2 1/2 weeks in--numbers are good, but still sleeping poorly

During sleep, my reported AHI is low, usually .5 or 1. Those apneas I have are usually central and don't bother me the way the obstructive ones do; I often have no hypopneas. My leaks are not bad, and nothing else that I can see is problematic. But I still wake up every hour or two, and I'm exhausted all day.

I find there are three issues bothering me. First, the pressure is difficult for me to deal with. My settings were originally 7-11 cm, even though I never actually went above 7 cm in my titration. My doctor later told me it would be okay to change this to 5-11 cm. I have found that the pressure is usually about 6 or 7 and never goes above 9 cm; when it goes above 8, I often wake up. Second, I'm used to sleeping on my stomach, and it's uncomfortable with the CPAP. I have a special pillow, but it doesn't help much. Third, while the S9 is pretty quiet, I'm incredibly sensitive to sound, and its noise disturbs me. I've tried ear plugs and white noise; both help, but just a little.

I've tried varying my pressure settings (e.g., 5-8 or 7-8) and humidity, but so far I haven't found anything that lets me sleep long periods without waking up.

Could it be that I'm getting leaks but they're not being reported? Can anyone else recommend something for me to try?

Thanks in advance for your replies.

syzygy wrote:During sleep, my reported AHI is low, usually .5 or 1. Those apneas I have are usually central and don't bother me the way the obstructive ones do; I often have no hypopneas. My leaks are not bad, and nothing else that I can see is problematic. But I still wake up every hour or two, and I'm exhausted all day.

I find there are three issues bothering me. First, the pressure is difficult for me to deal with. My settings were originally 7-11 cm, even though I never actually went above 7 cm in my titration. My doctor later told me it would be okay to change this to 5-11 cm. I have found that the pressure is usually about 6 or 7 and never goes above 9 cm; when it goes above 8, I often wake up. Second, I'm used to sleeping on my stomach, and it's uncomfortable with the CPAP. I have a special pillow, but it doesn't help much. Third, while the S9 is pretty quiet, I'm incredibly sensitive to sound, and its noise disturbs me. I've tried ear plugs and white noise; both help, but just a little.

I've tried varying my pressure settings (e.g., 5-8 or 7-8) and humidity, but so far I haven't found anything that lets me sleep long periods without waking up.

Could it be that I'm getting leaks but they're not being reported? Can anyone else recommend something for me to try?

Thanks in advance for your replies.

Couple of things could help:
1) If your usually at 7 cm, try setting your S9 for CPAP mode and turn off the APAP. Keep track of your AHI and ensure it's not jumped up.
2) Look for the "Falcon position" it may help (it's a stomach sleeping position)
3) For the sound, you will probably get use to it, but you may want to try for a few nights listening to some music (soothing) through a MP3 player. The other thing is to try wearing your CPAP in the evening while you are watching television. It will help you get use to being relaxed with it, and to ignore the sound (your listening to TV instead of the machine). That should help you to tune it out.

Good luck!

Tielman wrote:

syzygy wrote:During sleep, my reported AHI is low, usually .5 or 1. Those apneas I have are usually central and don't bother me the way the obstructive ones do; I often have no hypopneas. My leaks are not bad, and nothing else that I can see is problematic. But I still wake up every hour or two, and I'm exhausted all day.

I find there are three issues bothering me. First, the pressure is difficult for me to deal with. My settings were originally 7-11 cm, even though I never actually went above 7 cm in my titration. My doctor later told me it would be okay to change this to 5-11 cm. I have found that the pressure is usually about 6 or 7 and never goes above 9 cm; when it goes above 8, I often wake up. Second, I'm used to sleeping on my stomach, and it's uncomfortable with the CPAP. I have a special pillow, but it doesn't help much. Third, while the S9 is pretty quiet, I'm incredibly sensitive to sound, and its noise disturbs me. I've tried ear plugs and white noise; both help, but just a little.

I've tried varying my pressure settings (e.g., 5-8 or 7-8) and humidity, but so far I haven't found anything that lets me sleep long periods without waking up.

Could it be that I'm getting leaks but they're not being reported? Can anyone else recommend something for me to try?

Thanks in advance for your replies.

Couple of things could help:
1) If your usually at 7 cm, try setting your S9 for CPAP mode and turn off the APAP. Keep track of your AHI and ensure it's not jumped up.
2) Look for the "Falcon position" it may help (it's a stomach sleeping position)
3) For the sound, you will probably get use to it, but you may want to try for a few nights listening to some music (soothing) through a MP3 player. The other thing is to try wearing your CPAP in the evening while you are watching television. It will help you get use to being relaxed with it, and to ignore the sound (your listening to TV instead of the machine). That should help you to tune it out.

Good luck!

Thanks for the suggestions, Tielman. I'll try them all. The MP3 player idea is one I hadn't thought about before. It just might work!

