Oscar Data from a couple nights and some issues I'm experiencing

Hey all, excited to have found this forum and OSCAR. Interesting to look over the data at first but also a bit overwhelming.

I have taken time to read some other posts on here with folks giving their thoughts on people's data from OSCAR so I thought maybe I could post some screenshots and get some thoughts as well possibly?

Like I have seen some others mention on here, when wearing my Fitbit at night I seem to mostly sit in the light sleep stage when using my CPAP and hit the Deep and REM stages much more often when I don't wear my mask.

Machine: ResMed AirCurve 10 ST
Mask: ResMed AirTouch F20 Full Face Mask Silicone
Humidifier (Part of the machien): ResMed Humidair

When I was first diagnosed with both obstructive and central apneas I weight around 240 lbs. Now I weigh about 190 lbs. I am 5'9" and a male. When I first started using my machine I absolutely noticed a difference in how much less tired and exhausted I felt and my energy levels increased greatly. Now, over the last year or so, I have been feeling more and more tired again. It is not near as bad as when I was untreated. I was almost falling asleep standing up sometimes, I was so exhausted. But, I have much less energy again and I can feel it affecting me in ways such as feeling much less enthusiastic about things, a little depressed, and a little anxious.

I don't know if maybe now that I have lost weight the pressure could be reduced some? Is that keeping me in the light sleep stage? I do get awful dry mouth as well. Never found a sweet spot for that tiny humidifier because I sleep hot so I worry that having the temp on the heated tube up too high will make that more of an issue... but I guess if I don't' have it high enough in temperature I will get rain out if I try to turn the humidity up. That's been my experience, at least.

I just want to feel alert and awake again. The neurologist I see couldn't be less involved in this whole process. They want me to get an entire new $2,000 sleep study before making any changes. Can they not read the data? Is that not nights upon nights of "sleep studies" basicaly?

Anyways, here are screen shots from two recent nights. Zoomed out and then zoomed in around an event or two. Thanks so much for any advice!

bump

There's nothing on the report that is just standing up screaming "fix me and you will feel better"...sorry, I wish it were that easy.

How about a little more history?
Age?
Do you take any medications of any kind, event OTC? If so, what?
How many hours of sleep are you averaging? Not time in bed but actually sleep. This report shows a little over 6 hours...is this common for you?
Do you wake up very many time during the night? If so, why?
Any other physical or mental health issues going on that might impact sleep quality or how you feel during the day?

Age? 34

Do you take any medications of any kind, event OTC? If so, what? Occasionally I need .5mg - 1mg of Xanax to fall asleep. Also am prescribed Adderall for ADHD, but very careful about what time that is taken to allow for plenty of time for it to wear off.


How many hours of sleep are you averaging? Not time in bed but actually sleep. This report shows a little over 6 hours...is this common for you? Eh... Yeah, 6 - 7 hours on average of actual sleep, I'm thinking.

Do you wake up very many time during the night? If so, why? I wake up because I get REALLY dry mouth and nose from the CPAP, even when using saline nasal sprays or gels. Tried Biotene but it lasts maybe an hour and then I'm dried out again. I do drink plenty of water. Occasionally wake up once to pee. Also wake up because I get hot or just randomly wake up. Some nights it is 6 times in a night, sometimes 1 or 2. I can't remember the last time I slept all the way through the night. If it's just one time it is usually the dry mouth/nose is so bad that it wakes me up.

Any other physical or mental health issues going on that might impact sleep quality or how you feel during the day? I have ADHD, not sure if that matters. I do medicate but I take it early enough that it should not impact sleep. I'm a little depressed and anxious more than I used to be. I partially think that may be attributed to sleep issues though. I seemed a lot better for the first year or more of using my cpap. That's why this is so confusing.

It does seem like my most common issue is hypopneas... not sure if that means much. I was diagnosed with obstructive (I was 65 pounds heavier at the time) and central apnea.

Thanks again to anyone for any input.

Was just hoping I could figure this out without dropping a bunch of money on another sleep study but if I have to do that I will.
Here is one other night to look at:

tirwander wrote: ↑

Tue Nov 24, 2020 8:35 am

Occasionally I need .5mg - 1mg to fall asleep.

What med??? Also what is your ADHD med?

You don't have enough hyponeas to really expect them to be a problem.

Dry mouth is a common complaint even with a full face mask and humidity set to maximum. The humidifier simply can't always generate enough moisture to keep the oral cavity well hydrated.

Sorry to pelt you with questions, but ... do you know why you were prescribed an ST machine?

About the dry mouth: are you opening your mouth inside your FFM? If so, you can try some tricks to keep your mouth closed.

1. Tongue position. Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar
3. Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar.

4. Tape. Some people (including me) rely on tape to keep the lips from opening. (I can't rely entirely on the tongue thing.) When the lips open, all too often that eventually leads to a noisy and disruptive mouth leak. To see whether tape would be feasible for you, I recommend that you invest in a box of Somnifix strips. They are very gentle on the skin but hold very well. Be sure to curl your lips inward per instructions before placing the strip. If these work for you, then you can experiment with lower-cost options.

