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How long ago did you try CPAP? Evidently you didn't stay with it. What problems were you having? Do you still have your equipment? So far, you haven't given us any usable information. If you want help, you have to help us help you. We are not mind readers.

desiderata wrote:If anyone wants to take a crack at helping, I'd be sincerely grateful. I can see there are still many knowledgeable people here. I've read quite a few posts over quite a few months. If anyone can actually help me figure out how to make the therapy work so my quality of life doesn't decline, like the other times I tried it -- that would be amazing and cause to be thankful the rest of my life.

OkyDoky wrote:Other than asking for doctor recommendations for a doctor in some unknown area, you haven't given us anything to help you with. In order to customize something we need to know what we are working with. What do you need help with? Do you have a machine if so what is it? Are you using it?
We've all learned that responsibility for our therapy is our own. If you want to learn how to control your own therapy, it begins by you asking questions and learning all you can.

what she said. you're actually going to have to present problems and ask questions, my crystal ball is in the shop and I can't just magically figure out what you need answers for.

What PR said...we will be glad to help and we are pretty good at what we do but we don't do much sugar coating and sometimes we have been known to swing a 2 X 4....and the "we" is a collective "we" for the entire forum..not just me and PR.
We just have to have some specific information to be able to help you and the more information we have the better our chances of getting you the help you need.
I try to stick to just the facts and leave personality out of things. I don't do much "there, there" type of stuff. It's not because I don't feel their pain or frustration but mostly because I just prefer to get straight to the technical business needed to get help for someone. Sometimes I am not successful in that regard but hey..I am only human. If someone pisses me off with attitude I usually don't say much...I just usually quietly ignore the person and let someone else do the helping.

On my list of things to do is a little cheat sheet for the stuff we need to help people. If we get this stuff it means we can help better and faster. When people don't provide what we ask it makes for a frustrating helping session. It makes our "job" harder and most of us would prefer easy work instead of hard work.

So...are you going to start therapy again or are we still just be going to help your partner?
I am good with either but we need some way of telling you two apart if we are going to be helping 2 people under one screen name. If we don't it's going to get awfully confusing.

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I don't know any MN doctors. Sorry maybe someone else does. I think I know some of your hesitation. Anytime we fail at something we always have that in the back of our mind. You said your numbers were good. Did you look at your reports with software? How were you sleeping? Were you able to go to sleep initally but wake up during the night?

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desiderata wrote:The most frustrating part was how well it seemed to go on the surface, but seemed to have a negative impact. I do rouse easily from sleep. I felt as if I woke more frequently and more fully when using the machine. But I didn't experience periods of insomnia; I almost always fell back asleep within several minutes.

Without knowing more particulars it sounds like using cpap created problems with what we call sleep maintenance insomnia. That's where we wake up during the night more than we would like and we may or may not have trouble going back to sleep during those times.

If we don't sleep so good for whatever reason it doesn't matter how good that AHI is....we are going to feel like crap. Some people equate that to mean using cpap isn't helping the OSA which isn't true...it's helping the OSA but there's another problem going on that cpap can't fix and unfortunately for some people it can make that problem worse.....sleep maintenance insomnia.
So people abandon cpap therapy instead of trying to fix the second problem.
One of our forum members has first hand experience with it and documented it very well on her blog. When you have time you might read it.
http://adventures-in-hosehead-land.blog ... er_19.html

It's not a problem that can't be fixed but it does take work and patience which unfortunately are things that we don't have an abundance of when we are sleep deprived for any reason.

Finally...I don't know what your reports looked like at the time...the AHI might well have been very low but you might still have had some stuff showing up on the reports that aren't included in the AHI that could maybe have been causing those wake ups. This is why we ask to see the detailed reports when people come here and say "My AHI is good but I feel like crap and I sleep like crap"...we try to make sure that there's nothing on the reports that is just screaming out "fix me".
Now sometimes everything looks good on paper and nothing is screaming out "fix me"...then we start looking for anything else that could be contributing to the bad situation.
It's not easy work by any means...it takes time and education and digging in.

Finally sometimes people expect cpap to fix a problem that is really unrelated to sleep apnea.
Maybe they have "bad" sleep from some other reason..like medication side effects or insomnia from some other reason than OSA (and there's a ton of causes for insomnia that don't mean OSA).
CPAP can't fix bad sleep unless the bad sleep is caused by sleep apnea.

desiderata wrote:
I don't currently have a machine.

Now we know what your first goal should be - getting a machine and mask.

Do you have a copy of the summary of your sleep study? If not, get it right away.

If you insist on seeing a doctor, you can find board certified sleep docs here - http://www.sleepeducation.org/find-a-facility

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desiderata wrote: Maybe the sense that I was awakening "more fully" indicates some kind of fragmentation or disruptions that messed up the sleep architecture...?

Maybe...wouldn't be impossible to have low level arousals that keep messing with your sleep cycle and you know that if the sleep cycle gets trashed that it doesn't really matter how many hours of sleep you get. You might be missing or getting a reduced amount of sleep in a particular cycle needed for optimal sleep restorative powers.

Exactly which model machine did you have? Did you use available software to evaluate your data or just the data from the machine's LCD screen?
There are other things that can show up on the software reports that might help point to causes for arousals that don't show up in the AHI numbers.

And of course there are a long list of other potential culprits for poor sleep quality possibly made worse because of just having the mask on the face.

How long did you actually use cpap before abandoning it?

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The removable card you used for data was it a normal little SD card or a little blue/white looking card and similar in size to a credit card?

desiderata wrote:Would a sleep study be required to assess for this?

Yep.

desiderata wrote:What potential culprits -- Is there a list I could review and do some checking into?

