating! I do have a polysomnography scheduled, but until then, I'm feeling a bit lost. Even if I manage to fall back asleep with my mask on, I find myself waking up again 90-120 minutes later. It's like this never-ending cycle that I can't break.

I've been entrenched in the CPAP world for about 5 months, absorbing every piece of advice from TheLankyLefty27's YouTube channel. Watched every video, you know! But my Oscar data is throwing me for a loop! These irregularities, like the spikes in my flow rate (which should be smooth), snoring (despite Oscar's denial), and these unflagged events, particularly the last one that led me to wake up and remove my mask, have left me perplexed.

So, I'm here, hoping this fantastic group could offer me a fresh perspective. Maybe there's something I've missed, and you guys could spot it. Or, maybe I should just pay TheLankyLefty27 to take a peek at my data! Jokes aside, any help or suggestions you have would be absolutely amazing!

[Pugsy]

Can you please post the OSCAR statistics page?
Make sure to include changes to device settings.

snoring (despite Oscar's denial)

Please be aware that OSCAR can only report the data it gets from the machine.
If the machine doesn't report it...OSCAR won't show what it can't get.
If you aren't seeing snores on the OSCAR report then it is because the machine isn't sensing any snores to report.

maybe I should just pay TheLankyLefty27 to take a peek at my data!

Your choice but his go to way of offering ideas is to try fixed pressure with no EPR and his crystal ball, as to why you are waking and can't go back to sleep, isn't any better than mine.
It's your money. You get to decide what to spend it on.

IMHO....you got a sleep insomnia problem but not from apnea events. I know you didn't want to hear that and you probably don't believe me but try to keep an open mind. My gut feelings are usually spot on.
Did you read RobySue's blog that I linked to above? If not...read it.

BTW...we have a problem with new account posts and when you reply to something you won't see it until I can approve it.
Not supposed to work that way (supposed to be the very first post from a new account) but the forum software is screwed up. So don't panic if you post a reply and can't see it...and don't go making multiple posts of the same thing.
As soon as I see your new post...I will approve it and it will show up.
IT is supposed to be working on the problem.....but I wouldn't go holding my breath because in the past these problems are hard to sort out much less fix.

[kteague]

Just a long shot, any chance your sleep is restless and you have issues with limb movements? They are notorious for disrupting sleep and making it hard to get into a good sleep.

[CPAPExplorer]

Just a long shot, any chance your sleep is restless and you have issues with limb movements? They are notorious for disrupting sleep and making it hard to get into a good sleep.

I don't think so but I do have a polysomnography coming up !

[chunkyfrog]

Just a long shot, any chance your sleep is restless and you have issues with limb movements? They are notorious for disrupting sleep and making it hard to get into a good sleep.

I don't think so but I do have a polysomnography coming up !

You can ask; but they may refuse to take requests.

[CPAPExplorer]

I find myself in a bit of a sleep mystery and I could really use your collective wisdom. My original prescription was 6-12, but due to aerophagia, my respiratory therapist lowered it to 6-9 (EPR turned on 3). However, for the past few days, I've set my max pressure back to 12 just to gather some data.

I've attached screenshots of my CPAP data for the past 3 nights. Two nights were at 7-12, with EPR turned off, and last night was at 9-12 with EPR turned on 2. Despite all my adjustments for the past 5 months now, I'm still waking up and removing my mask after a few hours of sleep, unable to discern the cause.

Oscar seems to be misbehaving too, showing incorrect bedtime, mask removal time (can't see when I removed my mask last night (9-12 with EPR turned on 2)), and temperature settings (my tube temp is set at 29C and my humidity at 5 but Oscar says my tube temp is set at 28C). I'm reaching out to you for insights. What do you think I should tweak? Should I decrease or increase my pressure settings, my EPR ?

[Pugsy]

Oscar seems to be misbehaving too, showing incorrect bedtime, mask removal time

OSCAR can only report the data that the machine spits out...so if your times are incorrect then the clock which is inside the machine is set incorrectly. You need to set the clock to the correct time....be aware that daylight savings time change is coming up soon so the clock would need to be changed again.

What do you think I should tweak?

Nothing.

[CPAPExplorer]

Oscar seems to be misbehaving too, showing incorrect bedtime, mask removal time

OSCAR can only report the data that the machine spits out...so if your times are incorrect then the clock which is inside the machine is set incorrectly. You need to set the clock to the correct time....be aware that daylight savings time change is coming up soon so the clock would need to be changed again.

What do you think I should tweak?

Nothing.

This was on Aug 2 (the only night I slept for 7 straight hours for some reason) all other nights following with same settings was below 4ish hours.

[Pugsy]

Tell me again (don't remember if you mentioned it before and no time to go back and reread your posts) why you are limiting the max to 9 cm???

On the Aug 2 night you maxed out the pressure because of an increase in flow limitations at around 23:00 (per the machine clock) and that coincides with what might be REM stage sleep.
First REM normally happens about 90 minutes after sleep onset and doesn't last all that long at 15 to 30 minutes.
So maybe this was REM stage sleep (where it is common for OSA to worsen and/or need more pressure) or it could also be positional like maybe you were on your back or experienced some chin tuck.
If this is a one off night and you rarely see this happen then I don't know that I would worry too much about it but if you are seeing this fairly often then there's a good argument for increasing the max pressure and letting the machine kill what it wants to kill.

Will it let you sleep more soundly ...which seems to be your main issue...we don't know because we don't know what might be waking you up.

I think you have a sleep maintenance insomnia problem but I am not so sure that it is related to airway issues and the machine only fixes airway issues. It can't do a damn thing for sleep issues related to anything else other than the airway.
Are you maybe wanting the machine to fix a problem that it can't fix? You wouldn't be the first.
The list of causes for sleep maintenance insomnia is a big long list...and sleep apnea is only one item on that list but it is the only item on that list that the machine can do anything about.