First nights with Sleepyhead

[jdr999]

I would assume that if this were my report. 2 little clusters of CAs with one at the very beginning of the night so either awake tossing and turning or sleep onset and again right before getting up time when it is likely that a person was again doing a big of tossing and turning and semi awake stuff with some sleep stage transition centrals being thrown in. I wouldn't give those 2 clusters more than a second glance.

That makes sense to me also.

An AHI of 3.32 isn't too bad I assume but it is higher than I'd like. Is there anything that I should tweak tonight judging by the graphs, or should I just keep things the way they are? Am I asking for too much too soon?

I only managed to get about 5 hours of sleep, but I think over the years I've become accustom to little sleep. Before the study I wouldn't go to bed until I was completely exhausted and ready to pass out - normally by 5-6am. Even then I'd only sleep until 10am or 11am, and most likely quite poorly.. Looking back I can see there was probably an underlying reason for it -- not just that I liked to work through the night..

[Pugsy]

There is really nothing that needs tweaking. I know the AHI is more than you probably want to see but the bulk of it is those centrals and a bit of awake/semi awake clutter. We don't treat the centrals with changes in pressure anyway and we can't do anything about the awake/semi awake clutter anyway.
Roughly half the AHI is central/clear airway...that takes the AHI down to 1.74 if we remove the Central index...that's pretty darn good if you ask me even if we couldn't blame any of it on awake stuff.
Remember when we see the centrals...we don't treat them with more pressure because it won't help.

[jdr999]

My numbers last night were pretty good also. Still quite tired this morning but I guess that's to be expected. I'd love to be part of the club that gets instant relief from the first night of treatment but that doesn't seem to be in the cards.. I guess not dying is a perk though....

I still have those clusters of CA's in the beginning and end. Is that common? I'm not really worried about them, but they do skew my numbers a bit..

[Pugsy]

Well...yes, it sort of skews the numbers a bit when we have a few awake/semi awake events get flagged and sometimes it's hard to make the adjustment in the AHI but in your case it's pretty easy. The bulk of your AHI is those centrals at sleep onset time and at the end of the night. Remove the central index from your AHI and you are sitting pretty in the really nice low AHI department.. Heck even with those centrals it is barely 2.
There's also a little trick you can do with SH to omit those numbers. Do a click and drag of the graph starting right when the first cluster ends to the point right before the last cluster starts and watch the AHI change between the Events graph and the Flow rate graph...

Don't get disheartened if you don't feel the "miracle" that others talk about.. More people don't get the miracle than people who do get the miracle.
If you had to take a pill for some sort of preventative measure for some sort of health problem that you could not measure the preventative results....that's often how we have to view cpap therapy. Preventing those hidden problems that sneak up on a person and bite them in the butt...like hypertension or heart disease or whatever.

I think it took me about 3 months before I had what I would call the "miracle"...had a totally awesome day. I said to myself "finally....the miracle and I am going to feel this way from now on".....wrong..it was a brief one day thing. Thought for sure my AHI must have been 0.0...wrong again...it was 10.3. Go figure that one. It isn't just the numbers..it's a combination of things and often a lot of little things that have to come together. Things like hours of sleep and quality of sleep (that's where the fragmented sleep comes in) and meds or other health issues all play an important part of how we feel in general. For the longest time I had to be content with knowing that things were working in the taking care of the AHI department because I had a nice low AHI and the morning killer headaches were gone and the getting up to pee every hour on the hour was gone. I simply didn't have the "miracle" I thought for sure I should have. Well, I had other issues that messed with my sleep quality that were unrelated to sleep apnea..guess what? the cpap machine doesn't do such a good job at fixing stuff not related to sleep apnea.

Finally, there's a lot of truth to "give it time" when we see good "numbers" on paper but still don't feel the good numbers.
Use the time to evaluate any other factor that might be present that the machine can't fix. This is where we look at meds, fragmented sleep, insomnia, pain, bed comfort, mask comfort, general health, and a long list of other possible culprits.

I finally discovered that for me one of my main issues (besides the pain that fragments my sleep) is the amount of good quality sleep. If I get 7 hours of good sleep I feel "okay" but if I get close to 8 hours I feel a whole lot better and if I get less than 6 hours then my butt is dragging the next day.

