Waking after 2-4 hours on bipap

[awgideon]

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I have been trying for years to use Bipap but hiatal hernia prevented it. I have the acid reflux under control and am using Resmed Aircurve 10 Vauto epap 4 inpap 10 ps 2.
I can only sleep for a couple of hours 2-4 then something wakes me up. I have a lot of clear apneas. I feel like I'm starving for air. Mask in comfortable. Resmed f20. No leaks and breathing easily .
Trying to understand what is waking me up.

[Miss Emerita]

Welcome! It'd be helpful to get a little more information from you. Did you have a sleep study, and if you did, do you know what your AHI was and what the breakdown was (obstructive apnea, central apnea, hypopnea)?

Those central (clear) events may not mean very much. They are pauses in your breathing of 10 seconds or more that are not associated with an obstruction or restriction in the airway. They are not uncommon when we're falling asleep, as the neurochemical hand-off from our waking systems to our sleeping systems occurs. They are also not uncommon when we are being briefly aroused from sleep. (We may not even remember those arousals.)

It seems as though you have two questions. One is about feeling air-starved, and the other is about the wake-ups that end your night's use of the machine.

Slightly higher pressures might help you with the feeling of being starved for air. And the one thing I see shortly before the end of your session is an abrupt change in pressure, which may have awakened you.

So if you'd like to try an experiment, I'd suggest setting your minimum EPAP to 5 and your maximum IPAP to 7, leaving your pressure support at 2. This will raise your minimum a little bit and eliminate pressure changes.

But there's another question lurking in the background. When you wake up, why don't you just leave your mask and machine on and try going back to sleep?

[awgideon]

I do try to go back to sleep a couple of times I did go to sleep for another hour or two. Most times am wide awake. I have a sleep study from 2012 and a new one from 2021.

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[Pugsy]

Do you take any medications of any kind? If so, what?
Any other physical or mental health issues going?

Any issues with mask comfort, leaks, cpap pressures, bed comfort, aches and pains?????

[awgideon]

No to all those questions on comfort. I'll try again tonight. If I have problems again, I will try increasing the pressure. I take benicar, allopurinol, pepcid, protonix, aspirin,singular, carvedlol and flomax. Had a triple bypass 31/2 years ago and gall bladder removed 3 years ago. That's all I can think of that would affect my sleep. I am retired and no major stress right now.

[Miss Emerita]

The summary for your home sleep study doesn't provide a breakdown of events. I do nonetheless think it'd be good to focus less on the central apneas and more on getting comfortable with all-night use.

Please review your meds with your doctor to see whether there are any side-effects or interactions that could be interfering with restful sleep.

In addition to the experiment I suggested, you might want to set your machine up outside your bedroom during the day or evening and use it while you read or watch TV. This can help you get used to it so it'll be less bothersome to you at night.

It's important to make this work, especially given the oxygen desaturation levels you experienced during the night of your sleep study. We're here to help however we can.

[Pugsy]

Some meds that are known to affect sleep...either keep us from falling asleep easily (sleep onset insomnia) and/or staying asleep (sleep maintenance insomnia).
While not likely that your meds are 100% the problem they could be aggravating things and a potential factor.
You've been taking them for a long time and probably not noticed a problem sleeping but perhaps combined with all the newness of cpap therapy and having the alien plastered on our face they can be a factor in waking up earlier than we might want. Combination of culprits perhaps.

https://www.goodrx.com/blog/could-your- ... -insomnia/

https://www.aarp.org/health/drugs-suppl ... omnia.html

[awgideon]

Thank you to everyone. A lot of good advice and a lot to think about. I will check on my meds and try your recommendations.