New CPAP user. Any tips from my first night? Oscar image attached

Did you wake during the night? If so about how many times?
Do you take any medications? If so, what?
Any other physical or mental health issues going on?

Pugsy wrote: ↑

Mon Apr 10, 2023 7:28 am

Did you wake during the night? If so about how many times?
Do you take any medications? If so, what?
Any other physical or mental health issues going on?

I remember waking up a couple times but fell right back asleep.
Yes, I take adderall.
No other physical/mental health issues. BMI is around 26. 5'9" and 180 lbs.

ResMed machines raise pressure fairly aggressively in response to flow limitations or snores, which can be precursors to airway obstruction. Because your AHI is very low, I think you could experiment with capping your pressure to see whether that gives you better sleep. You could try a maximum of, say, 9, and see what happens to the quality of your sleep and to your AHI.

But I'd also note that you're still in the early days of your treatment. As you get more and more accustomed to the night-time routine, you may well sleep better. And sleep deficit is a thing. More here:

https://www.sleepfoundation.org/how-sle ... h-up-sleep

Adderall is known to mess with overall sleep quality which can affect how a person feels the next day.
Now I don't know for sure that is what is going on with you but there's a chance.
Of course it could simply be you need for time and experience with the machine.

4/10/23 (night 7)
Miss Emerita, I took your advice and set the maximum to 9. I also bumped up the ramp pressure to 4.4.
I remember waking up a couple times and wasn't even sure if the machine was on. The pressure felt natural.
I turned the humidity down to 3 because this thing just runs through distilled water. Felt fine with the lowered humidity. I live in a very humid climate as well.

Feel much less tired this morning compared to the last 2 days.
Did a cardio workout last night before bed that I think helped. Been a while since I've worked out.

First image is full session.
Second image is a zoom of a hypopnea and a couple CA events (no CA events presented during my sleep study). Should I be worried about these or is it normal?

thomasc1126 wrote: ↑

Tue Apr 11, 2023 8:22 am

Second image is a zoom of a hypopnea and a couple CA events (no CA events presented during my sleep study). Should I be worried about these or is it normal?

Looks more like awake/arousal related central flagging but you need a little closer zooming in for better clarity. I don't think you were sound asleep and if you weren't these flagged centrals simply don't count except to point to not being asleep.

Even if you were really asleep though when those centrals were flagged it wouldn't be a problem. Not nearly enough of them to cause worry.
And occasional real asleep central is normal....like it's normal to have a sleep onset central when transitioning from awake to asleep.

Central apneas (real asleep centrals) aren't a problem unless present in large numbers, cause desats or keep bouncing a person out of sleep.

Pugsy wrote: ↑

Tue Apr 11, 2023 8:45 am

Looks more like awake/arousal related central flagging but you need a little closer zooming in for better clarity. I don't think you were sound asleep and if you weren't these flagged centrals simply don't count except to point to not being asleep.

Even if you were really asleep though when those centrals were flagged it wouldn't be a problem. Not nearly enough of them to cause worry.
And occasional real asleep central is normal....like it's normal to have a sleep onset central when transitioning from awake to asleep.

Central apneas (real asleep centrals) aren't a problem unless present in large numbers, cause desats or keep bouncing a person out of sleep.

Thank you for the clarification. That makes total sense. Does anything else in my charts jump out/cause any concern?

thomasc1126 wrote: ↑

Tue Apr 11, 2023 8:53 am

Does anything else in my charts jump out/cause any concern?

Not really. The little bit of stuff at the end of the night is probably just you waking up and being in and out of sleep for a short period of time.

If you could/would SleepHQ to share your reports we could zoom in and see what's going on zoomed in all night.
That way we can zoom in to the level that makes it much more clear.

I am going to do an educational post as a sticky later so everyone can learn how to distinguish awake vs asleep flagged centrals (along with other false positive flagging).
I don't have time right now.

It's great you felt better today! It looks as though your pressure never got close to 9, so capping it there actually didn't have any effect. This is good -- it suggests you'll just naturally be feeling more more and more rested as you continue to get used to PAP therapy.

For what it's worth, some research suggests avoiding cardio-type exercise right before bedtime. If your schedule allows, you might try doing it at least one hour before bedtime.

https://pubmed.ncbi.nlm.nih.gov/30374942/

Traveling all day yesterday so uploading 4/11 and 4/12.

Night of 4/11
Went to bed late and had to be up early to catch a flight so I only got about 6 hours of sleep.
I felt somewhat tired throughout the day. Slept about 1.5 hours on the plane.
It looked like the machine wanted to go higher than 9 pressure.
https://sleephq.com/public/81ac4304-89c ... f28f8fc009

Night of 4/12
Went to bed early and got about 10 hours of sleep.
I upped the max pressure to 12.
Also lowered EPR to 2 which I think helped reduce my leak rate.
Still feel pretty tired today (4/13). Napped for about an hour around noon.
https://sleephq.com/public/bf1e6f92-f62 ... 0b24544264

Trying the sleephq links. Let me know if those don't work and I'll post screenshots.
I still feel pretty tired as I'm typing this and could likely go to sleep if I closed my eyes.
Telling myself it's part of the process and it takes some time. I have no trouble going to sleep with the mask/machine, so is it a matter of not getting "deep" sleep that is causing me to feel tired?

4/13/23

Miss Emerita wrote: ↑

Tue Apr 11, 2023 11:33 am

It's great you felt better today! It looks as though your pressure never got close to 9, so capping it there actually didn't have any effect. This is good -- it suggests you'll just naturally be feeling more more and more rested as you continue to get used to PAP therapy.

For what it's worth, some research suggests avoiding cardio-type exercise right before bedtime. If your schedule allows, you might try doing it at least one hour before bedtime.

https://pubmed.ncbi.nlm.nih.gov/30374942/

I probably changed too many variables too quickly, but I felt a bit more rested today.
I remember waking up 4 or 5 times throughout the night and I wasn't breathing. It was weird. I wasn't out of breath or anything it was like my brain forgot how to breathe and had to wake me up to do it. Is that what a "CA" event is? I've zoomed in to a a couple of those events. How do I prevent that from happening?

Here's a link to my sleephq for last night: https://sleephq.com/public/b95c97c9-791 ... 0dc4f47575
Here are the images.

Your SleepHQ links work fine. The night of the 12th, the events at the end of the night look like post-arousal sleep/wake junk to me -- probably even the OAs. And your CAs mostly reflect post-arousal pauses. It's true that the cap of 9 may have let in some more OAs, so raising the cap to 10, 11, or 12 would make sense.
Even though you're back to EPR of 3, your leaks look fine, so perhaps stick with 3.

I would suggest that you settle in with settings for at least a week and see how that goes. Sleep quality varies so much from night to night that you want to be looking for patterns or trends over time rather than fine-tuning from night to night.

As for continued daytime feelings of being unrested, it can take time (and therefore patience) to see significant improvement. Partly you're still getting used to a new experience, which is not exactly conducive to great sleep. And partly you may be in sleep debt, with some catching up still to do. So hang in there!