CPAP wakes me up multiple times a night

Hi!

I have been using CPAP for 6 months to you guys and for the last month I have been sleeping with it +7 hours every day!!

I wake up way more rested but still feel tired, specially the days I get 7 hours instead of 8 or more.

The issue that is happening is that CPAP is waking me up multiple times a night, I do not wake up feeling I need more air or stressed, I just wake up with the mask still on, turn sides, and in a matter of minutes fall sleep again.

For context, I use the Resmed Airsense 10 with the Resmed P10 nasal pillows, I also mouth tape every night to avoid leaks!

So far I have tried playing with EPR, reducing and increasing the pressure, but with no luck. Some days I wake up 2 times and others 8 times, it depends.

For instance, today I woke up at: 3:30, 5:25, 7:40 and 8:20 (I know the exact times because I use a wearable to track my sleep)

And these are the OSCAR graphs:
Any advice would be appreciated! Thanks for your time!

Is there a reason your max pressure is set so low relative to the min. and not e.g. closer to 20 which is standard?

Are you taking any meds? I haven't looked at your orig. posts tho' - would have been better if you'd stayed in that thread so we could follow the sequence of things.

On paper you're having great results with your current settings, and I wouldn't recommend changing them. I suspect you're just one of those people who needs a minimum of 8 hours per night.

It is normal to wake up several times a night. For example, many people wake up briefly after a period of REM sleep. If you turn over and go right back to sleep, and if it's happening around 4 times a night, that's unlikely to be causing you to be unrested during the day.

This is sheer speculation, but I wonder whether you've started having more REM sleep and as a result having little post-REM wake-ups.

DavidTre wrote: ↑

Sun Apr 04, 2021 4:11 am

Hi!

I have been using CPAP for 6 months to you guys and for the last month I have been sleeping with it +7 hours every day!!

I wake up way more rested but still feel tired, specially the days I get 7 hours instead of 8 or more.

The issue that is happening is that CPAP is waking me up multiple times a night, I do not wake up feeling I need more air or stressed, I just wake up with the mask still on, turn sides, and in a matter of minutes fall sleep again.

It is *normal* to wake up multiple times per night. we just don't normally remember it, CPAP provides enough extra stimulus that you wake up a little more, and remember it.

palerider wrote: ↑

Mon Apr 05, 2021 5:28 pm

It is *normal* to wake up multiple times per night. we just don't normally remember it, CPAP provides enough extra stimulus that you wake up a little more, and remember it.

mainly because of that big scary machine by your bed.

Miss Emerita wrote: ↑

Sun Apr 04, 2021 12:17 pm

On paper you're having great results with your current settings, and I wouldn't recommend changing them. I suspect you're just one of those people who needs a minimum of 8 hours per night.

It is normal to wake up several times a night. For example, many people wake up briefly after a period of REM sleep. If you turn over and go right back to sleep, and if it's happening around 4 times a night, that's unlikely to be causing you to be unrested during the day.

This is sheer speculation, but I wonder whether you've started having more REM sleep and as a result having little post-REM wake-ups.

Thanks for the answer! What you are saying actually makes sense

But I still feel that I wake up a bit too much, some days I wake up 8 times a night, i.e. at 3.30 and then at 4. It would not be possible to go through a REM phase in 30mins, would it?

Also, according to my wearable, while I am asleep my heart rate goes from 45 to 55, but when I wake up there is usually a peak up to 90bpm

Do you think that is concerning??

palerider wrote: ↑

Mon Apr 05, 2021 5:28 pm

DavidTre wrote: ↑

Sun Apr 04, 2021 4:11 am

Hi!

I have been using CPAP for 6 months to you guys and for the last month I have been sleeping with it +7 hours every day!!

I wake up way more rested but still feel tired, specially the days I get 7 hours instead of 8 or more.

The issue that is happening is that CPAP is waking me up multiple times a night, I do not wake up feeling I need more air or stressed, I just wake up with the mask still on, turn sides, and in a matter of minutes fall sleep again.

It is *normal* to wake up multiple times per night. we just don't normally remember it, CPAP provides enough extra stimulus that you wake up a little more, and remember it.

That makes sense, and I think it explains some of the arousals

But I still feel something is missing, sometimes I wake up with 30mins between arousals, and also my wearable is telling me that when I wake up sometimes my heart rate goes up to 90bpm

You're right that you wouldn't normally go through a whole sleep cycle in 30 minutes. I used a Dreem 2 headband for a while; it has a rudimentary EEG capacity and the output includes information about sleep stages. I did sometimes see REM periods that had an interruption in the middle that included a brief wake-up, which more or less correlated with the flow-rate chart in Oscar. So that's not impossible.

Still, you may well be waking up more often than would be normal, and that may contribute to how you feel during the day. It's impossible to be sure this will be true for you, but for many people, it just takes some time to get used to the novel experience of using PAP. The adaptation does generally come with time, and when it does, it turns into your "new normal." It can be awfully hard waiting, but that may be the right advice.

I'm not a doctor, but I don't see a cause for concern if your heart rate sometimes goes up to 90 when you wake up during the night. Waking rates are higher than sleeping rates, and rates can climb during REM sleep, which you may be waking up from. You may also be briefly having a "fight/flight" response to PAP before your brain figures out that PAP is OK. More information here, from a trusted source:

https://www.health.harvard.edu/blog/how ... 1012921846

Have you tried using a fixed pressure? Even the slight jump in pressure from 7 to 8 may be too arousing in some people. You can do your own self-titration of fixed pressure by sleeping for three nights at 7 and then three nights at 8. You may even want to try 9 if tolerable.

Also, often during true wake periods the flow rate pattern will be different than during sleep. Check if there are differences at the clock times when your device indicates waking.