New to Forum: 6 Months in and Sleep is Still Very Fragmented

[M'ohms]

I have been reading the forum for the past 6 months after starting CPAP therapy, and this is the first time I have posted a question.

I started on CPAP, then APAP, and am now on straight Bipap (for the last 6weeks) with settings of 12/16 with low AHI's typically under 3.0. The majority of my events are CA's, but I still have clusters that include OA's, H's, and RERA's. Since starting therapy 6 months ago, I have only slept 4 to 5 hours straight on 2 occasions. The rest of the time, I sleep around 1 to 1.5 hours before waking. I do go back to sleep, sometimes right away, sometimes after an hour or longer, but I am always worn out during the day.

I have worn the mask all night, every night, since the first night, and accept the treatment gladly. I am anxious to begin feeling better. My Pulmonologist/Sleep Doctor recommends that I see a sleep therapist. I don't think I have mental problems, just mechanical ones. I have read everything I can get my hands on concerning good sleep hygiene, and I already practice those things.

Do I need to change doctors, or does anyone have any ideas for me to resolve my fragmented sleep?

[Rickv]

I am having a similar problem but, I have been on CPAP since 2006 and this problem just recently started with me. I started a thread yesterday maybe some of the replies can shed some light.

viewtopic/t91602/Dreaming-Problem.html

[Wulfman...]

I have been reading the forum for the past 6 months after starting CPAP therapy, and this is the first time I have posted a question.

I started on CPAP, then APAP, and am now on straight Bipap (for the last 6weeks) with settings of 12/16 with low AHI's typically under 3.0. The majority of my events are CA's, but I still have clusters that include OA's, H's, and RERA's. Since starting therapy 6 months ago, I have only slept 4 to 5 hours straight on 2 occasions. The rest of the time, I sleep around 1 to 1.5 hours before waking. I do go back to sleep, sometimes right away, sometimes after an hour or longer, but I am always worn out during the day.

I have worn the mask all night, every night, since the first night, and accept the treatment gladly. I am anxious to begin feeling better. My Pulmonologist/Sleep Doctor recommends that I see a sleep therapist. I don't think I have mental problems, just mechanical ones. I have read everything I can get my hands on concerning good sleep hygiene, and I already practice those things.

Do I need to change doctors, or does anyone have any ideas for me to resolve my fragmented sleep?

I would think that there SHOULD be some clues in your reports.
Sleeping position?
Do the awakenings coincide with the clusters (or leaks)?
Leaks and leak rates?
Do you have a pad and pencil next to the bed to make notes of when you awaken? Might not hurt.

Could you post one or more "typical" reports from some nights?


Den

.

[SleepWellCPAP]

In order for a sleep episode to feel rested a person should descend from being awake, to light sleep stages 1 then 2, then hit deep wave stage 3 for a while. Momentarily hit stage 2 again and then enter REM. With the exception of hitting 1, or being awake for that matter, the cycle should repeat four to five times over the course of an evening. You should also hit your lowest body temperature and highest melatonin 1/2 way through your sleep episode. Each cycle should last approximately 90 minutes, giving you 6 to 7 1/2 hours to feel rested.

I should have prefaced my post - I am not a doctor. I have read this in my research and will post the references if needed.

After 6 months of pressure therapy, you should by now be feeling better. Were or are you a shift worker? I'm wondering if it could be a body clock issue. Are you taking naps during the day more than 20 or 30 minutes long? Timing is very important. Are you turning in at approximately the same time everyday? Are you under a lot of stress? What is your aerobic activity schedule if I may ask?

You have a very interesting story, please keep posting. It will be very interesting to see what resolves this for you.

Jim

[49er]

I have been reading the forum for the past 6 months after starting CPAP therapy, and this is the first time I have posted a question.

