First 30 days.

Hello all,

I have spent the last 30 nights with my first ever machine. I was diagnosed with OSA 6 or 7 months ago after a home sleep study and subsequent inpatient sleep study. My doctor pointed me in this direction after I complained to him about being extremely tired most of the time, as well as my wife complaining about my snoring. One night she recorded audio of me snoring and it freaked me out because it sounded absolutely crazy. A year later here I am.

When I did the titration study at the hospital, I felt AMAZING the next morning. Colors were brighter, I was not tired. I was thinking clearly. I had ENERGY. I remember at the end of the work day feeling like I could work another 8 or 9 hours. I thought my life was about to be changed. Needless to say, I was greatly anticipating the day when I would pick up my very own machine and start using it nightly.

I left the medical supply store beaming. The consultant/salesman/whatever remarked that he was happy to see somebody who was actually excited to receive the machine. I couldn't wait to go to bed that night.

The next morning I felt... bad. Not worse than usual-- although, perhaps I did feel worse than usual because I had such high expectations. I checked some settings, my AHI was something like 12.6. My original inpatient sleep study was around 9. Huh? This thing is making me WORSE? No way.

I googled around, I believe that was the first time I discovered this site. I downloaded sleepyhead and checked out the information-- most of it I didn't understand (still don't) but I saw that the first few hours were good, basically no events, but for 2 hours in the morning (say 5am-7am) I had OA after OA. Back to back, constant.

I know I snore much worse on my back. I know when I lay on my back and turn a certain way, I cannot breathe even while awake. After talking with my wife (and more googling), I hatched a plan to tie a shirt around my waist and put something hard on my back to keep me on my side during sleep. If I rolled over onto my back, it would be too uncomfortable and I would return to my side. This worked. The next night my AHI was 1.8. I felt a little better, but still no "bright colors" like that first time at the hospital.

And this is basically what I've done for the last 30 nights. I have graduated to tying a pair of sweatpants around my waist and rolling a hard plastic cup inside. It's not ideal but the machine cannot help me when I'm on my back so I have to stay on my side. Sometimes I rip off the sweatpants in the middle of the night and wake up on my back, still. I have no recollection of taking them off. My AHI jumps around, most nights its slightly below 5, some nights it's up to 8 or 9. I think I've had 2 10s in 30 nights (not including the first night which was the worst one). On the other end, I've only had 2 or 3 nights where it was below 2, and those nights I really noticed a difference in the morning. This is not some psychological thing where I look at the number and feel better or worse depending on what it says. When I wake up in the morning, I know if it's going to be high or low based on how I feel with 100% accuracy thus far.

I'd like to post some of my sleephead information for some of the more experienced users to take a look at if anybody would be willing. I will probably do this when I get home tonight.

The main question I have is this: Should I still be snoring (quite severely) and having apneas every time I sleep on my back? Should the machine "break through" the obstruction? Based on my understanding of machine's sole purpose, it should be keeping the airway open, right? Does it sound like I need more pressure? I'm currently set at 13, I'm confident I can tolerate more if necessary.

I feel like tying a cup to my back is doing more to help my sleep apnea than the machine. But I am still hopeful. Any feedback or help is greatly appreciated.

King Tea

Welcome to the forum.

I actually believe that people should be able to sleep in any position that they wish to sleep in and usually they can accomplish that goal with just some minor setting adjustments to allow the machine to better deal with any special pressure needs that supine sleeping might need.

No...you shouldn't be snoring very much...that points to sub optimal therapy.
And don't assume that just because you had an in lab sleep study where they supposedly came up with the "right' pressure that it is perfect.
My in lab titration study got close but wasn't ideal. We often simply can't sleep well during those in lab sleep studies so maybe we don't get a chance to get the worst case scenario sleep situation and optimal pressures aren't found.

Let's see what your data shows and go from there.
Sounds like all you need is a little pressure adjustment.
Need to see those reports though to know for sure.

And unless there are massive variations in pressure needs when sleeping on your back....lets have you sleep in whatever position allows for the best/most sleep and just let the machine deal with it with more optimal settings.

Pugsy,

Thanks for the quick reply. I am at work right now (heh) but I will post some data this evening at home. I am assuming it would be wise to show a few nights with varying AHIs?