If you are a male, the falcon position is quite nifty, if you are female, forget it, its a boob squisher..

however, I have found using three pillows you can still sort of do a modified falcon position..

the mp3 player is a terrific idea!!!!

elena88 wrote:If you are a male, the falcon position is quite nifty, if you are female, forget it, its a boob squisher..

however, I have found using three pillows you can still sort of do a modified falcon position..

the mp3 player is a terrific idea!!!!

Squishing will not be an issue for me...

Could it be that I'm getting leaks but they're not being reported?

With your mask and the S9 set for the Swift mask, I don't see how that could happen.

Music through earphones stimulates and awakens me. You might also consider environmental sounds, like surf or rain.

I think the passage of time will result in adaptation. Many of us needed a few months.

I just read about syzygy. Very cool handle.

syzygy wrote:...when it goes above 8, I often wake up...

You'll probably get used to this...make sure EPR is enabled, might need to increase exhalation relief (increase the number).

syzygy wrote:...while the S9 is pretty quiet, I'm incredibly sensitive to sound, and its noise disturbs me. I've tried ear plugs and white noise; both help, but just a little...

Try positioning the machine below the mattress level, like on a 1-step library stool, that way the sound is not at your ear level. Some of us sleep with a fan running and that helps mask the noise.

syzygy wrote:During sleep, my reported AHI is low, usually .5 or 1. Those apneas I have are usually central and don't bother me the way the obstructive ones do; I often have no hypopneas. My leaks are not bad, and nothing else that I can see is problematic. But I still wake up every hour or two, and I'm exhausted all day.

I find there are three issues bothering me. First, the pressure is difficult for me to deal with. My settings were originally 7-11 cm, even though I never actually went above 7 cm in my titration. My doctor later told me it would be okay to change this to 5-11 cm. I have found that the pressure is usually about 6 or 7 and never goes above 9 cm; when it goes above 8, I often wake up. Second, I'm used to sleeping on my stomach, and it's uncomfortable with the CPAP. I have a special pillow, but it doesn't help much. Third, while the S9 is pretty quiet, I'm incredibly sensitive to sound, and its noise disturbs me. I've tried ear plugs and white noise; both help, but just a little.

I've tried varying my pressure settings (e.g., 5-8 or 7-8) and humidity, but so far I haven't found anything that lets me sleep long periods without waking up.

Could it be that I'm getting leaks but they're not being reported? Can anyone else recommend something for me to try?

Thanks in advance for your replies.

Try straight pressure......CPAP mode.

Got software?

Editing for a few more comments.
Sleep stages cycle through at approximately 90 to 120 minutes. If you're hitting a deep sleep stage or REM and the machine interprets (or misinterprets) your breathing as something that is a precursor to an impending event, it most certainly will increase pressures to try to prevent what may be coming. Those pressure changes could be throwing you out of whatever sleep stage you're in......even wake you up.......which will leave you feel like you haven't slept much......you're not getting any restorative sleep.


Den

Trying to think of a good way for you to note your wakeup times without waking up more. If you are using software, it would be interesting to see if pressure changes immediately precede your wakings. At one time I turned my machine off and right back on every time I woke up as a marker in the data. Also could lift the mask briefly just enough to cause a leak spike as a marker. If pressure changes are suspect based on a bit of investigation, that strengthens the case for using a fixed pressure. If you are sensitive to sounds, maybe there's a vague sound change with pressure fluctuations that wakes you. Is it machine noise, hose noise, or mask noise that seems to bother you? I keep an old style rubber computer mouse pad under my machine as a muffler. A hose cover can muffle hose noise. If I have the hose too near me on the pillow I can hear the air wooshing thru.

I don't know, just trying to throw out some things to consider. All that said, it is still a bit early in your treatment to expect to have fully acclimated. It can be hard to know if it is all still just unfamiliar or if you have a problem needing addressed. Did your sleep study reports make any mention of limb movements?

At least your numbers are good. Hopefully your blocks of sleep time will increase and the wakings become fewer and fewer.

Thanks to everyone for replying. Most everyone suggested using CPAP mode, and that seems to have helped. The software did indeed tell me that I was waking up when the pressure increased, as kteague alluded to. Now I have it fixed at 7.2 and feel significantly better. I find that the following things have been very helpful:

1) No caffeine of any kind, at least for now. When I stopped drinking coffee, I quickly started feeling less stressed and more relaxed. My blood pressure also seems to have gone down a large amount.

2) Not going to bed too early. These days, I feel as if I'm jet lagged, and it's very tempting to lie down at 7:30 for a "nap." But I'm inevitably up in the middle of the night when I do. When I go to bed around 10, I've had better success.

3) The fixed CPAP pressure. My AHI is around 2, and my leaks are around 5-7. I know I can improve on this, but my plan is to do so over time. As I adjust, I'll probably raise the pressure to around 8.

I also lowered the machine (why didn't I think of that?) as a couple of people suggested. That, and the fact that I'm generally sleeping better, has made the noise less of an issue for me.

Thanks again for the replies. I hadn't checked this forum for a couple of days, and it was a pleasant surprise to see so many posts.