Just getting started - advise appreciated

[steveko23]

Here's a sample of my OSCAR data along with my apple watch report of my sleep: https://imgur.com/a/lGNLAy1

Basically here's me situation I haven't really slept well in 10-15 years, finally got a sleep study done and was diagnoses with sleep apnea and 2 weeks ago received my AirSense 10 and have been attempting to get some better sleep to no avail. Most nights I wake up every hour or so, maybe as long as 2 hours between but that's rare. When I do wake up some times i can fall back to sleep right away and sometimes I'm laying there for what seems like a long while. When I'm laying there for a long while I end up taking off my mask finding a different sleeping position and falling asleep. I end up waking up 30-60 min later and I'll put the mask back on and repeat the process throughout the night. So this particular night it looks like I had the mask off 3 different occasions and this was actually one of my best nights honestly. I have hit 4 hours each night and looks like I avg 5.2 hours with the mask on over the course of at least 8 hours in bed. I do end up taking the mask off because I find it hard to exhale at times. It seems like one of my nostrils gets stuffed up. I saw something in one of the getting started posts about and exhale relief system that you can enable, is that an option for my machine? I'm not seeing anything like that in my settings.
Is it a problem that I'm wearing the mask part of the night and not the full night? Obviously I'm not getting the full benefits though at this point I'm not seeing any change wearing the mask vs not wearing the mask. Is there anything in my graphs that would indicate as to why I'm waking up every hour? Last night for example I'm pretty sure I looked at my watch at exactly 1:12, 2:12, 3:12 and I think maybe 12:12 or 4:12. What is going on with my body to so precisely wake up every hour?

Thanks!
Steve

[LSAT]

Go into your settings and find EPR.....That is the pressure relief. You can set it to 1,2,3,. That's the amount of pressure reduction when you exhale.

[Miss Emerita]

Your minimum pressure and your median pressure are 5. This is a pressure so low that it can make some people feel air-starved. I'd recommend raising your minimum to 7. You might sneak up on that by starting with 6.

I agree that EPR might make you more comfortable, as LSAT has suggested. Please be aware that 4 is the lowest the machine can go. So if your pressure is 5, the most EPR the machine can deliver is 1.

It's actually common to wake up often and on during the night. Many people wake up after each period of REM sleep, and the timing of your wake-ups suggests that maybe that's what's going on with you. What's important is being able to roll over and go right back to sleep. I hope that with a few little changes to your settings, that's something you can do more often.

Taking off your mask deprives you of therapy for your sleep apnea. It also trains your mind and your body into some bad habits, so do try to keep your mask on.

[Pugsy]

Is it a problem that I'm wearing the mask part of the night and not the full night? Obviously I'm not getting the full benefits though at this point I'm not seeing any change wearing the mask vs not wearing the mask.

You can't expect to see much improvement in how you feel with such short hours using the mask and machine.
So yes....it's a problem not wearing the mask all night while asleep. It's hard enough to see improvement even with 7 or 8 hours of sleep using the mask and machine.

Is there anything in my graphs that would indicate as to why I'm waking up every hour?

No...not really because the machine only measures air flow (breathing) and it can't even tell if we are asleep or not...much less what might have caused us to wake up except maybe if we see evidence of a lot of apnea events maybe causing the wake ups and I just don't see that much going on with the report you shared.

Some questions...
1...Do you take any medications of any kind (even OTC) and if so...what? Name and dosage please.
2...Do you have any other physical or mental health issues that might be messing with your sleep quality or causing wake ups?
3... You probably have both sleep onset insomnia (trouble falling asleep) as well as sleep maintenance insomnia (trouble staying asleep). Google both and read up on them so you understand them. While you may not have that big of a problem at the very beginning of the night with sleep onset insomnia you do have it when you wake during the night prematurely and can't fall right back to sleep.

What is going on with my body to so precisely wake up every hour?

Unknown at this time. You are going to have to do some detective work and try to figure out what might be going on.

I saw something in one of the getting started posts about and exhale relief system that you can enable, is that an option for my machine? I'm not seeing anything like that in my settings.

You do have that option on your machine....it's called EPR or exhale pressure relief and it looks like it is already enabled and set to 3 but here's the deal...at your current settings you aren't getting full benefit because your starting pressure (once ramp is over with) is 5 cm and the machine can't go below 4 cm so you are only getting a 1 cm drop initially (once ramp is over) and that's not much relief at an already low pressure.

I suggest setting the minimum to 7 cm so you can get the full benefit of EPR at 3 and it may also help with the exhale issues you are having. Test it out during the day while awake and under no pressure to get to sleep and see how it goes.

Turn the ramp feature off if you can...that low starting pressure of 4 could also be a factor in the exhale issues.
Most people find that 4 or 5 cm pressure simply isn't enough air movement to be all that comfortable.

Do you have the provider/clinical manual for your machine? It's different from the typical user manual you probably got. It explains the secret handshake to get into the clinical setup menu to change the settings.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

Did you have a home sleep study or one done in a lab setting?
What were the results?

Roll up your sleeves and get prepared for some work and try not to expect overnight miracles.
Insomnia of any kind is a real SOB because not only do we need to fix it...we have to first try to figure out what is causing it so we can even try to fix it.
Plus sometimes when we do know what the problem is....it isn't always so easy to fix it. Been there and done that myself so I know first hand how hard it is to fix even a known problem.

[steveko23]

Thanks so much for the replies!!