There's nothing on your reports that screams out "fix me"...so you look good on paper. It may be that all you need is time and the improvements you want to see and feel will very gradually sneak up on you. Remember you didn't get this way overnight and expecting immediate improvement overnight is a bit of a stretch despite what a few lucky people experience.
You have to use the machine anyway...so use the "give it time" time to evaluate other aspects of your sleep and any other mitigating factors that may have an impact on how you feel.
Take a good hard look at sleep hygiene, insomnia, meds, comfort, general health, mask issues,pain or discomfort, etc to see if anything else could be contributing to feeling less than we want.
Sick kids and lack of sleep is obvious....the other stuff isn't nearly so obvious and takes a lot of detective work sometimes to figure it out.

[jdr999]

Well...yes, it sort of skews the numbers a bit when we have a few awake/semi awake events get flagged

Just out of curiosity, I've heard the term "AHI Olympics" mentioned. Do the hardcore number watches do anything differently to avoid muddying their averages with awake/semi-awake events?

If you had to take a pill for some sort of preventative measure for some sort of health problem that you could not measure the preventative results....that's often how we have to view cpap therapy. Preventing those hidden problems that sneak up on a person and bite them in the butt...like hypertension or heart disease or whatever.

That's a good way to look at it. Unfortunately though from what I'm learning most people aren't diagnosed with OSA until *after* those hidden problems come to light.

I think it took me about 3 months before I had what I would call the "miracle"...had a totally awesome day. I said to myself "finally....the miracle and I am going to feel this way from now on".....

Awesome! Just what I wanted to hear!

wrong..it was a brief one day thing.

ummm... No. That's really not at all what I wanted to hear!

It isn't just the numbers..it's a combination of things and often a lot of little things that have to come together. Things like hours of sleep and quality of sleep (that's where the fragmented sleep comes in) and meds or other health issues all play an important part of how we feel in general.

This is actually quite true as I'm finding. Just strapping on the mask and heading to bed doesn't cut it. Heck, I even have to sleep in a certain position (right side with arm propped on pillow), door closed, air cleaner on (to drown out any other household noises), and have zero distractions. That's a lot to ask just for the ability to sleep.

Finally, there's a lot of truth to "give it time" when we see good "numbers" on paper but still don't feel the good numbers. Use the time to evaluate any other factor that might be present that the machine can't fix.

True, my sleep habits have become terrible due to dealing with undiagnosed OSA. The machine can't fix all of them -- only time will I figure..

Thanks again for all your help! I'd be lost without it!!

- Joe

[jdr999]

We're getting there.

Now if I could just stay asleep for more than four or five hours at a time..

[jdr999]

By the way the doctor finally called today with the results of my titration study.

He said my titration pressure was 11.

Yeah, thanks but Pugsy and I already figured that one out!

[Pugsy]

Now if I could just stay asleep for more than four or five hours at a time..

It will come with time and patience. Probably not as quickly as you want it to

Just out of curiosity, I've heard the term "AHI Olympics" mentioned. Do the hardcore number watches do anything differently to avoid muddying their averages with awake/semi-awake events?

I have never heard the term AHI Olympics but I think I get the drift. I am not a member because I don't obsess over minor variations in the AHI and when I have a really oddball AHI (like the time I was awake for about an hour fighting nausea and had probably 25 centrals which totally messed up my otherwise great AHI) because it's easy for me to just do quick mental math adjustment and come close.
I learned a long time ago that numbers themselves don't guarantee feeling great nor feeling bad all the time either.

One thing I did try to not do though back early only in my therapy....I tried not to look at my numbers for a night until the next evening. I knew I had a tendency to have sort of a self fulfilling prophecy if I looked first thing in the AM.
It's hard not to want to look though so I understand when people do...we go to a lot of work to get this all "right" and feeling great is elusive so we want to at least see great numbers as some sort of validation for all our hard work.

Like last night...away from my own home and away from my own bed and in a beautiful hotel room (actually a suite close to the size of my tiny house) and I got probably 7 1/2 hours of extremely fragmented sleep. I haven't looked at my report yet but I bet I had a bunch of awake/semi awake centrals because I remember a lot of wake ups (bedroom temp too warm) and even though I probably got a decent number of hours of sleep and probably a decent AHI except for the centrals ...my butt is dragging today. I don't really need some numbers to tell me why I don't feel so great today. I forgot to take my pain pills with me...so back pain was pretty bad during the night...woke up pretty much every time I tried to move in bed...and all that stuff.

So I just now downloaded my SD card and here is my ugly night...and yep...it looks pretty much like I expected or maybe just a tiny bit better than I expected. Certainly much worse than my usual nights....So I shrug my shoulders and move on.
It isn't worth the time or effort to pick it to pieces trying to come up with a number for the AHI Olympics.
Let me show you last night followed by a typical report. Bear in mind that first hour last night or so with nothing happening...totally awake watching TV.