Do this format please
viewtopic/t158560/How-to-post-images-for-review.html

Show the best and the worst night....that's all for right now. 2 images.
And pick best and worst from the last week or so.
We care more about recent stuff than the first week stuff because typically we just don't even sleep much that first week or so.

Will do. Thanks again.

The first one is from last night, I am posting it because 0.0 seems highly unlikely and unusual. Also I woke up around 5am to find that the air pressure seemed to cut off every 15 or 30 seconds, this happened maybe 6 times. It was as if something was blocking it for a second and then it would kick right back on. I don't know if this was occurring all night while I was asleep. I wasn't awake for long, and I believe it stopped happening before I fell back to sleep (I was scared, and I kind of remember feeling like it stopped so I felt better).

The other two nights were the worst and best nights I had over the past week or so.

What position do you usually sleep?

Any correlation between the really bad night and the good night in terms of sleeping position?

Take any meds of any kind? If so, what?

I always fall asleep in the same position on my side, this is actually my preference as far as comfort. I know I snore much less on my side, but I roll onto my back during sleep and this is when the snoring is typically worse. I have been tying a hard plastic cup to my back with a pair of sweatpants, which has kept me on my side but it is hardly a permanent solution-- sometimes I take it off in the middle of the night, sometimes I wake up at a weird angle somewhere between my side and my back. I assume my sleep position has a lot to do with the occurence of events.

As for meds I take
250mg Nuvigil
.5 mg clonazepam
12mg Suboxone

The sleep doctor did note that the buprenorphine (Suboxone) could be partially causing, or at least worsening the OSA.

Do you see anything abnormal with the 0.0 night? I feel like the machine was acting funny, not sure if you can tell from those charts.

Thanks again.

edit: Just thought to add, about the meds, I am stable on all of them and take them routinely at the same times every day so there is really no variation there.

I don't know what to make of the 0.0 night.
Can't see much of anything really except a very obvious wide variance in the nights with no apparent reason for it.
With it being a fixed pressure setting can't even tell if the machine would have varied the pressure or not.

It's almost like all the event flags were turned off or something.
Go down to the bottom of the graphs and click on the Flag arrow thing...on the left bottom. Expand the menu and look to see if any are red/black....if you see some that are red...click on them to change to green.

Flags were on for that night. Last night I had AHI 1.67. Felt pretty good today.

I guess for now I will continue trying to put something on my back in order to stay on my side all night. When I see the doctor I will ask him about increasing pressure so that maybe I can sleep on my back with fewer issues which would be fantastic.

Looks like you have a really significant case of your OSA being MUCH worse on your back. It happens to some people.
And as you have already discovered staying off one's back is easier said than done for any number of reasons.

Been there and done that myself but for different reasons....it's hard.

What I found that was more help to me than anything was figuring out something to support me on my side and if I tried to roll over on my back it didn't cause pain but was actually comfortable.
I think putting stuff in something to cause pain or wake ups when we roll over onto our backs is not the best way to do it.
Talk about causing a lot of wake ups which is of course the last thing we want to do.

So I tried all sorts of things that would be comfortable and not wake me up.
Rolled up bed linens...comfy but they won't stay in place...will slide right out from under the back.
Bed pillows...comfy but again won't stay in place...too easy to move out from under the back.
Tried a hard wedge foam thing...comfy enough but again...moves out from under a person and it takes up massive space in the bed...not great if you have a bed partner who wants some room.
I had the best luck with a buckwheat hull bed pillow....had been using one for my neck anyway and decided to move it to behind my back when I was on my side. It's heavy enough to not move around much and the support from the hulls actually felt good against my back. Wasn't a huge pillow either and it really only needed to be up against the small of my back.

You might consider it if you wish to try more measures to keep you off your back.
It might be more comfy than the pressures you apparently are going to need when you are on your back.

Thanks for the suggestion about the pillow. Sounds like the type of solution I will need.

A friend of a friend uses one of those mouth guard type dental devices for snoring and claims its effective. Any opinion on those? I'm sure it depends on each person and the cause of the obstruction but what do you think?

Using a mouth guard instead of cpap?

Are you aware that you can have bad OSA and not snore?
Are you aware that not all snoring is related to OSA?

If someone wants to try a mouth guard of any kind...to treat OSA...they need to have a sleep study done while using the mouth guard to make sure it is doing anything.
It might be enough for some people....might not...but you don't want to be guessing about it.