1...Do you take any medications of any kind (even OTC) and if so...what? Name and dosage please.

No medications of any kind.

2...Do you have any other physical or mental health issues that might be messing with your sleep quality or causing wake ups?

Not that I'm aware of. I'm 46 yr old male, 6'1, 210lbs. Not in my best shape, but not in bad shape either. I do have 2 large labs who sleep in bed with us, though I don't think they move around much during the night and they tend to lay on my wife because I kick them off me. But I can try sleeping in our spare bed to take them out of the equation for a bit.

3... You probably have both sleep onset insomnia (trouble falling asleep) as well as sleep maintenance insomnia (trouble staying asleep). Google both and read up on them so you understand them. While you may not have that big of a problem at the very beginning of the night with sleep onset insomnia you do have it when you wake during the night prematurely and can't fall right back to sleep.

I will look into these. My ability to fall back to sleep varies quite a bit as well. I normally wake up probably 5-10 times throughout the night (just kinda guessing here) and I'd also guess that I fall back to sleep fairly quickly many of those times. Maybe once a night I cannot. Maybe less, but I'll research that.

Do you have the provider/clinical manual for your machine? It's different from the typical user manual you probably got. It explains the secret handshake to get into the clinical setup menu to change the settings.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

I will have to look into that manual to see how to get into the secret menu options as I don't see anything like that in the basic settings I currently have access to. I can turn the ramp feature off though with what I can access easily.

Did you have a home sleep study or one done in a lab setting?
What were the results?

It was a home study where I wore a bunch of stuff. When I woke the next morning I could swear I didn't sleep one bit. But my results said I had: 0.1 OA, 7.6 Central Apneas, 20.5 hypopneas for a total of 28.3 per hour. Is that what you were asking about?

Roll up your sleeves and get prepared for some work and try not to expect overnight miracles.
Insomnia of any kind is a real SOB because not only do we need to fix it...we have to first try to figure out what is causing it so we can even try to fix it.
Plus sometimes when we do know what the problem is....it isn't always so easy to fix it. Been there and done that myself so I know first hand how hard it is to fix even a known problem.

Yeah I'm all for putting in some work, I was SUPER excited for the cpap machine because I thought as soon as I put it on I'd sleep through the night and all would be well. I will try and dig into the insomnia issues and see what I can find and I'm sure will have more questions. I'll also attempt to keep the mask on all night, though I fear at least in the near term that will mean slightly less sleep as it'll take me longer to fall back to sleep during my random wake-ups.
I do need to figure out the rainout situation as well as I do get some droplets of water which I may struggle to resolve as I like to sleep with a fan blowing on my head and I'd imagine that's not helping the situation.

[Pugsy]

I do need to figure out the rainout situation as well as I do get some droplets of water which I may struggle to resolve as I like to sleep with a fan blowing on my head and I'd imagine that's not helping the situation.

Short on time but this is a quick easy thing to address.
See this thread my posts number 2 and 3
http://www.cpaptalk.com/viewtopic/t9403 ... -road.html

You have multiple options depending on whether or not your hose is heated or not heated.
If you have a heated hose the easiest thing to do is just crank up the hose air temp.
I have lots of experience with rain out because I use max humidity and like a cold bedroom.

Your fan isn't hurting things all that much. It's your overall bedroom ambient temperature that is the culprit.
If you like and need that fan...then use it and heat up that hose air a bit. You gotta be comfortable to sleep and without sleep not much else matters.

Gotta run...busy day today but I will be home later tonight.

[Miss Emerita]

To get into the clinician menu, hold down the home button and the round dial for a few seconds until the option appears on your screen. Don't forget to exit it it when you're done.

In your place, I would definitely try sleeping in the spare room while you're getting on track with CPAP.

[steveko23]

You have multiple options depending on whether or not your hose is heated or not heated.
If you have a heated hose the easiest thing to do is just crank up the hose air temp.
I have lots of experience with rain out because I use max humidity and like a cold.

I believe I have a heated hose. At least I have the config option to turn the hose heat on at a specific temp so I’m assuming that does what you’re asking. I also like the room cold but i will try turning the hose heat up to see about the rainout. I had a ton of moisture last night felt like I got soaked. When that happens is the only thing I can do is try and shake out the water and put the mask back on?

[Pugsy]

I had a ton of moisture last night felt like I got soaked. When that happens is the only thing I can do is try and shake out the water and put the mask back on?

Yep...that's about all you can do. I have had it so bad at times I had to take the hose off and hang it upside down and let all that water drain out.
Preventing the condensation in the first place is the better choice and for sure less disturbing to a person's sleep...or in my case it also disturbed hubby's sleep from the freight train in the hose.

If you have hose air temp options available on the menu....you have a heated hose.
Just crank up the hose air temp.

[steveko23]

Set hose temp to 78 and no rain out. Kept mask on from 10-5 then ended up sleeping for another 3 or so hours without it on. Can’t say I slept any better though certainly no rainout was a big plus.
Next problem is I have the p10 nasal pillow mask and it seems like one of my nostrils gets stuffy over the course of the night. And this makes breathing more difficult, thoughts on what I can do about that?

Thanks!!!

[Pugsy]

Next problem is I have the p10 nasal pillow mask and it seems like one of my nostrils gets stuffy over the course of the night. And this makes breathing more difficult, thoughts on what I can do about that?

What to do about it depends on what might be causing the congestion.

Google "nasal cycle" and see if that might be what is going on.