Note about tape: Some people avoid it, for two reasons. (1) If you suddenly need to vomit in the night, the tape could lead to your aspirating some vomitus, which would be bad. However, you can sacrifice one strip to see for yourself how well you can pull you mouth open in an emergency using only your jaw muscles. (2) If there is a power failure and your machine goes off while you're sleeping, you won't be able to do the natural thing and open your mouth to breathe. As for that, out of an abundance of caution, I've put a circuit alarm in a plug on the same circuit as my machine. It will wake me up immediately if I lose power to the machine.

You can also try using Xylimelts, which a little discs that stick to your teeth or gums and during the night release a substance that stimulates saliva production.

Do try sleeping longer. I've learned that if I can cobble together 7 hrs 45 mins, I can function OK, but with less I can't. Everyone's magic number is different, so do try to find yours.

And these are very stressful times for everyone, given the changes to our lives that COVID has made. It wouldn't be too surprising if that partly or wholly explained your depression and anxiety.

Finally, congrats on the weight loss -- that is so impressive!

Miss Emerita wrote: ↑

Tue Nov 24, 2020 11:47 am

do you know why you were prescribed an ST machine?

In his first post and for some reason they opted for the ST and not the ASV.
The ST works okay for centrals but not so great for obstructives. Have I mentioned lately how much I hate ST model machines?

tirwander wrote: ↑

Fri Nov 20, 2020 4:40 pm

When I was first diagnosed with both obstructive and central apneas

Pugsy wrote: ↑

Tue Nov 24, 2020 9:32 am

tirwander wrote: ↑

Tue Nov 24, 2020 8:35 am

Occasionally I need .5mg - 1mg to fall asleep.

What med??? Also what is your ADHD med?

You don't have enough hyponeas to really expect them to be a problem.

Dry mouth is a common complaint even with a full face mask and humidity set to maximum. The humidifier simply can't always generate enough moisture to keep the oral cavity well hydrated.

Sorry, updated that post. 0.5mg - 1mg of Xanax occasionally for help fall asleep. ADHD med is Adderall XR 30. I make sure to take it no later than 10am so it has definitely run it's course by 8pm - 9pm. Get in bed around 11pm.

Yeah the dry mouth is awful... may need chin strap as suggested above.

Adderall XR half life is 10 to 13 hours...that just means it is only half out of your system after 10 to 13 hours.
Dry mouth and trouble sleeping...known side effects along with some others.

So you still have some of it in your system throughout the night. Now is it affecting your sleep...maybe.
It also might be a partial factor in the dry mouth issues.

Sometimes it's not so much one single thing that causes a problem but a combination of little things that add up to a bigger problem.

Pugsy wrote: ↑

Tue Nov 24, 2020 3:14 pm

Adderall XR half life is 10 to 13 hours...that just means it is only half out of your system after 10 to 13 hours.
Dry mouth and trouble sleeping...known side effects along with some others.

So you still have some of it in your system throughout the night. Now is it affecting your sleep...maybe.
It also might be a partial factor in the dry mouth issues.

Sometimes it's not so much one single thing that causes a problem but a combination of little things that add up to a bigger problem.

I can tell you I only take my Adderall as needed. I've gone multiple months in a row in the last year without taking one and still had the same issues.

Okay. You didn't tell me that you took the meds only on a prn basis and had gone long term without it and still had same symptoms.

We have to look at all sides of the picture and rule out other potential culprits....especially when the detailed reports from the machine aren't standing up screaming "fix me and you will feel better".

The more history is always more better when trying to figure out the cause of a problem because to fix a problem we first have to identify the cause of the problem in the first place.

Have you considered that this may not be a sleep apnea problem but more of a mental health problem?
You said "a little depressed and a little anxious in your OP."
I am wondering if you are more than just a "little depressed."
The reason I ask is because I am going through something very similar to what you are going through so I am very in tune to this.
Just thinking out loud.

Pugsy wrote: ↑

Tue Nov 24, 2020 12:25 pm

Miss Emerita wrote: ↑

Tue Nov 24, 2020 11:47 am

do you know why you were prescribed an ST machine?

In his first post and for some reason they opted for the ST and not the ASV.
The ST works okay for centrals but not so great for obstructives. Have I mentioned lately how much I hate ST model machines?

tirwander wrote: ↑

Fri Nov 20, 2020 4:40 pm

When I was first diagnosed with both obstructive and central apneas

But why not an ASV? Or do I have the wrong picture of its capabilities?

Miss Emerita wrote: ↑

Tue Nov 24, 2020 8:18 pm

But why not an ASV? Or do I have the wrong picture of its capabilities?

Because some doctors are idiots or they are afraid to prescribe ASV due to that flawed study some years back which caused such a panic among doctors (that congestive heart failure thing) and stuck people on the ST machine. You don't have the wrong picture at all. The ST isn't probably the best choice for someone with both central and obstructive apneas because it is a totally fixed pressure machine with a back up rate.

I hate ST machines for OSA and barely can stand them for central apnea alone because what it forces people to do might actually even cause some centrals....high PS with every breath no matter if a person needs it or not.

Thanks, Pugsy. I will do my darndest to remember this information.