Sleep Onset Disruption - OSA/CPAP Related or? Need Help

Hey Folks,
I've made a couple of posts recently regarding some sleep issues (Insomnia?) I've been experiencing. My sleep and comfort with my CPAP for the last 3-4 years has been very good.
Without going through the long story again, let me say that I've had 4 "events' now over the last 16 years where I had heightened anxiety that made it hard to sleep.

I could be sleepy as hell but could get to sleep. Every time I would doze off, something would wake me up and the cycle would repeat.
Many times, it felt as if I stopped breathing for a few seconds as I was falling to sleep. Sometimes I would just wake u and sometimes it would make my heart and breathing race a bit.

Repeat this a few times in a night and I quickly become afraid of my bed.

I think a lot of this may have originated from undiagnosed OSA. It seems to be activated during times of high stress in my life (every 3-5 years now).

This most recent event began at the end of October and has gotten progressively worse.
You'll see how my AHI score over the last almost 2 years shot up from <1 to where it's at now.

I'm waiting to get into a CBT-I program to address these issue and in the meantime, I'm using a CBT-I app provided by the Cleveland Clinic.
I'm also participating in a weekly Yoga class and doing daily relaxation exercises.

So far so good and it's helping but I'm up and down.

The key factor I notice is that damn sleep disruption as I'm falling asleep!

So I wanted to post my Sleepyhead results to see if anything stands out as an issue.

You'll notice that I tried to sleep about 10:00 PM and got up for a while (because of the sleep disruption).
I tried again briefly but not good. Finally went back to bed again about 11:00 PM and did sleep. I transitioned through the disruptions.
I woke up about 1:30 AM and got up for a few minutes.
My anxiety was elevated through the night so I never felt at ease.

Any help/advice you can offer would be appreciated.

If I could get beyond this early sleep faze disruption issue, I feel like all of my insomnia symptoms would be gone.
I really think this triggers and elevates my anxiety - which creates a vicious circle.

Hopefully, I've formatted and provided the right Sleepyhead images. If not, please let me know.

Too many graphs makes all the graphs so tiny they are hard to evaluate.
All you need is
Events
Flow Rate
Pressure
Leak
Flow Limitation since you are using a ResMed machine
and maybe the snore graph only if you see much activity on it. If you don't see much...no need to include it.

And you need to zoom in on the breath by breath flow rate to see what might be happening when you are transitioning to sleep to have any hope of spotting anything. At this level of overall zooming in...impossible to see anything that might give you a clue.

Watch all the videos here
http://freecpapadvice.com/sleepyhead-free-software

Thanks Pugsy.
I’ll reformst and update my post.

Hopefully, the revised images tell the story.

I don't mean to seem impatient. It's just that this little "issue" is causing m sever anxiety.

Hi JCWarrior,

CBT is good for some things, but for anxiety, there is a newer method called Havening which is having good results.

Havening starts from the premise that anxiety is a learned response - and sez it is possible to 'unlearn' that response, and to unlearn it quite quickly.

The method was developed by Dr Ronald Ruden, an American medical doctor and neuro-scientist, and there's a video about it here:

https://www.youtube.com/watch?v=0C1liEFCZm4

Ideally, you would find a trained Havening practitioner near you - or within a distance you can reasonably travel. If that's not possible, then I suggest you watch the video – twice. The first time to understand what's involved in the process. The second time to apply the process to yourself.

Thanks, Rick for the info on Havening. I did the exercise in the video last night. I will also look into this practice more as well as a local practitioner.

Regarding my Sleepyhead results in my OP, I was wondering if someone could take a look at the CA event shown and give me your opinion. If does appear that my experience is correct and that I do stop breathing (or hold my breath) as I'm falling asleep.

These cause major disruptions in initiating sleep.

Any thoughts?

The flow rate graph is too tiny and I can't see enough of the breathing prior to the flagged event in question to even hazard a guess.

Pugsy wrote: ↑

Mon Jan 28, 2019 1:48 pm

The flow rate graph is too tiny and I can't see enough of the breathing prior to the flagged event in question to even hazard a guess.

I was just watching the videos again and was thinking the same thing.

I'm going to post new images. One second, be right back! LOL

OK, new images updated in the OP.

They look like SWJ post arousal flagged events to me. The breathing is jagged and irregular. Not nice normal rhythm of asleep breathing.
Can't really see enough of the breathing prior to the one flagged at 22:13 to be sure about that one.
I think something caused an arousal and the centrals flagged are just a reflection of irregular awake/semi awake breathing.

Now what caused the arousal in the first place???? Million dollar question.

Even if these centrals were the real deal....not nearly long enough in duration to be an issue and not nearly enough of them to be an issue.
I think they just point to crappy sleep...but doesn't tell us why it is crappy.

What does SWJ stand for?

SWJ Sleep/Wake/Junk flagged events that don't look like you were really asleep when they got flagged.
Looks more like awake/semi awake breathing irregularities getting flagged by mistake.
Remember the machine only measures air flow....doesn't know sleep status.

I was just looking at my report from last night. Fragmented sleep from reasons unrelated to apnea...and I have 1 OA flagged at the very beginning of one time frame where I turned the machine back on and I know I was NOT asleep.
Very irregular breathing just prior to the flag. So this 1 OA flagged event is SWJ.

Interesting.

I'll keep looking at my records to see if I can recognize a pattern. i.e Nights that I notice I have many arousals in the beginning of sleep vs nights that I noticed fewer/none.

Last night would have been good but I forgot to put my card back in!

I slept well last night. I did have a few arousals (felt like I was holding my breath) but slept well overall.

I spoke wth my sleep doctor about this and showed him the events from Sleepyhead.

He doesn't think they are true CA's but understands how the disruptions can be contributing to my sleep initiation problem.

He suggested we first experiment with a different "CFLEX" setting. He explained it very well but I'm not 100% certain of what to expect.

He put in an order to have my DME contact me and change it, perhaps remotely or by instructing me.