On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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niurefine
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On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Tue Jan 02, 2024 5:39 pm

Hi everyone, I am a 24 year old man who recently started BiPAP therapy for a combination of obstructive and central sleep apnea. I have the AirCurve 10 and wear the AirFit F20 full face mask. Untreated, I have sleep apnea on what I think is the low end of severe with a typical AHI in the 40s. According to my last sleep study, when I'm on the bipap, I have an AHI around 18-20 on my back (so I try very hard not to sleep on my back) and around 5-8 on my side, though my machine often puts me lower than that. The lowest my AHI gets according to my machine is around 2. A typical day is around 4-5 AHI, I think. I'm not sure exactly what pressure I'm on, but the doctor I saw said something along the lines of it starting high and going up to the highest pressure. (Fortunately I don't find it uncomfortable :) )

The AHI thing bothers me less than the amount I sleep, although I know they're connected. Since I was in my late teens, I feel pretty exhausted unless I get at least 11 hours of sleep (on a good day) up to 13-14 hours of sleep (on a bad day). Being on the bipap has made me have a lot more good days, but my dream is to feel rested after only 8 or 9 hours of sleep, and I'm pretty far off from there. I'm a college student, so I formed my class schedule around only being in class on alternating days so I can get my 12 hours in on the days I don't have school, and on the days I have class, I have to have an energy drink or I can't keep my eyes open. When I don't have class (like right now, winter break) I tend to move towards a schedule of being awake from 4pm to 4 or 5 am, which as you can imagine isn't great for most purposes, and my sleep schedule certainly confuses myAir :lol:

So my main question is:

When should I expect to see improvement in the amount I need to sleep? Is it possible I'm just hardwired to always need at least 11-12 hours of sleep? That would really not be great. Is it just a time thing? Also, I haven't set up OSCAR yet, but I'm willing to do that if people think it would be a good idea. Thanks so much for any insight :)

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niurefine
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Tue Jan 02, 2024 5:59 pm

Ah, sorry, just read the information for newbies more carefully and saw that it's asked of us not to ask how long things will take to improve lol. In that case, I would like to amend my question to: Has anyone else experienced similar sleep problems and did it improve after starting therapy? :) Apologies!

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Pugsy
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by Pugsy » Tue Jan 02, 2024 7:53 pm

The most frequently asked question is "when will I feel better or sleep better" and unfortunately there is no clear cut one answer that works for all people.
There are simply too many variables to the equation to be able to give that sort of answer. Everyone is different and respond differently plus there are often other factors at play that we can't know about or even see on the reports the machines give us.

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

Any other physical or mental health issues going on?

Do you wake often during the night?

And yes....get OSCAR up and running and get familiar with it.

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niurefine
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Wed Jan 03, 2024 2:52 am

Hi Pugsy, I take a fair deal of medications as I have several health conditions, mostly well-managed - depression (very well-treated now fortunately :) ), ADHD, and a thyroid disorder (Hashimoto's). Off the top of my head (there may be one or two more that I've forgotten), I take levothyroxine (thyroid), lurasidone (depression), and atomoxetine (ADHD), as well as the supplement N-Acetyl Cysteine - without that last one I tend to pick at my skin pretty badly when I get anxious. I also have asthma, but haven't had any symptoms of that for several months. I do know that my thyroid disorder isn't well-managed right now according to my last bloodwork, which is probably making me a bit sleepier, and the dose of levothyroxine I'm on will probably be increased within the month, which ought to fix things on that front. I'm also on the lower end of obese - I weigh about 190lb and am 5'3.

I do wake several times during the night (or day, lol) and I notice it more now that I am on the bipap as I usually move in bed and sometimes my mask starts leaking and I have to readjust it. I've just ordered an SD card for OSCAR and that will hopefully arrive in a few days. Thank you for the response!

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niurefine
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Fri Jan 12, 2024 7:04 pm

Hi everyone! I'm back with some OSCAR stuff! I apologize for the weird times of day this was taken! Here is what today's data looks like (lol - 12pm to 2pm - I slept from around 2am to 2pm)! Please ignore the crazy leak - that's not normal for me. I think my mouth just fell open while I was asleep a few times, which doesn't usually happen :)
https://i.imgur.com/Yh4w9HW.png
Here is something I'm interested in, in the next image: It looks like I had a couple central apneas before taking my mask off while I was still half-asleep, but it doesn't seem like the second one was detected and I don't see any pressure increase. Is the bipap supposed to increase the pressure in response to central apneas or just obstructive ones?
https://i.imgur.com/njcjDyo.png

Also, with regards to how I'm feeling: I had a couple days this week where I was able to get up after about 7 hours of sleep, but on one of them I had an energy drink and on the other one I had a nap. Fingers crossed it will get better :) I'm just glad I was able to get up for once!

