Are my graphs normal?

I've been using CPAP for 3 months, and while I've seen some improvements (heart palpitations mostly went away, I sleep a little longer) I still sleep rather poorly, mainly that I'm sleeping too little, waking up early, and feel generally anxious. I've attached the data from last night, as the graphs suggest I couldn't fall asleep until my third attempt and I woke up at 5:00~ and then fell asleep again. I also took off the pulse oximeter when I woke up the first time. I'm mainly curious if there's anything going wrong or could be better while I wait for my sleep to improve.

Machine settings (Airsense 10):
- APAP 7-12
- EPR 2
- Ramp Off

On paper your data looks really great.

The RDI/AHI is fantastic.

You've got some leaks, but the leaks stay well below 24 L/min---which is Resmed's definition of Large Leak.

You had a rough start at the beginning of the night---it doesn't look like you got to sleep until about 0:15. But after you got to sleep, at this scale, the breathing looks pretty smooth. There don't seem to be any prolonged SWJ periods except the beginning of the night. I would assume that the first of the two short on/off breaks is tied to waking up to go to the bathroom? The second one seems to be when you first woke up for the morning, but you decided to try to get just a bit more shut-eye and (wisely) turned the machine back on in case you did get soundly back to sleep for any length of time.

You self report:

I still sleep rather poorly, mainly that I'm sleeping too little, waking up early, and feel generally anxious. . I've attached the data from last night, as the graphs suggest I couldn't fall asleep until my third attempt and I woke up at 5:00~ and then fell asleep again.

I would suggest that when you can't get to sleep in a timely fashion (less than 15-20 minutes), get out of bed and go into a different room and some something relaxing and quiet. Read a book or even just sit quietly in the dark. (Don't web browse and don't watch tv.) When you start feeling sleepy (as opposed to just tired or worn out), go back to bed and put the mask back on and try to get to sleep.

Given that you don't feel like you are sleeping well, you might also consider that while the leaks are not large enough to be a concern in terms of the efficacy of your therapy, they may be pesky enough to be keeping you from getting into a restorative sleep. When you do wake up, do you ever think a leak might have woken you up? When you are having trouble getting to sleep, do you ever feel like you're fighting to find a position where the mask is not leaking?

I also took off the pulse oximeter when I woke up the first time. I'm mainly curious if there's anything going wrong or could be better while I wait for my sleep to improve.

It sounds counterintuitive, but worrying less about your sleep might help you improve your sleep.

The only thing "wrong" with this data is that you had trouble getting to sleep at the beginning of the night and you already know that: You first went to bed at 22:20, but you didn't get to sleep until just after 0:20. Two hours of "trying" to get to sleep is enough to make anybody question. However, it looks like you did the right thing: It looks like you turned the machine off when you realized you weren't getting to sleep and did something else until you felt like you could try again to fall asleep. And the third time was the charm: When you put the mask back on around 23:40, you did fall asleep---soundly---in just about 20 minutes.

So instead of worrying about the beginning of the night, you should focus on the positive: This data indicates that you most likely got some very high quality sleep between 0:20 and 5:00. And you got some decent quality sleep between 5:10 and 7:20. That little wake between those two stretches of sleep? It's not that important and it was most likely a normal post-REM wake.

First of all, thanks for the very in depth response, I imagine it took you a while to type out. I'll start with answering your questions.

Waking up from leaks: This is the main thing I'm worried about because I've never had a leak actually wake me up enough for me to remember. Some days I wake up with a slightly dry mouth since drool caused my mouth tape to loosen, however the on the day I recorded that data it was more likely due to the nasal pillows slipping a little as I moved around in bed. The nasal pillows fit well, however compared to the full face mask it's less secure since pulling on it a little can cause them to leak. I'll try tightening them more and see if that helps, and I guess if that doesn't work I'll just go back to the full face mask.

As for general sleep hygiene, I was for a time able to fall asleep within 15 minutes of my first attempt but then I got just a little sloppy and I'm back here again. I know it's possible so I'll just have to renew my efforts. Anyways thanks for the reassurance, the other thing I was worried about was how I consistently wake up early and then go back to bed and I'm glad to hear that it's not as bad as I thought it was.

Chicken_Tendies wrote: ↑

Thu Jul 04, 2024 2:40 pm

Waking up from leaks: This is the main thing I'm worried about because I've never had a leak actually wake me up enough for me to remember. Some days I wake up with a slightly dry mouth since drool caused my mouth tape to loosen

If the leaks are not waking you up and the dry mouth is not enough to bother you, then you don't need to worry too much about the leaks---the data shows that your leaks are well under Resmed's definition of Large Leak, so they are not affecting the efficacy of your data.

And note: Sometimes the effort to eliminate every last bit of leaking causes more problems for folks than just living with minor, "pesky" leaks that are not enough to affect the efficacy of your therapy.

however the on the day I recorded that data it was more likely due to the nasal pillows slipping a little as I moved around in bed. The nasal pillows fit well, however compared to the full face mask it's less secure since pulling on it a little can cause them to leak. I'll try tightening them more and see if that helps, and I guess if that doesn't work I'll just go back to the full face mask.

You don't need to "fix" anything if the leaks didn't wake you up.

In other words, you do NOT need to tighten the nasal pillows mask based on this leak data. And you don't need to go back to the full face mask, particularly if the pillows are a lot more comfortable for you.

As for general sleep hygiene, I was for a time able to fall asleep within 15 minutes of my first attempt but then I got just a little sloppy and I'm back here again. I know it's possible so I'll just have to renew my efforts.

Sleep hygiene is important for anyone, not just folks trying to adjust to CPAP.

the other thing I was worried about was how I consistently wake up early and then go back to bed and I'm glad to hear that it's not as bad as I thought it was.

A few wakes here and there that separated by enough time for at least one full sleep cycle are normal. The trick is to not worry about those occasional wakes and thus prolong them long enough where they do become a problem.