tstiefler wrote: ↑Wed Mar 12, 2025 10:30 am
is anybody seeing this?
Your data is showing up, so yes we can see it.
You started the thread with:
tstiefler wrote: ↑Thu Feb 27, 2025 6:23 pm
BACKGROUND
I first got diagnosed with sleep apnea back in 2019 with a 24 AHI. I tried a CPAP but it just made things worse even though the AHI was lower. I gave it about 6 months and then gave up. I tried different masks, changing pressure, etc. I even posted on here.
I'm back at it again. Just got a new sleep study which still shows moderate sleep apnea. I have been sleeping with the CPAP for about 3 weeks or so and have the same results. My AHI will hit 4 - 6 most nights according to the Airsense app, which I know isn't perfect, but I'll wake up feeling worse than I did before using CPAP.
Thanks so much for your help everyone.
What I'm seeing in the data you posted is this:
1) Some confusion (on my part) about your normal sleep period. It looks like you tend to go to bed very late (often after 3:00 or 4:00 am) and that you also then sleep rather late---often until around noon or later. So it begs the question: Are you a night owl? Do you work an evening shift? And is the sleep schedule a problem for your life style?
2) Leaks seem to be a problem. And there are two good reasons for getting them under control:
A) Large leaks can make it more difficult for the machine to maintain enough pressure to keep the airway propped open; hence when the leaks are high, it's possible for more obstructive events to occur.
B) Leaks can trigger restless sleep. And restless sleep leads to waking up not feeling at your best. Restless sleep can also lead to higher AHIs being reported by the machine since restless sleep can lead to a vicious cycle of "sleep-wake-junk" (SWJ) breathing where false events get recorded as you are bouncing back and forth between very light sleep and wake. Often these false events are scored as
centrals, and they represent sleep transitional central apneas that would not be scored on an in-lab sleep test because they occur as you are transitioning to sleep: Part of that transition is handing off control of the respiration to the autonomous nervous system and resetting the CO2 trigger for "inhale now" a bit higher. The result is a normal temporary pause in breathing. This wouldn't normally be a problem, but if you get "stuck" in a prolonged SWJ period, you're not getting high quality sleep. The problem is not the higher than expected AHI; rather the problem is just that you're not getting past the transition to real sleep---you're stuck in a nether world between real sleep and real wake, and that's not "good enough" for the body to feel the benefits of high quality sleep.
3) Lots of your events are scored during the last hour you are in bed. And that brings up (yet again) the question of whether you are actually sleeping or just dozing. If you are spending a lot of time in bed just dozing while
hoping to fall back to sleep to get some more decent (real) sleep, that strategy of staying in bed while not really sleeping might need to be looked at more carefully.
In other words, looking at your data, I see things that raise additional questions rather than things that suggest easy tweaks to fix a particular problem.
So ...
Some questions:
1) Just how restless is your sleep? (Sleep fragmentation was mentioned on your sleep test, but the assumption would be a significant fraction of the fragmentation would be caused by the arousals triggered by the obstructive apneas and hypopneas when sleeping without a CPAP.)
2) Any history of insomnia? Particularly sleep maintenance insomnia? If so, what (if anything) have you done in the past to try to keep it under control?
3) What's your sleep hygiene look like? How much caffeine do you consume? How much alcohol? Do you use marijuana in any form on a regular basis? If so, how much? How much time between supper and bedtime? Do you spend a lot of time lying in bed watching TV or playing with your cell phone or a laptop computer?
4) Any other medical problems? If so, do you take any medication on a regular basis? If so, do any of the medications have known side effects that might make it more difficult to get and stay asleep?
5) Are you a shift worker? Or is there some other reason that you are going to be so late and sleeping so late? If your very late sleep schedule is an accepted part of your lifestyle, what does your sleep environment look like after the sun comes up? In other words, is your bedroom reasonably dark even though most of your sleep period is after sunrise and before noon? A lot of light coming in through the windows might be triggering some of the restlessness we see in your flow rate data. Is your bedroom reasonably quiet when you are trying to sleep? Or are you living with a house full of people on a more typical "daytime schedule" who make a lot of noise when you're trying to sleep? (This includes young children and pets if you've got them.)