snore index

JohnCatt · Post by **JohnCatt** » Wed May 24, 2006 7:48 am

Hi, everyone. I've been analyzing my smart card results and have a question.

My APAP is presently set at a minimum pressure of 9.5. My AHI numbers look great (consistently around 1.0), but I'm still doing a fair amount of snoring (snore index usually 8-11) . My sleep is still disturbed (waking up after 3 hours and not being able to fall back asleep for a good while) and I'm wondering if reducing my snoring might help me stay asleep.

So here's the question: I have noticed that ALL my snoring comes at 9.5-10.5 pressure. When the APAP kicks up to 11 or higher, the snoring COMPLETELY disappears. Would it be a good idea to bump my minimum pressure to 11.0 in the hopes that snoring would almost totally stop and my AHI would stay low?

Any advice will be greatly appreciated!

John

Bonnie · Post by **Bonnie** » Wed May 24, 2006 8:34 am

I remember being concerned a while ago with high snore numbers. Rested Gal posted that the Remstar Auto picks up a lot of noises that are not necessarily snores.

The beauty of the Auto and the ability to read your numbers is that you can make adjustments. Maybe try upping it 1 and read the data for several days and then upping it again if needed. Seeing that it is such a small incriment rather than say going from 5 to 11, I think you'll be fine.
Keep us posted.

As to waking up and not falling back asleep, that could me a whole different issue.

Celic · Post by **Celic** » Wed May 24, 2006 11:00 am

I will jump out of lurker mode.

I have the same REMstar (replaced my old CPAP 2 months ago) and have made similar observations. As an experiment, I removed the humidifier for one night and my Snore Index went up into the 22 range. If the pressure was 8 or 9 (I did not go lower), the SI was high. If pressure went to 10, the SI went below 1. I could see that the machine was reporting snores right after I turned the machine on and I know I was awake for a while. I wondered how the machine could determine if the humidifier was installed or not since so I completly removed the humidifier base from the unit and got the same results. My prescription is 9 and I currently have the machine set for 8-12. I THINK I have seen this issue with two different masks.

If the vibrations were inside the machine, I would have expected it to act the same with the humidifier installed or removed unless the presence of the humidifier changes the vibration. maybe I will try putting a couple books on the machine with the humidifier removed tonight to see if it changes anything. Now you have me wondering again.

I was just thinking you might be seeing something similar to what I am seeing.

Celic (Steve)

JohnCatt · Post by **JohnCatt** » Thu May 25, 2006 7:13 am

Well, I upped my minimum APAP pressure from 9.5 to 10.5 last night. AHI stayed low (less than 1.0), but snore index dropped from my usual 9-11 to less than 1 (!). Alas, I still woke up a couple times during the night (usually 2am and 5am).

Here's my dumb followup question: if my AHI is already less than 1, will a dramatic reduction in snoring actually improve my quality of sleep and ultimately reduce my awakenings, or is the prime beneficiary of not snoring going to be my wife?

Thanks to everybody who replied. I'd love to hear your take on what snoring less will actually "do" for me.

John

Goofproof · Post by **Goofproof** » Thu May 25, 2006 7:57 am

What is your pressure range total? In your case I would use 9.5 to 12, snores can be recorded from moving the hose, IE, draging it on the headboard, when awake we move around, thast could account for snores.

I have found that the less the snore rate the more restful the night, A AHI of 1, isn't anything to Snore about. Jim

Bonnie · Post by **Bonnie** » Thu May 25, 2006 10:19 am

Your wife would be the best indicator of your snoring. Does she actually hear you snoring? Your AHI number is very good, I really don't think you are waking because of anything to do with the pressure or snores. You need to now concentrate on finding out why you are waking up. Give us some clues, how do you feel when waking? Noises? Depression, hunger or thirst? Anything?

JohnCatt · Post by **JohnCatt** » Thu May 25, 2006 3:21 pm

Bonnie...I'm very much trying to figure out why I wake up. I was hoping it would be correctable by ramping up my pressure, but (admittedly after just 1 night), so far it seems it doesn't have anything to do with my apnea.

What do I feel like when I wake up? Well, it's almost always 3 hours after I've first fallen asleep. I feel "alert". Not anxiety, not hungry, don't have to go to the bathroom, I'm just awake. On a good night, I fall back to sleep within 15-20 minutes...on a bad night, it may take me 2 hours to drift off again. Very frustrating. Full disclosure: I'm also taking Trazodone and Lunesta, which seem to knock me out enough to fall asleep, but aren't helping me stay asleep.

