Waking 3:30 am

[Pugsy]

Your flow rate graph in this instance...how come you aren't getting the event flags in it? They should show up but it doesn't show any events at all..nothing and that's strange. We should see the same events as is on the top Events graph.

In your situation I didn't really need the flow rate graph and that's why I didn't ask for it.

[palerider]

Your flow rate graph in this instance...how come you aren't getting the event flags in it? They should show up but it doesn't show any events at all..nothing and that's strange. We should see the same events as is on the top Events graph.

In your situation I didn't really need the flow rate graph and that's why I didn't ask for it.

probably turned them off.

[lorrpb]

12/5 Flow rate with flags. Palerider asked for it.

[palerider]

12/5 Flow rate with flags. Palerider asked for it.

I also said, event flags, flow, pressure, leaks..

not the useless AHI chart

[lorrpb]

I believe I showed the event flags, flow and pressure and said I have no leak issues. If this is not what you're looking for can you please post an example because I'm not understanding. Thanks. What do you make of this info?

[lorrpb]

Last night I upped pressure to 9. Once I got adjusted to the heavier flow, I had minimal events until I woke up at 1:45 coughing. Thought I would go back to sleep but did not. What is going on after the 1:45 wake up that the events go crazy? I was awake most, and prob all, of this time. Thx for your thoughts.

[Nick Danger]

Last night I upped pressure to 9. Once I got adjusted to the heavier flow, I had minimal events until I woke up at 1:45 coughing. Thought I would go back to sleep but did not. What is going on after the 1:45 wake up that the events go crazy? I was awake most, and prob all, of this time. Thx for your thoughts.

When you are awake, you don't breathe as regularly as when you are asleep - this irregularity frequently produces apnea events according to the machine. I'm guessing that the big cluster of events at the beginning of the night (from 10:30 to 11:00 according to the graph) are while you are awake (or half awake) and that is probably also what happened after the 1:45 wakeup. Don't worry much about events that happen while you are awake (or half awake). The machine can't tell when you are awake or asleep (or half awake) and flags events based on your breathing patterns. In a real sleep study they have you hooked up to an EEG (which can tell if you are awake or asleep - or even "half awake") and they don't count events during those periods in determining your AHI.

[Krelvin]

Last night I upped pressure to 9. Once I got adjusted to the heavier flow, I had minimal events until I woke up at 1:45 coughing. Thought I would go back to sleep but did not. What is going on after the 1:45 wake up that the events go crazy? I was awake most, and prob all, of this time. Thx for your thoughts.

When you wake up, What do you do? keep the mask on, stay lying down? When I wake up and know I am not falling back to sleep, I take off the mask, get up out of bed, go get something to drink etc... I wait at least 20-30 mins before starting the process of going back to sleep again.

Also, you charts say your machine is set with a min of 9 and a max of 20. but you never get past 11 or so, you are never getting close to the max setting. Makes me wonder what is going on.

[lorrpb]

When you wake up, What do you do? keep the mask on, stay lying down? When I wake up and know I am not falling back to sleep, I take off the mask, get up out of bed, go get something to drink etc... I wait at least 20-30 mins before starting the process of going back to sleep again.

I've tried different things. I generally stay in bed, usually with mask on but not always, because I feel like I can go back to sleep. Then after an hour or so I realize I'm not going to, so I might get up for awhile. A few times I can go back to sleep about 6 or 7am, but not usually. I suppose I could try getting up right away and see if that makes it easier to get back to sleep.

Also, you charts say your machine is set with a min of 9 and a max of 20. but you never get past 11 or so, you are never getting close to the max setting. Makes me wonder what is going on.

I did not have a titration study due to short sleep time during PSG, so the original setting was 5-20. 5 seemed too low so I've gradually upped it to 9 over the past few days but I'm going to try 8 tonite.

[cathyf]

I'm in the same waking-up-at-3am boat as you, but it is really striking to me how different the PR algorithm is from the ResMed. I have flow limitations and snores and my machine aggressively raises the pressures, and then backs them off pretty aggressively, too, when I move into another sleep stage and the FLs and snores back down. I have had only one AHI over 1 in the 8-1/2 weeks since I started therapy. Here are my graphs from Friday night:

As you can see, I've got 2 long wakeups (2am-3am, and 6:45-715), and the machine knows that I'm not having FLs, and it's because I was awake -- staring at the clock, and tossing and turning and staring at the other clock! I can tell REM sleep -- it's when the respiration rate has a "awake" look to it, but the flow limitations have an "asleep" look to them. The ResMed algorithm aggressively raises the pressure during rem sleep for me, because during my sleep study my non-rem AHI was 14 while my rem AHI was 45. And it is VERY successful at preventing events.

It's just not so successful at keeping me asleep...

Here are the overview pictures since I started this adventure:


As you can see, lots of fractured sleep, and not very much apnea at all. What does your total time in apnea look like?

[lorrpb]

AHI 2.72/4.49/6.41
TTIA (2 weeks) 4.40/10/30/14/20 (I think this is low, median, & high)
Most of the apnea occurs when I am awake after 3 am.
My doc seemed very optimistic that early waking would diminish when apnea was controlled. It's only been 2 weeks. During the first week, things seemed to improve a small amount each night, improved restorative sleep and sleeping 6-8 hours, but this past week it's all gone downhill and I feel as bad as before I started APAP.

Although I've had various sleep issues for years, this 3 am waking started last July. During July and Aug I usually went right back to sleep. But since Sept, I've gone back to sleep only a handful of times. I started working out with a personal trainer in June and have lost 50 pounds in 6 months. I've been able some major stressors that were affecting me last summer. You would think that all of this would improve OSA and sleep quality/quantity, so it's very confusing and frustrating what is happening.

[cathyf]

I also started with the early waking last summer, but for me things have gotten better with the cpap. What I have noticed is that my body is doing a jet-lag kind of thing... When I wake up at 2am and am up for a couple of hours, I'm punked the next day, so I go to bed at 9:00 -- and then when I wake up at 4am I think it's because I've gotten 7 hours of sleep. The couple of times where I have just slept through the whole night with no wakeups that I remember and no periods without flow limitations showing up on the Sleepyhead reports, it has been on some of the occasions that I have not been able to get to bed until 11:30 or midnight, and the 6:25 alarm goes off and, while I've only gotten 6-1/2 or 7 hours in bed, I've gotten 6-1/2 or 7 hours of good solid sleep and feel pretty good. (That's usually NOT what happens when I go to sleep at midnight -- usually I'm up every couple of hours and so the total sleep is only 4-5 hours and I feel like total crap.)

One thing that I do notice is that I can sleep in on weekends. I will wake up early, be awake for an hour or two, and then go back to sleep for a couple of more hours. This really seems to help the sleep deficit. It's different from teenaged self where I just slept straight through and for a long time, but, hey, it works. You aren't supposed to need as much sleep when you get older (I'm 51) so maybe that's part of it, too.