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I hope this works - lol

That works.
Can you now post the image from the daily detailed graphs for last night?
You have had some decent enough nights AHI wise...around July 23 and a few others randomly but as a whole the AHI is higher than I would want to see and the proportion of clear airway events is higher than I would like to see.
The daily detailed graph would maybe show us if the CAs were clustering in large numbers at sleep onset or wake up time and in that case they might be awake/semi awake events getting flagged by mistake....or if they are for sure happening all through the night in large numbers then we may have a slight problem.

Leaks don't appear to ever reach anywhere near large leak territory so I don't think that they are an issue unless they are maybe waking you up.

You didn't say if you are snaping the hose into the clip at the top of the head gear it keeps the hose ridgid as you turn. If mine comes out of the clip the leaking will wake me. I also wear a chin strap and use the surgical paper tape along the edge of the head gear to the chin strap, about 2" on each side. The fact that you shave your head probably magnifies your problem.

Let's see, here's the chart from last night.

Note that I woke up at 3am and didn't get back to sleep until around 4, then woke up around 5-5:30.

That sometimes happens - I wake up around 3-4 and my alarm goes off at 5:30. Part of the reason is stress at work and sometimes it's the cat deciding it's time for me to get up and play.

I'll try to go to bed earlier tonight and see if I can get a longer nights sleep.




Thanks for the help everyone

Here's my data from last night.

I went to sleep around 9, woke up around midnight to use the bathroom, back to sleep and then ended up waking up at 4:30.

How long does it typically take you to get to sleep?
Like the midnight break in therapy...did you go right back to sleep or have some awake time on the machine?
Do you wake often during the night and maybe lay there with the mask and machine on for a little while?

Refresh my memory as I can't go back to see your first post now to see if you have already mentioned these items.
Did you have any history of centrals during either your diagnostic sleep study or the titration sleep study?
Do you have copies of your sleep study reports? If not you might want to get them.

Can you post one of those really good AHI night's detailed reports? Like the July 23rd?

Edit: Do you have a follow up visit scheduled with your sleep doctor? Not the RT at the DME but the sleep doctor?

Hi everyone, here are some new sleepyhead screenshots.

Last night I went to bed a little after 9pm and slept okay. I woke up a few times when I rolled over and had to adjust my hose, but overall no major issues.



and



and then my 3 month look:



I have not returned to my sleep center for a follow up sleep study - I asked about that and they said they didn't feel it was needed at this time....I'm just wondering if the peaks in AHI are too high for me.

The AHI would be too high to suit me. I was hoping that your doctor would care enough to go over things with you.

I don't know what to offer. It's hard to judge if the Clear Airway events (which makes up probably at least half your AHI...are real or related to arousals.
If real...we don't want to increase the pressure because that could make things worse.
If arousals from the obstructive events are causing maybe sleep onset CAs...then increasing the pressure might reduce both. Reduce the obstructive maybe arousal and reduce the chance of sleep onset or tossing and turning CA...it's a stretch I know.

Did you ever get copies of your sleep studies and find out if your OSA was worse when supine or during REM sleep?

Are you wanting to try something on your own because you are unhappy with what you are seeing on your reports since no one at your doctor's office is worried?

HI Pugsy,

I'm unhappy with the way the sleep study place is treating me, but they are the only one in the area covered by my insurance. I feel like they wanted to get me signed up and now that I am, I'm just a source for 3 month supplies. During my last visit the consultant I spoke with didn't really go over where my sleep numbers are now compared with my original study. He said they were better, but the visit was only 10-15 minutes, so there wasn't a lot of time to review. Most of the time was spent talking about if I needed a new hose, water reservoir, etc.

Maybe I should go back and push for a more in depth review.

Before I got on CPAP, I was a very bad snorer and I would have major episodes where I would stop breathing and my legs would twitch until I restarted breathing. I don't do that anymore, or if I do, it's very rare. So from that standpoint, it's working.

I still get tired during the day, and there are mornings where I don't feel like I got enough sleep - but that could just be a normal thing.

What worries me, is the high AHI numbers, but maybe they are okay based on where I started.

I do toss and turn a lot in bed. I'm a slide sleeper and I will go from sleeping on one side, to the other and then back. When I do roll over, I am awake enough to shift my hose and mask into position before I go back under. I'm not sure how to tell if that's when I'm seeing the high AHI numbers or not.

I've been tempted to take a sleep aid to really put me under and then see how my numbers are.

The awake tossing and turning might account for some or even mostly all of those Clear Airway events because sometimes we hold our breath when we turn over in bed. I know that nights where I am much more restless with frequent short awakenings my reports are full of clutter but not to the extent that yours are.

It may be nothing to worry about but I am always concerned about a higher AHI until it is proven to me that there is no need for worry.

Also..those hyponeas..they could be responsible for some of the minor awakenings and the tossing and turning...so maybe an underlying factor in the Clear Airway events if maybe those are sleep onset centrals. You know if you awaken a lot...then you have more chances of sleep stage transition centrals. If that is the case then in theory if you remove or reduce the awakenings then the CAs should reduce along with it.

In my opinion the minimum pressure of 5 is not doing such a great job preventing the hyponeas.

Also another factor might be APAP mode itself. You know that some people find that the changing pressures of APAP mode are a disruptive factor and can cause arousals or awakenings.

If you are aware of repeated tossing and turning...then you are having a good number of arousals and awakenings. When this happens there's a good chance that you are also having arousals that you don't remember...little mini awakenings from sleep.

If you have a sleep aid that you can try...worth trying to see if you can sleep a little deeper without the awakenings and maybe reduce the "clutter" that we see on your report.

Though my gut tells me that the minimum pressure is sub optimal and that would be the first thing that I would look closely at if it were me. At this point I don't know if the CAs are in response to pressure or just maybe related to the awakenings and tossing and turning. Since your doctor already has you on APAP mode with varying pressures maybe he wouldn't get too upset if you increased the minimum to maybe 6 or so just to see if the hyponeas reduced in number and took those CAs with it.
If you are unwilling (don't feel comfortable) to make that slight change then I strongly urge you to have a more in depth discussion about your treatment and your reports. A lot of time they will say "give it time" but if the therapy is sub optimal...no amount of time is going to fix that and I think that enough time as passed.

Thanks again Pugsy.

I think I'm going to make another appointment at the sleep center and ask for a different tech. I'm positive the people I'm talking to at the sleep center are not doctors - I'm not even sure if they are communicating my results to my normal doctor, that's something I need to look into.