1 year on CPAP, still very restless sleep

[manacles]

I've been on CPAP since March 2022 and despite OSCAR showing great results (AHI <2) my sleep quality still feels pretty terrible, just slightly better than how I felt before starting CPAP therapy. I've been using a Resmed Airsense 11 with a full face mask, as even though I breathe easily with my nose every nasal pillow mask I've tried seems to make my sleep worse. I wake up multiple times a night, every 1-3 hours, and feel very drowsy whenever I wake up. Usually I won't be able to get out of bed and just fall back asleep but sometimes it is an effort to fall back asleep as well. In total, I'll get 9-11 hours of sleep a night but never really feel rested or awake. I"m also dealing with some pretty bad aerophagia, and trying different levels of EPR doesn't appear to affect it while also making my sleep even more disturbed. I've also noticed that my heart rate will frequently spike to over 100 bpm, which is concerning as my resting heart rate is usually in the 50's-60's. My sleep doctor couldn't find anything wrong with a repeat sleep study, and I've asked on other forums to no avail before finding this one. I have a generally healthy lifestyle, though being excessively tired does negatively impact my daily life, and try to go to bed every night, though anxiety causes me to take a very long time to fall asleep. Are these problems worth getting a second opinion on from a new sleep doctor? I've attached my last night's data from OSCAR, with breaks whenever I wake up in the night. During that night, according to my Apple Watch, my heart rates were very high between 2-5 (80-130 bpm), and lower for the rest of the night (50-60). Looking for anyone who has similar experiences or advice that they can share, anything would be appreciated, different settings, equipment, etc.

[ChicagoGranny]

I've attached my last night's data from OSCAR

Welcome!

You seem to have forgotten to attach it.

[manacles]

Ah well, apparently the board attachment quota has been reached so I can't post it.

[Pugsy]

Ah well, apparently the board attachment quota has been reached so I can't post it.

Well....there are other options available.
Anywhere on the internet that lets you host images.
viewtopic/t183806/Attachment-storage-is ... MENTS.html

[Pugsy]

Do you take any medications (even OTC) and if so, what?

Any other physical or mental health issues going on?

Your age and gender?

[manacles]

My primary prescribed my Trazodone for sleep, but I've only used it once. Also Flonase for my sinuses but i've since stopped since my sinuses never gave me any issues. Other health issues i'm not sure about, my mental health feels pretty off but i'm not sure if it's just because i'm really tired. I'll try to look for a therapist or psych in the meantime. 25 male

[manacles]

https://imgur.com/a/uOpBIFI This is the oscar data

[manacles]

https://imgur.com/a/Xnx9wQQ here's last night's data as well

[Miss Emerita]

Aerophagia can show up at one pressure setting and disappear at another setting just a little bit lower. So you might want to try finding the point at which your aerophagia disappears (or becomes nothing worse than a nuisance). I'd suggest setting your min = max = 6. You'll probably get more OAs/Hs/FLs, but if this pressure manages your aerophagia successfully, you can then start edging upward by .2 increments to see whether you can hit a sweet spot with an OK AHI and OK aerophagia.

It is normal to wake up from time to time during the night. Some people wake up after every REM cycle, for example. But if you wake up and stay awake for long periods of time, or wake up so frequently that your sleep cycles are disrupted, then that's a problem.

Have you tried cognitive behavioral therapy for insomnia? More information here:

https://www.sleepfoundation.org/insomni ... y-insomnia

As for getting a second opinion from a different sleep doctor: sure, why not!

[kteague]

Haven't searched to see your prior posts, just throwing out that periodic limb movements can cause fractured and unrestful sleep and has been associated with increased heart rate when active. Has this been ruled out for you?

[manacles]

I'm not certain about the movements, but I think in my first sleep study they said there was no indication of restless leg syndrome if that's at all similar.

[manacles]

Apologies for the long absence, had a vacation and then got sick. I've been trying the titration from constant 6.0 pressure and I've found that my aerophagia gets pretty bad as soon as I hit 6.2. Even at 6.0 I still have aerophagia but it doesn't seem to be enough to cause discomfort, but still a lot of burping and farting whenever I wake up. For the past couple of weeks I've been sticking to constant 6.0 because it seems to have the best effect on my heart rates as well, with my averages now generally in the 60-70s though with some intermittent spikes. This does cause me to get a lot of flow limits but I feel like I'm in a catch-22 of either having too high pressure causing horrible aerophagia and too low pressure causing flow limits. Regardless of pressures I still do wake up frequently, generally with a pattern starting once I hit 5-6 hr of sleep and then I keep waking up every hour or so after. I still generally feel tired during the day, but I think it's still better than before, these days I usually get 8.5-9 hours of sleep and not feel like passing out which I think is an improvement. I definitely would really appreciate more advice though in trying to make things better, and have attached some nights here.

https://imgur.com/a/mPWHQOW (and why did Imgur flag my content as adult?)

[ChicagoGranny]

(and why did Imgur flag my content as adult?)

You checked the Mature block.

[manacles]

Hmm, I don't know how I could've done that considering I didn't even notice that haha, but in any case the content warning is gone now...

[manacles]

So last night I also tried using the AirFit P10 instead of my usual AirTouch F20 full face mask. I didn't wake up as much during the night and my AHI seemed to really improve. However, I still got about the same amount of aerophagia and slept a lot longer for some reason. In addition, I was getting heart rate spikes again, with my average BPM last night being 86. I also don't really feel more rested, I'm starting to think whatever is causing my heart rate problems is having the biggest effect on my sleep quality, but I can't seem to track down the source of those problems at all. Looking for any advice.

https://imgur.com/a/sllCnhM