Still having obstructive apneas..normal?

Good morning! I got almost 10 hours on my S9 last night..wow! Longest ever I've been able to keep my mask on for. However, I still woke up quite a few times last night. Briefly, just long enough to know I woke up and then right back out I went. Looking at my charts this morning it shows that I had 9 obstructive apnea events. Most of them clustered right before I actually woke up for the day. I'm pretty sure that when I was awoken during the night though it was not within the hour before I actually woke up for good. I could say I probably was awake at least 5-6 times, but it's only for a few seconds and then I'm out again. Anyway, my question of the day is..am I supposed to still be having obstructive apneas? Is it possible that the data in the hour before I got out of bed is incorrect? I've included my chart below. Thanks.

It is possible that the data showing right before you woke up and turned the machine off is reflecting some flagged events that happened while awake. The machine doesn't know if you are awake or asleep and sometimes awake/semi awake breathing irregularities will get flagged.

Even if every one of those 9 flagged obstructive apneas were the real thing....it isn't a huge problem.
You will most likely always have a few events get flagged randomly through the night.
We don't expect the machine to stop every single event and get an AHI of 0.0. It's an unrealistic expectation.

So yes, you will likely always have some events get flagged...some nights more than others and probably every now and then you might get real lucky and not have any...I have had it happen maybe 3 times in 4 years.. Some nights maybe just one event...some night a whole lot more.

Are you sure you aren't mouth breathing once asleep - thereby losing the Cpap air to the breeze rather than your airway?
A full face mask trial would be in order.

I don't see any evidence of mouth breathing to the level that therapy would have been impaired.
The worst level of leak at all was at 6 AM and it only hit 10 L/min. and that was for a very brief spike.
ResMed says it can compensate for leaks up to 24 L/min. So even the worst spike is well below that line.
The rest of the night the leak was maybe barely hitting 2 L/min intermittently.
Mouth breathing to the level enough that it will impact therapy will most likely be evident on the leak reports.

I agree. I don't think I was mouth breathing last night. There was no physical evidence of it anyway (dry mouth, sore throat, etc.) I do have a Mirage Quattro full face mask that I could wear but I'd really rather not. Going from the Pilairo to the Quattro will be challenging and oddly enough I find that I breath out of my mouth even more when I wear the FF. I think it's a psychological thing . I also have problems with air in my eyes with that mask, so unless I'm certain I need to be wearing it..i'll stick with pillows. But I appreciate the suggestion!

bucksbeek wrote:However, I still woke up quite a few times last night. Briefly, just long enough to know I woke up and then right back out I went.

Hi,

That is actually pretty common. Most people don't remember doing this. Some folks will happen to remember looking a the clock, and then they might remember that the following morning. Since you have been focusing on sleep issues recently, you are much more in tune with how you are sleeping, so you happen to remember it. I don't know how many times is normal, but 4 or 5 times, including once after each REM cycle seems about right.

One slim possibility is that you are sensitive to the APAP pressure changes. Some folks are, and some folks do better on fixed CPAP. If this was my data, an experiment that I might try is to bump up the lower pressure number to be about 1 or 2 centimeters below the 90% or 95% level. That will keep the machine from ramping up so suddenly at the onset of having breathing issues.

Events when you are awake or half-awake are common. Funny thing about your body--it breathes on a very regular pattern when you are asleep, but all bets are off when you are awake. Everyone has events when they are awake. Another item that I have noticed is that I hold my breath when I turn over at night (or adjust my pillows). I can do that long enough to have it scored as an event. I put that under the category of "self-inflicted events".

-john-

jweeks wrote:

bucksbeek wrote:However, I still woke up quite a few times last night. Briefly, just long enough to know I woke up and then right back out I went.

Hi,

That is actually pretty common. Most people don't remember doing this. Some folks will happen to remember looking a the clock, and then they might remember that the following morning. Since you have been focusing on sleep issues recently, you are much more in tune with how you are sleeping, so you happen to remember it. I don't know how many times is normal, but 4 or 5 times, including once after each REM cycle seems about right.

One slim possibility is that you are sensitive to the APAP pressure changes. Some folks are, and some folks do better on fixed CPAP. If this was my data, an experiment that I might try is to bump up the lower pressure number to be about 1 or 2 centimeters below the 90% or 95% level. That will keep the machine from ramping up so suddenly at the onset of having breathing issues.

Events when you are awake or half-awake are common. Funny thing about your body--it breathes on a very regular pattern when you are asleep, but all bets are off when you are awake. Everyone has events when they are awake. Another item that I have noticed is that I hold my breath when I turn over at night (or adjust my pillows). I can do that long enough to have it scored as an event. I put that under the category of "self-inflicted events".

-john-

This was actually very helpful. I did not know that you naturally awoken after sleep cycles. Thank you.