I started on CPAP, then APAP, and am now on straight Bipap (for the last 6weeks) with settings of 12/16 with low AHI's typically under 3.0. The majority of my events are CA's, but I still have clusters that include OA's, H's, and RERA's. Since starting therapy 6 months ago, I have only slept 4 to 5 hours straight on 2 occasions. The rest of the time, I sleep around 1 to 1.5 hours before waking. I do go back to sleep, sometimes right away, sometimes after an hour or longer, but I am always worn out during the day.

I have worn the mask all night, every night, since the first night, and accept the treatment gladly. I am anxious to begin feeling better. My Pulmonologist/Sleep Doctor recommends that I see a sleep therapist. I don't think I have mental problems, just mechanical ones. I have read everything I can get my hands on concerning good sleep hygiene, and I already practice those things.

Do I need to change doctors, or does anyone have any ideas for me to resolve my fragmented sleep?

Hi M'Ohm's,

Welcome to the forum. As one who has experienced similar issues, I really empathize with your struggles.

Unfortunately, there could be many issues why this is occurring and it can be hard to pin down. Definitely agree with Den about providing data and keeping notes on what the issues might be.

I know from personal experience when you don't sleep well, it is hard to keep all the issues straight. So that is why writing things down is helpful.

My first question would be is your mask comfortable? I assume it is since you have worn it every night but since I feel that mask comfort is a major issue in tolerating pap therapy, I thought I would ask.

Unfortunately, many sleep doctors are not capable of helping their patients troubleshoot their issues even when their intentions are good. It is simply easier for them to refer you to a sleep therapist. In some situations, that may be warranted but in other cases, it isn't what you need. That is why this forum is so valuable.

Best of luck to you.

49er

[Todzo]

I have been reading the forum for the past 6 months after starting CPAP therapy, and this is the first time I have posted a question.

I started on CPAP, then APAP, and am now on straight Bipap (for the last 6weeks) with settings of 12/16 with low AHI's typically under 3.0. The majority of my events are CA's, but I still have clusters that include OA's, H's, and RERA's. Since starting therapy 6 months ago, I have only slept 4 to 5 hours straight on 2 occasions. The rest of the time, I sleep around 1 to 1.5 hours before waking. I do go back to sleep, sometimes right away, sometimes after an hour or longer, but I am always worn out during the day.

I have worn the mask all night, every night, since the first night, and accept the treatment gladly. I am anxious to begin feeling better. My Pulmonologist/Sleep Doctor recommends that I see a sleep therapist. I don't think I have mental problems, just mechanical ones. I have read everything I can get my hands on concerning good sleep hygiene, and I already practice those things.

Do I need to change doctors, or does anyone have any ideas for me to resolve my fragmented sleep?

First guess, ventilatory instability.

It sound like your doctor is making a lot of good efforts. In that regard, could you tell us a bit about how you came to have your current machine - from the top - from "this CPAP machine is not working for me too good Doc ...". I would love to hear how it went for you.

Thanks!

Todzo

[M'ohms]

I would think that there SHOULD be some clues in your reports.
Sleeping position?
Do the awakenings coincide with the clusters (or leaks)?
Leaks and leak rates?
Do you have a pad and pencil next to the bed to make notes of when you awaken? Might not hurt.

Could you post one or more "typical" reports from some nights?


Den

Thank you for your reply!
I have been sleeping in a recliner for the 9 months, off and on before that. Although I do have clusters, my wakes are consistent enough that nothing seems to coincide with them. I wear a QFX FFM and my leak rate is usually 40-45ish; well below what EncoreBasic flags as normal. If something unusual happens during the night, I make a mental note of it and the time and check it against my reports first thing in the morning. Nothing stands out...
I will try to post some data later.

[M'ohms]

After 6 months of pressure therapy, you should by now be feeling better. Were or are you a shift worker? I'm wondering if it could be a body clock issue. Are you taking naps during the day more than 20 or 30 minutes long? Timing is very important. Are you turning in at approximately the same time everyday? Are you under a lot of stress? What is your aerobic activity schedule if I may ask?