PS: Looking at OSCAR it looks like my maximum pressure is actually 22.0! I thought it would be 25.0, but I guess not.

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Pugsy
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by Pugsy » Fri Jan 12, 2024 8:39 pm

niurefine wrote:
Fri Jan 12, 2024 7:04 pm
Is the bipap supposed to increase the pressure in response to central apneas or just obstructive ones?
The machine will NOT increase the pressure in response to central apneas because it wouldn't help anyway.
They only respond with an increase in pressure to obstructive events (OAs, hyponeas, Flow limitations, snores).


Get all your meds out and start looking at all the known side effects.

_________________
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If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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niurefine
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Sun Mar 17, 2024 2:21 am

Hi everyone, just wanted to update. I have been using the bipap for a few months now and I am starting to get better. I'm also making some medication changes, albeit very slowly - titrating takes a long time! I have a long train commute to my university, but I'm noticing that I usually don't sleep on the train now - I used to fall asleep almost every time. Sometimes on my days off I get up after only 7-8 hours of sleep and I don't end up having to take a nap. It's not so unbearable anymore. I still sleep for long periods of time a lot, but I haven't had any really bad days where I lose 16 hours in a while. I'm also less irritable in the mornings. I guess I just hadn't given it enough time :)

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Miss Emerita
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by Miss Emerita » Sun Mar 17, 2024 11:35 am

This is excellent news! Many thanks for coming back to tell us how you're doing.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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niurefine
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Mon Jul 08, 2024 9:56 pm

Hello everyone! I'm back again because I was looking at my OSCAR data recently (I was debating whether I should talk to my pulmonologist about looking into an ASV at my next visit since my machine says my AHI in the morning is usually around 8 or 9, sometimes higher, even if I make sure to sleep on my side) and I was curious about why my normal respiration has this shape (see attached screenshot). The apneaboard OSCAR guide says this isn't normal respiration and classifies it as "Class 6" here: https://www.apneaboard.com/wiki/index.p ... lasses.png

I'm not exactly worried about it but I am curious - what does it mean? All my non-apnea breathing while I'm asleep has that approximate shape (though it seems to get a little wacky shortly before a CA or OA - I can send pictures if requested). Also, my sleep schedule is pretty strange, hence the weird times - I'm on summer break from college and only work a few days a week! (In addition to that, I think my machine's time is an hour off, but that's not a big deal to me.)
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robysue1
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by robysue1 » Mon Jul 08, 2024 11:14 pm

niurefine wrote:
Mon Jul 08, 2024 9:56 pm
Hello everyone! I'm back again because I was looking at my OSCAR data recently (I was debating whether I should talk to my pulmonologist about looking into an ASV at my next visit since my machine says my AHI in the morning is usually around 8 or 9, sometimes higher, even if I make sure to sleep on my side) and I was curious about why my normal respiration has this shape (see attached screenshot). The apneaboard OSCAR guide says this isn't normal respiration and classifies it as "Class 6" here: https://www.apneaboard.com/wiki/index.p ... lasses.png
Those shapes are only the inspiration part of the flow rate curve. In other words, the folks who created that image did not put the 0-line on the picture, and that's confusing you. Here's the same image with the 0-line added:
Image

Now when you look at the snippet of your breathing in your Oscar data, you will notice that the plateau occurs just before your inspiration starts. And that's actually a normal, sleep breathing pattern.

In the Oscar curve: When the flow is above the 0-line, you are actively inhaling. When the flow is below the 0-line, you are actively exhaling. And it's normal to have a small plateau of no air movement between the end of the exhalation and the beginning of the inhalation.
Also, my sleep schedule is pretty strange, hence the weird times - I'm on summer break from college and only work a few days a week! (In addition to that, I think my machine's time is an hour off, but that's not a big deal to me.)
It's no weirder than my own sleep schedule as a (not yet retired) college professor who is on summer break from college, but preparing for a class I've not taught before in the fall.
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

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niurefine
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Re: On BiPAP for almost 3 weeks, but still sleeping 11-12 hours a day?

Post by niurefine » Mon Jul 08, 2024 11:34 pm

Oh, thank you! I didn't read closely enough - I should have realized! I appreciate the explanation. I'm glad my breathing is normal :) I appreciate the answer!