List of potential culprits for poor sleep quality...
Google...causes for sleep maintenance insomnia to start with.
Read up on sleep maintenance insomnia
and the list is the same as regular sleep onset insomnia

Medical Causes of Insomnia

There are many medical conditions (some mild and others more serious) that can lead to insomnia. In some cases, a medical condition itself causes insomnia, while in other cases, symptoms of the condition cause discomfort that can make it difficult for a person to sleep.

Examples of medical conditions that can cause insomnia are:

Nasal/sinus allergies
Gastrointestinal problems such as reflux
Endocrine problems such as hyperthyroidism
Arthritis
Asthma
Neurological conditions such as Parkinson's disease
Chronic pain
Low back pain

Medications such as those taken for the common cold and nasal allergies, high blood pressure, heart disease, thyroid disease, birth control, asthma, and depression can also cause insomnia.

In addition, insomnia may be a symptom of underlying sleep disorders. For example, restless legs syndrome—a neurological condition in which a person has an uncomfortable sensation of needing to move his or her legs—can lead to insomnia. Patients with restless legs syndrome typically experience worse symptoms in the later part of the day, during periods of inactivity, and in the transition from wake to sleep, which means that falling asleep and staying asleep can be difficult. An estimated 10 percent of the population has restless legs syndrome.

Sleep apnea is another sleep disorder linked to insomnia. With sleep apnea, a person's airway becomes partially or completely obstructed during sleep, leading to pauses in breathing and a drop in oxygen levels. This causes a person to wake up briefly but repeatedly throughout the night. People with sleep apnea sometimes report experiencing insomnia.

If you have trouble sleeping on a regular basis, it's a good idea to review your health and think about whether any underlying medical issues or sleep disorders could be contributing to your sleep problems. In some cases, there are simple steps that can be taken to improve sleep (such as avoiding bright lighting while winding down and trying to limit possible distractions, such as a TV, computer, or pets). While in other cases, it's important to talk to your doctor to figure out a course of action. You should not simply accept poor sleep as a way of life—talk to your doctor or a sleep specialist for help.
Insomnia & Depression

Insomnia can be caused by psychiatric conditions such as depression. Psychological struggles can make it hard to sleep, insomnia itself can bring on changes in mood, and shifts in hormones and physiology can lead to both psychiatric issues and insomnia at the same time.

Sleep problems may represent a symptom of depression, and the risk of severe insomnia is much higher in patients with major depressive disorders. Studies show that insomnia can also trigger or worsen depression.

It's important to know that symptoms of depression (such as low energy, loss of interest or motivation, feelings of sadness or hopelessness) and insomnia can be linked, and one can make the other worse. The good news is that both are treatable regardless of which came first.
Insomnia & Anxiety

Most adults have had some trouble sleeping because they feel worried or nervous, but for some it's a pattern that interferes with sleep on a regular basis. Anxiety symptoms that can lead to insomnia include:

Tension
Getting caught up in thoughts about past events
Excessive worrying about future events
Feeling overwhelmed by responsibilities
A general feeling of being revved up or overstimulated

It's not hard to see why these symptoms of general anxiety can make it difficult to sleep. Anxiety may be associated with onset insomnia (trouble falling asleep), or maintenance insomnia (waking up during the night and not being able to return to sleep). In either case, the quiet and inactivity of night often brings on stressful thoughts or even fears that keep a person awake.

When this happens for many nights (or many months), you might start to feel anxiousness, dread, or panic at just the prospect of not sleeping. This is how anxiety and insomnia can feed each other and become a cycle that should be interrupted through treatment. There are cognitive and mind-body techniques that help people with anxiety settle into sleep, and overall healthy sleep practices that can improve sleep for many people with anxiety and insomnia.

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desiderata wrote:It doesn’t appear I meet the criteria/definition for sleep maintenance insomnia. I almost never have difficulty falling back asleep.

You don't have to have difficulty falling back asleep to have sleep maintenance insomnia. Just the multiple wake ups is enough.
But it is normal to wake up after REM stage sleep and we have (or should have) multiple cycles of REM during the night. Most of the time we don't remember those wake ups though.

Here's the deal with wake ups...they mess with the normal progression of the sleep cycle through all the stages in the required % in each stage for the restorative powers of sleep to work their magic. You don't always fall back into the middle of whatever sleep cycle you were in when you had the wake up. Sometimes you have to start all over in the sleep cycle progress which means the end result is more time in the first/lighter stages of sleep and less time in the deeper stages of sleep where the bulk of the restorative powers of sleep reside.

Now I don't know that is your problem...only that it's a possibility.

Sounds like you had the Smart Card with your old machine..probably S8 model since you mention having to rig up an adapter to slide the card into to get the data off the card. The data from that old machine is/was very limited compared to the data available with today's machines.

Sleep studies done in a lab with all the wires and in a foreign environment...you are right...not necessarily representative of a "normal" night. It's a starting point though and the best we have. There are some home studies that go into almost as much detail as a sleep lab study. They even have electrodes for evaluating EEG which is needed to determine sleep. If you didn't sleep well in the sleep lab setting it makes it hard to say what is going on at home where things are more familiar.

Some people do find that cpap disturbs their sleep significantly and they can't seem to work through it for whatever reason.
They decide they feel worse with cpap because of this than they do with just having the OSA go untreated.
There are other alternatives than simply not using the cpap machine for those people. They may not work as well as cpap does but some treatment is better than no treatment in my book.

Up to you if you want to try again. Machines have improved since the S8 (discontinued in 2010 and we have had 2 more generations of ResMed machines since it was discontinued)...lots of improvements and more choices in masks.
Or you can look at one of the alternatives depending on how "bad" your OSA is or was.