New to CPAP

[dumborat]

You all are so helpful, and I am so obsessed with looking at my data in SleepyHead, that I thought I would ask some questions just to see if I am on the right track. Backstory: I am 23 and have had severe fatigue since my teenage years that has gotten worse and worse, and I got diagnosed with OSA a couple months ago. I just started CPAP on Thursday, you can see my equipment in my profile (edit: If my machine says 560P on the bottom, it's the 60 series, right?)

I forgot to ask what my AHI was before starting CPAP, though my pulmonologist said that it was "mild" which I guess would put it anywhere from 5-15. (I will make sure to ask about it on my follow-up visit.) My pressure was titrated to 10cm H2O during my second sleep study, the pressure where my doctor said I had zero apneas even while lying flat on my back.

My AHI on each day has been 0.48, 0.69, 0.39, and now 1.72 last night into this morning. Is that increase something I need to worry about? I know it is still excellent, but the increase worried me. Could it just be because I am finally sleeping more deeply? I got a "boppy pillow" - one of those U-shaped pillows for nursing mothers and babies, and it helped me a lot because I could finally sleep comfortably on my stomach and side while letting the mask hang into the space in the middle. I feel excellent so far today!

I know that some of the events are falsely reported, because I can look at the chart and see that they happened while I was awake reading on my iPad before sleep.

Is it normal to still be tired and napping during the day? I am trying to just listen to my body and give it all the sleep it needs, because I imagine that it needs to catch up a lot. Thankfully since I am on summer break from college I can stay home and rest all I need.

What is a good leak rate for my equipment? I attached an image with my basic statistics in case there is anything I should look into more. (I used to have ramp on but I turned it off because it made me feel like I was suffocating.) I can upload more images if there is anything I should be concerned about. I know that my data is probably really good, but I need reassurance.

[HoseCrusher]

I think you are doing just fine. You can expect fluctuations from night to night and that is considered normal. If you want to obsess a little, you can graph the daily numbers and see if there is any trend.

[kteague]

So you are using an auto range of 4-10? I f that is correct, consider increasing your lower pressure a bit ( like 6 or 7 ) and if the machine senses impending trouble and a need to increase pressure, it won't take as long to reach an effective pressure. Auto machines are methodical and incremental in their increases so reducing the response time seems only logical. Also, when I used an auto, I found it helpful to keep the top number in my range just a bit over what I usually needed, just for those once-in-a-while times I needed more - probably while supine in REM. All that said, I agree with the prior poster who said to expect variances in your nightly pressure. We don't sleep the same every night. Now if your upward trend were significant and continuing an upward trend, that's another story. But I'd be more concerned about the duration of those few events. Once you dial in your personal most effective pressure range and are consistently getting adequate hours of sleep, your need for extra sleep should decrease. At this point, I agree with your philosophy of giving your body what it tells you it needs as far as naps - as long as it isn't interfering with your ability to go to sleep and get sustained sleep at night.

[dumborat]

Thanks for the replies, both of you!

Sorry for the confusion, I am using a constant pressure of 10. The 4 remaining there is from when I was using the ramp feature the first few times. I stopped using that because I felt like I was suffocating (even when I put it to start at 6 or so), so now I just have it start at 10.

How long is long enough to be concerned about? Is the number next to the event in the SleepyTime event log the length of the event? Looking at the flow rate graphs, it looks like most of my events last around 10-15 seconds. I know 10 is the minimum to even be scored as an apnea, so that doesn't sound too bad. If I'm reading it correctly, anyway (looking at the time the line is flat). On some of the graphs it doesn't look like anything different happened at all.

Here is a scored event from when I was actually asleep:



Right now it's still a little hard to get a nice sustained chunk of sleep, because of the machine, I think. It seems hard to stay asleep for more than 4 hours. I'm hoping that once my body adjusts to the machine, I'll be able to get more sleep at one time and not have such an urge to take a nap anymore. I have a very bad sleep cycle, though. I'm not even quite sure what my body considers to be "night" these days (especially because of being off from in-person school).

[SleepWellCPAP]

Statistically, I would agree with Hosecrusher, in my opinion you're doing off the charts good!

Your body clock should reset between one and two weeks, provided if you do take naps, they are not longer than the standard 15 to 30 minute power variety.

Good luck!

[dumborat]

Thank you! Logically I knew the numbers are, indeed, excellent, but I still had the need to ask.

Urgh, I guess I need to find a way to not nap that long, then. I nap for about 2 hours, and I guess it's messing everything up by making me need less sleep at night, which in turn makes me tired and need a nap the next day too. Right now it's just so, so hard not to go lie back down. Even my initial dislike of the mask couldn't stop me.

Thankfully, my naps are shorter and more energizing than pre-CPAP, so maybe that will continue to make things easier. Before, particularly recently when my tiredness has been at its worst, I would just pass out for hours and hours and still feel terrible. I did not understand how it was possible for one human to even be capable of that much sleep... it makes sense now, because I suppose it wasn't really sleep.