Those are the only clues I can give you. Any thoughts?

Your AHI number is very good, I really don't think you are waking because of anything to do with the pressure or snores. You need to now concentrate on finding out why you are waking up. Give us some clues, how do you feel when waking? Noises? Depression, hunger or thirst? Anything?

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI[/quote]

brasshopper · Post by **brasshopper** » Thu May 25, 2006 3:57 pm

Normal human sleep patterns are, as I recall, you go to sleep - go through 1, then stage 2, 3 and into 4 - this is deep sleep - you then rise out of 4, back to 3, then 2, then 1. At this point you are likely to have some REM associated with your state 1, (I have heard what used to be called "stage 1 REM" called stage 5), and perhaps you will experience the associated tumescence. At this point you wake up - just a little, and you check your surroundings.

See Wikipedia's article on sleep for more information.

Now, these cycles generally take 70-90 minutes. Check the box diagram - At the end of REM, many people wake up, check their surroundings for things like wolves and bears and then go back to sleep. This is a survival characteristic. If you notice the tribe being attacked you can sound the alarm!

It sounds to me like you are going through two cycles and then becoming "disturbed" - perhaps at the end of a full sleep cycle, which is when you would expect to wake. Generally, people just go back to sleep without remembering that they have woken up, unless they think that something odd might be happening - note that in some primitive cultures, people actually wake at this time and engage in some activity then go back to sleep.

I hate to say it, but I think this is normal. Something about your environment is telling your body that it is time to rouse the tribe or, at least, to check out the world. It might be the mask, it might just be the way you are. It might even be an environmental sound. One thing for sure is that if you become upset by it, you will be upset by it and you won't be able to get back to sleep

JohnCatt · Post by **JohnCatt** » Thu May 25, 2006 4:20 pm

Brasshopper...thanks for your thoughtful reply. I agree with pretty much everything you said. I knew a bit about sleep cycles, and it does indeed seem to me that I can't go smoothly from Cycle #2 to Cycle #3. The timing of the awakening is VERY consistent.

I used to have night terrors, which always occured early in the night...for whatever reason, they always happened right after I completed my first 90 minute cycle. I had these for years....oddly, I have not had a single one since I started CPAP about 18 months ago.

And you hit the nail on the head: I do get irritated when I wake up at 2am and my stewing about it makes it that much harder to fall back to sleep. I have concluded that being pissed-off is not conducive to falling back asleep! I need to work on not panicking when I awaken after my 2nd sleep cycle and allowing myself to drift off again. Easier said than done, of course!

Thanks again!

John

roztom · Post by **roztom** » Thu May 25, 2006 7:20 pm

I have the issue of waking up thru the night. I had hoped xPAP would take of it but I still wake up.

It can be almost anything: a little mask leak, a noise, the wife bumping me -anything.

I have tried wearing an eye-mask so I wouldn't wake at dawn and buying a white-noise generator to drown out the birds. I still wake at 2-3am and also a dawn 5-6am.

I'm not sure why it happens and wish it didn't. I used to get frustrated about it and lay there angry, especiqally when I got to bed at 11p and wake up at 2am and think it's time to get up. Usually I get back to sleep fairly quickly. I cannot remember sleeping thru a night. I wish I could.

I do not take anything to induce sleep -it's not falling asleep that's the issue, it's the fragmented sleep. It is better than it was with xPAP but not perfect.

Tom

brasshopper · Post by **brasshopper** » Thu May 25, 2006 7:49 pm

I don't have formal training, but I've watched more eeg paper peel off than most people - and I can tell you that waking up several times a night is normal - most people - even those without apnea, with perfectly "normal" sleep patterns, wake several times a night.

The difference between you and them is that you remember waking. They don't.

Probably if you looked at an eeg, you'd never get to the state where your attention was "grabbed" by anything - most people get into alpha (see: http://en.wikipedia.org/wiki/Electroencephalography) and then drift back into sleep after a short time.

Bonnie · Post by **Bonnie** » Thu May 25, 2006 9:47 pm

Here's a solution, when you are lying there trying to get to sleep, tell yourself you might as well get up and do a few loads of laundry, clean the bathroom or maybe paint the hall way. I bet you fall asleep real fast!

brasshopper · Post by **brasshopper** » Thu May 25, 2006 9:56 pm

Gosh, maybe those technical reports I never read back when I was supposed to have some use after all.

snore index

snore index

Normal human sleep patterns

waking through the night

Falling asleep