Thanks, Jim, for your interest!

I am currently a stay-at-home gal who lives with my mom and husband. I help my mom take care of her home on 4 acres, so yes, I do get exercise! I do not nap during the day. I was never a shift worker.

I must say that I felt better before I was diagnosed with moderate OSA than I do now. I suffered for 5+ years before I could get a doctor to pay attention to my complaints! Now, I am in a fog and poop out by 3:00 in the afternoon.

[M'ohms]

My first question would be is your mask comfortable? I assume it is since you have worn it every night but since I feel that mask comfort is a major issue in tolerating pap therapy, I thought I would ask.

Unfortunately, many sleep doctors are not capable of helping their patients troubleshoot their issues even when their intentions are good. It is simply easier for them to refer you to a sleep therapist. In some situations, that may be warranted but in other cases, it isn't what you need. That is why this forum is so valuable.

Thanks for responding, 49er!

Mask: In the sleep lab, I was given a Quattro FFM since my mouth opens when relaxed. I used that one until I wore a hole on my nose. RT gave me a Swift FX; couldn't keep my mouth sealed. Then Respironics Gel Blue--didn't fit. Finally settled on Quattro FX. I got a size large, even though the RT told me I needed a medium, so that the bottom of the mask cups my chin. Perfect!

[49er]

My first question would be is your mask comfortable? I assume it is since you have worn it every night but since I feel that mask comfort is a major issue in tolerating pap therapy, I thought I would ask.

Unfortunately, many sleep doctors are not capable of helping their patients troubleshoot their issues even when their intentions are good. It is simply easier for them to refer you to a sleep therapist. In some situations, that may be warranted but in other cases, it isn't what you need. That is why this forum is so valuable.

Thanks for responding, 49er!

Mask: In the sleep lab, I was given a Quattro FFM since my mouth opens when relaxed. I used that one until I wore a hole on my nose. RT gave me a Swift FX; couldn't keep my mouth sealed. Then Respironics Gel Blue--didn't fit. Finally settled on Quattro FX. I got a size large, even though the RT told me I needed a medium, so that the bottom of the mask cups my chin. Perfect!

Thanks for letting me know M'ohms. Hopefully, we can help you figure out what is going on.

49er

[M'ohms]

It sound like your doctor is making a lot of good efforts. In that regard, could you tell us a bit about how you came to have your current machine - from the top - from "this CPAP machine is not working for me too good Doc ...". I would love to hear how it went for you.

Thanks, Todzo, for your reply.

Titration: 2:00 sleep tech gave me an Ambien saying that she needed me to go to sleep before the night was over...typical of my nights (minus the meds). Needless to say, she got minimum data on me and I was given an Rx pressure of 10. I got a PRS1 560 CPAP Auto, pressure 10, and struggled with that for 5 weeks, no improvement. Follow-up to doc with an increased pressure of 12, then 14. Developed aerophagia, so doc moved me to PRS1 760 Bipap Auto, pressure. 12/16. Aerophagia has diminished, and I like the pressure. My overall experience is positive, in large part because I read this forum everyday and don't feel alone , but I still can't stay asleep.

[M'ohms]

My day has begun, so I will try to post some data later on when I can get back to my computer.

[M'ohms]

This is from last weekend, an example of a night that I got no sleep:

[img][IMG]http://i774.photobucket.com/albums/yy29 ... 8886f5.jpg[/img][/img]

And this is from last night (better than average):

[img][IMG]http://i774.photobucket.com/albums/yy29 ... 8886f5.jpg[/img][/img]

Last night I had my usual nightly routine--sleep an hour, wake, sleep an hour, etc.

OOPS. SEE BELOW...

[M'ohms]

Sorry, I didn't do that quite right. Here's the No Sleep version:



and here's last night's version:

[M'ohms]

One more for good measure, this time clusters from night before last: