AHI low, but still tired and waking frequently

Flyboy · Post by **Flyboy** » Thu Mar 09, 2006 10:38 am

I have been on CPAP therapy for over a month now. RemStar Pro 2 machine at 10 (CFlex 3), heated humidifier, and FP FF mask. My compliance has been excellent and my average AHI is around 2.3 (down from over 50 untreated.)

I am much more awake for more of the day than I was untreated, but still start to peter out by about 2-3 pm. I also am aware of waking 6-8 times a night.

Question: If my AHI is so low with treatment, why am I still waking up so often? My sleep studies mentioned alpha intrusions--is that the culprit and if so, are there treatments for that?

Goofproof · Post by **Goofproof** » Thu Mar 09, 2006 10:55 am

I had the same problem, it takes time for the body to adjust in some people we are all different. It took 10 weeks for me to get my sleep to level out, I wake up about 3 time nightly to adjust for leaks and from congestion, but I just rollover and go back to sleep, most of the time I don't even open my eyes.

You can probably lower your AHI even more. You are off to a fine start, congrats. Jim

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Flyboy · Post by **Flyboy** » Thu Mar 09, 2006 11:06 am

Thanks Goofproof! The best thing about these boards is helping manage expectations--I'll try to be patient! (not my strong suit)

Hardly Breathing · Post by **Hardly Breathing** » Thu Mar 09, 2006 11:15 am

My advise is to look at your snores with the software and determine if your setting of 3 is causing some problems. I noticed that when beginning the exhale cycle, level 3 for relief may let your soft palat close somewhat and cause you to wake. I decreased mine to level 1 after I got used to the system and found that I slept better with lower snore scores.

Good Luck!

Goofproof · Post by **Goofproof** » Thu Mar 09, 2006 11:43 am

Flyboy wrote:Thanks Goofproof! The best thing about these boards is helping manage expectations--I'll try to be patient! (not my strong suit)

If you are allowed by the DME & Dr., you could bump the pressure up .5 cm more and check the data after a few nights for a lower AHI, You need a few night to adv. You also want to look for higher HA, too high a pressure makes them worst, so you need to be under their trigger. Jim

Flyboy · Post by **Flyboy** » Thu Mar 09, 2006 12:39 pm

Hardly Breathing, great advice. I am having a bunch of "snores" showing up in the reports. I will try backing off the CFlex and see how that works.

Goofproof, I did try adjusting pressure a bit and was surprised to see 10.5/11.0 seemed to make things considerably worse. That makes sense in light of your comments about HA which I assume refers to hypopnea events.

slumberer · Post by **slumberer** » Thu Mar 09, 2006 2:05 pm

Be skeptical of the snores on the Resprionics machines; they tend to over-report as many have indicated. However, you might also want to consider your time spent in variable breathing as recorded on Derek's MyEncore. For me, the closer I get to 30% the better I feel. As I understand it, this is an indirect measurement of REM sleep.

Goofproof · Post by **Goofproof** » Thu Mar 09, 2006 7:41 pm

slumberer wrote:Be skeptical of the snores on the Resprionics machines; they tend to over-report as many have indicated. However, you might also want to consider your time spent in variable breathing as recorded on Derek's MyEncore. For me, the closer I get to 30% the better I feel. As I understand it, this is an indirect measurement of REM sleep.

Then mine being high is a good thing, it had me worried but I feel good.

Goofproof · Post by **Goofproof** » Thu Mar 09, 2006 7:48 pm

[quote="Flyboy"]Hardly Breathing, great advice. I am having a bunch of "snores" showing up in the reports. I will try backing off the CFlex and see how that works.

Goofproof, I did try adjusting pressure a bit and was surprised to see 10.5/11.0 seemed to make things considerably worse. That makes sense in light of your comments about HA which I assume refers to hypopnea events.

sleepless_in_ny · Post by **sleepless_in_ny** » Thu Mar 09, 2006 9:32 pm

I had a similar situation with continuing to wake several times night. It took some getting use to the equipment,

With that being said I also discovered that I was having leaks, which I believed changed the pressure being received and caused me to wake. Someone on this list suggested cleaning the silicon mask part with alcohol. I did this and found I get a much better seal. I also clean the oils from my face. this is a nightly ritual.

I also seem to have leaks with lite snoring, so I have taped my mouth and that also made a big difference.

I am truly a sleeping beauty.............................LOL

Jim Eads · Post by **Jim Eads** » Fri Mar 10, 2006 6:05 am

Flyboy, no one has asked the obvious question...

How many hours are you getting each night?

Jim

Hosed All Night · Post by **Hosed All Night** » Fri Mar 10, 2006 7:27 am

My sleep study titrated pressure was 10/15 and I was waking several times a night and couldn't figure out why. After looking at the data over a several week period with My Encore I found my AHI was averaging 8 events and snore index sky high. I tweaked pressures until I zeroed in on 14/17. After almost 900 hours "under the mask" at this point, I'm consistent at around 1-2 AHI and zero snore index and sleeping all night. Snoring is caused by the airway starting to close and is considered a precursor to apnea events. Most mfgs use this as a means (one of several) to adjust their autopap pressures. So in theory... stopping snoring is controlling apnea. I really don't think a one night sleep study number should be the final number. Its a good starting point. Trending long term data tells the real story.

Flyboy · Post by **Flyboy** » Fri Mar 10, 2006 1:29 pm

Jim,

I am sleeping 7.5-8.5 hours a night.

Mike

Machine	Mask

Additional Comments: Pressure Range=7cm---15cm Avg. AHI 0.6

AHI low, but still tired and waking frequently

AHI low, but still tired and waking frequently

AHI Low